Otorhinolaryngologic Procedures

Hannallah, Raafat S.; Brown, Karen; Verghese, Susan T.

doi:10.1016/b978-0-323-42974-0.00033-1

Cited by 3 publications

(5 citation statements)

References 362 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common indication for laryngeal microsurgery in adults is a fixed airway obstruction, [16,18] whereas in pediatric patients, dynamic airflow obstruction (e.g., laryngomalacia, tracheomalacia, or subglottic stenosis) is a common indication for diagnostic laryngoscopy and bronchoscopy. In these patients, dynamic assessment of the native airway movement (functioning of vocal cords, larynx, and trachea) is the most valuable diagnostic tool [12,13] (Video 1, Supplemental Digital Content, http://links.lww.com/MD/G891). However, this is impossible in cases of apnea.…”

Section: Discussionmentioning

confidence: 99%

“…In pediatric patients, carbon dioxide elimination during apneic oxygenation is controversial. [15,23,24] Although, hypercarbia is inevitable and generally well tolerated in pediatric patients, [13] care should be taken to monitor and avoid it.…”

Section: Discussionmentioning

confidence: 99%

“…[3–10] Furthermore, high-flow nasal oxygen has an advantage over other techniques in that it allows oxygen delivery with excellent surgical access to the larynx without obstructing the surgical field in smaller infants. [11–13]…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of high-flow nasal oxygen in spontaneously breathing pediatric patients undergoing tubeless airway surgery: A prospective observational study

Kim

Lee

et al. 2022

Medicine

View full text Add to dashboard Cite

The use of high-flow nasal oxygen is gaining popularity in apneic and spontaneously breathing adult patients during anesthesia. This prospective observational study evaluated the effect of high-flow nasal oxygen in maintaining adequate oxygenation and ventilation in spontaneously breathing pediatric patients with dynamic airway obstruction, undergoing tubeless airway surgery.Oxygenation was provided via an age-appropriate, high-flow nasal cannula at a flow rate of 2 L kg −1 min −1 . Propofol and remifentanil were used to maintain anesthesia while preserving spontaneous respiration. We sought to determine the incidence and risk factors of rescue ventilation. Rescue ventilation with a face mask was performed when the pulse oximetry oxygen saturation was <90% or transcutaneous carbon dioxide was >80 mm Hg.In total, 27 patients were included in the final analysis. Median (interquartile range) of pulse oximetry and transcutaneous carbon dioxide were 100% (99%-100%) and 58.4 mm Hg (51.4-70.3 mm Hg), respectively. Altogether, 9 (33.3%) patients needed rescue ventilation during anesthesia. Of these, 7 patients (25.9%) developed oxygen desaturation (<90%) and 2 patients (7.4%) developed hypercarbia. Patients who required rescue ventilation were significantly younger (8.2 vs 28.8 months, P = .02) and required a longer anesthesia time (55.7 vs 41.0 minutes, P = .04) than those who did not.In conclusion, High-flow nasal oxygen is an alternative technique to maintain oxygenation in children undergoing airway surgeries. However, younger age and longer anesthesia time are significant risk factors leading to the requirement of rescue ventilation in these patients. Further studies with large sample size are required for clinical application of these techniques.Abbreviations: CI = confidence interval, FiO 2 = fraction of inspired oxygen, IQR = interquartile range, ORI = oxygen reserve index, TcCO 2 = transcutaneous carbon dioxide.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of high-flow nasal oxygen in spontaneously breathing pediatric patients undergoing tubeless airway surgery: A prospective observational study

Kim

Lee

et al. 2022

Medicine

View full text Add to dashboard Cite

show abstract

“…Pneumothorax is a known complication of cartilage graft and must be assessed for throughout the perioperative period. 42 This has the additional benefit of recruiting collapsed alveoli from spontaneous ventilation under general anesthesia.…”

Section: Intraoperative Managementmentioning

confidence: 99%

“…A Valsalva maneuver is performed to determine if the pleural space has been compromised following graft harvesting. Pneumothorax is a known complication of cartilage graft and must be assessed for throughout the perioperative period 42 . This has the additional benefit of recruiting collapsed alveoli from spontaneous ventilation under general anesthesia.…”

Section: Anesthetic Considerations For Ltrmentioning

confidence: 99%

Anesthesia for laryngotracheal reconstruction in children: A narrative review

Lee

Prager

Mandler

et al. 2023

Pediatric Anesthesia

View full text Add to dashboard Cite

Laryngotracheal stenosis, congenital or acquired, is a common cause of pediatric airway obstruction. Acquired subglottic stenosis frequently results from prolonged neonatal intubation. The clinical presentation of subglottic stenosis is variable, ranging from biphasic stridor and frequent upper respiratory infections to acute airway compromise. Optimal patient care requires clinical coordination within a multidisciplinary subspecialty team. Medical management includes optimizing respiratory status, gastroesophageal reflux, speech, feeding, nutrition therapies, and providing psychosocial support. If surgical intervention is required, the otolaryngologist, anesthesiologist, and perioperative team must collaborate closely to ensure successful operative outcomes. This narrative review of laryngotracheal stenosis will discuss the pathophysiology, clinical evaluation, medical management, and surgical interventions, and focus on the perioperative anesthetic considerations for children undergoing laryngotracheal reconstruction.

show abstract

Croupy Cough and O2 Desaturation in Ex-Premature Toddler

Gupta

2023

Anesthesia STAT! Acute Pediatric Emergencies in PACU

View full text Add to dashboard Cite

Otorhinolaryngologic Procedures

Cited by 3 publications

References 362 publications

Use of high-flow nasal oxygen in spontaneously breathing pediatric patients undergoing tubeless airway surgery: A prospective observational study

Use of high-flow nasal oxygen in spontaneously breathing pediatric patients undergoing tubeless airway surgery: A prospective observational study

Anesthesia for laryngotracheal reconstruction in children: A narrative review

Croupy Cough and O2 Desaturation in Ex-Premature Toddler

Contact Info

Product

Resources

About