Management of pediatric ‘cannot intubate, cannot oxygenate’

Okada, Yohei; Ishii, Wataru; Sato, Norio; Kotani, Hirokazu; Iiduka, Ryoji

doi:10.1002/ams2.305

Cited by 21 publications

(24 citation statements)

References 7 publications

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“…However, pediatric CICO is very rare, and this suggestion is mostly based on animal experimental results and expert opinions [5]. Therefore, further reports are necessary to consider the best strategy for pediatric CICO [14]. The recently released the American Society of Anesthesiologists recommended cannula cricothyroidotomy for management of the CICO scenario in the increasingly hypoxic and/or bradycardic child [15].…”

Section: Discussionmentioning

confidence: 99%

A survey of current practice of difficult airway management and equipment in pediatric anesthesia

Karasu¹

2019

Ann Clin Anal Med

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Aim: Airway management is one of the key areas of pediatric anesthesia practice. In this study, we aimed to investigate the availability of equipment for difficult airways in pediatric anesthesia and to increase the awareness on the subject among anesthesiologists. Material and Method: The survey was carried out using the forms.google.com. Our questionnaire was forwarded to the members on the internet by the Turkish Society of Anesthesiology and Reanimation. Anesthesiologists working in Turkey and willing to join the survey were included in the study. Results: The mean age of the 390 participants who completed our questionnaire was 39.40±7.26 years. The majority (34.6%) of the participants were working for training and research hospitals; 35.4% had been working for 1-5 years; 53.1% had attended a training course on airway management. The frequency of pediatric anesthesia every day was 32.8% and 46% of the participants had been administering pediatric anesthesia to few pediatric patients each week. A special kit of equipment for difficult airway management was available to 35.4%. The classical LMA was most frequently used equipment (95.6%). While 40.8% of the participants had encountered difficult airway in 1-5 pediatric patients, 7.9% also had the previous experience of an emergency surgical airway. Discussion: Our study has determined that the incidence of emergency surgical airway experience was low despite the high risk of encountering difficult airway management in pediatric anesthesiology. We believe that the success rates in difficult airway management would be increased by starting training courses with frequent periodicity on pediatric difficult airway management at different centers in our country, by widening the availability of required equipment and by increasing experience.

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Section: Discussionmentioning

confidence: 99%

A survey of current practice of difficult airway management and equipment in pediatric anesthesia

Karasu¹

2019

Ann Clin Anal Med

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“…The rare but frequently discussed need for front of neck airway (FONA) in children can be attempted as a last resort in a “cannot oxygenate‐cannot intubate” situation. FONA is likely to be futile in a child in an emergency . It is not possible to sufficiently practice or gain experience for this situation to be useful and relied upon in an emergency due to age and size range from neonates to adolescents .…”

Section: Framework For the Approach To The Pediatric Airwaymentioning

confidence: 99%

“…FONA is likely to be futile in a child in an emergency. 31,32 It is not possible to sufficiently practice or gain experience for this situation to be useful and relied upon in an emergency due to age and size range from neonates to adolescents. 33…”

Section: Universal Approachmentioning

confidence: 99%

A framework for the management of the pediatric airway

Engelhardt

Fiadjoe

Weiß

et al. 2019

Pediatric Anesthesia

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Summary Critical airway incidents in children are a frequent problem in pediatric anesthesia and remain a significant cause of morbidity and mortality. Young children are at particular risk in the perioperative period. Delayed management of airway obstruction can quickly lead to serious complications due to the short apnea tolerance in children. A simple, time critical, and pediatric‐specific airway management approach combined with dedicated teaching, training, and frequent practice will help to reduce airway‐related pediatric morbidity and mortality. There is currently no pediatric‐specific universal framework available to guide practice. Current algorithms are modifications of adult approaches which are often inappropriate because of differences in age‐related anatomy, physiology, and neurodevelopment. A universal and pragmatic approach is required to achieve acceptance across diverse pediatric clinicians, societies, and groups. Such a framework will also help to establish minimum standards for pediatric airway equipment, personnel, and medications whenever pediatric airway management is required.

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“…Case reports in the literature describe CICO cases in children where eFONA training was required . Recently, the Airway Collaboration has started gathering information of all cases of CICO, in adults and children, so that we can learn from extremely rare events that cannot be studied with high fidelity in prospective randomized trials .…”

mentioning

confidence: 99%

Comment on: Rehearsing for a rare event: One small step in the right direction

Sabato

2020

Pediatric Anesthesia

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Management of pediatric ‘cannot intubate, cannot oxygenate’

Cited by 21 publications

References 7 publications

A survey of current practice of difficult airway management and equipment in pediatric anesthesia

A survey of current practice of difficult airway management and equipment in pediatric anesthesia

A framework for the management of the pediatric airway

Comment on: Rehearsing for a rare event: One small step in the right direction

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