Annales françaises d'anesthèsie et de rèanimation
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High frequency jet ventilation (HFJV) is an alternative ventilatory mode during anaesthesia for laryngeal microsurgery. This procedure ensures good visualization of the operating field but is not without risk. Thus, its use in paediatric patients requires sound knowledge of respiratory physiology of children and infants. ⋯ The air-oxygen mixture must be adjusted to provide the lowest FIO2 possible (< or = 30%) when using the CO2 laser. The main indications for the use of HFJV in paediatric laryngeal microsurgery are laryngomalcia, laryngeal papillomatosis and subglottic haemangioma. HFJV is a reliable and useful technique in airway paediatric surgery providing the operator has good knowledge of the physiological particularities in children.
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Ann Fr Anesth Reanim · Jul 2003
Review[Outcomes of children after bronchial foreign body inhalation].
Bronchial foreign body inhalation is a frequent and potentially serious accident in children. It can provoke long-term complications such as bronchiectasis. ⋯ To decrease the risk of complications, one must emphasize the importance of early diagnosis and the potential role of fiberoptic bronchoscopy to help the diagnosis in case of suspected inhalation without clinical or radiological signs. Rigid bronchoscopy is the only procedure that allows diagnosis and removal of the foreign body.
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Recent surveys have reevaluated the risk of aspiration of gastric content during anesthesia in pediatric patients. Emergency, bowel obstruction and inadequate depth of anesthesia are the main high-risk situations. Airway protection requires the placement of cuffed tracheal tube. ⋯ Internal diameter of cuffed tubes should be reduced compared to uncuffed tubes. It is recommended to monitor cuff pressure if nitrous oxide is used during anesthesia. Crash induction is described with special reference to pediatric specificities.
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Since its introduction in 1981 by Brain, the laryngeal mask airway has achieved increased popularity in pediatrics. Despite widespread use, the definitive role of the laryngeal mask airway has yet to be established. ⋯ Finally, we review the techniques of insertion, details of misplacement, the removal and complication associated with the use of laryngeal mask airway. Cleaning, pre-use checking and maintenance were also discussed.
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Ann Fr Anesth Reanim · Jul 2003
Case Reports[Left ventricular thrombus and myocarditis induced by paraphenylenediamine poisoning].
We showed that the paraphenylenediamine (PPD) poisoning caused myocarditis but there is no data on the echocardiographic features. We report a case of myocarditis induced by PPD poisoning with echographic data. After ingestion of 5 g of PPD, a 18-year-old woman was admitted to the hospital with asphyxia and rhabdomyolysis. ⋯ A follow-up echocardiogram performed on the 15th day showed normalization of ventricular function and disappearance of the thrombus. No embolic event was noted. Echocardiography is indicated in the myocarditis induced by PPD poisoning to prove the ventricular function as well as the presence of a thrombus.