Paediatric anaesthesia
-
Paediatric anaesthesia · May 2003
Case ReportsDifficult airway in a child with spinal muscular atrophy type I.
Spinal muscular atrophy (SMA) type I is a relatively common inherited neuromuscular disease of hypotonic newborns, but is not associated with craniofacial abnormalities. There is nothing in the literature about difficult intubation in patients affected by this disease. We report a case of 34-month-old girl with SMA type I who was scheduled for emergency endoscopic laser treatment of tracheal stenosis caused by granulations. ⋯ A feeding nasogastric catheter was used as a guide catheter, and our strategy was successful. In this study we report a case of difficult airway in a child with SMA type I. The relationship between SMA type I with a tracheostome and difficult airway are discussed.
-
The incidence of neurodevelopmental impairment in children with congenital heart disease is high. Its aetiology is multiple and complex. ⋯ Research has resulted in a clearer understanding of the relationship between congenital heart disease and the brain, and of the effects of cardiopulmonary bypass, hypothermia and circulatory arrest. This has led to modifications in management which may improve neurological outcome in the future.
-
Paediatric anaesthesia · May 2003
Increased respiratory symptoms following surgery in children exposed to environmental tobacco smoke.
The aim of this study was to determine if children exposed to environmental tobacco smoke (ETS) via parental smoking (ETS+) developed more respiratory symptoms resulting in longer recovery times following surgical outpatient procedures compared with children of nonsmoking parents (ETS-). ⋯ In children undergoing general anaesthesia for inguinal hernia repair, ETS exposure was associated with an increased frequency of respiratory symptoms during emergence from anaesthesia and during postoperative recovery.
-
Paediatric anaesthesia · May 2003
The dynostatic algorithm accurately calculates alveolar pressure on-line during ventilator treatment in children.
Monitoring of respiratory mechanics during ventilator treatment in paediatric intensive care is currently based on pressure and flow measurements in the ventilator or at the Y-piece. The characteristics of the tracheal tube will modify the pressures affecting the airways and alveoli in an unpredictable manner. The dynostatic algorithm (DSA), based on a one-compartment lung model, calculates the alveolar pressure during on-going ventilation. The DSA is based on accurate measurement of tracheal pressure. The purpose of this study was to test the validity of the DSA in a paediatric lung model and to apply the concept in an observational clinical study in children. ⋯ Fibreoptic measurement of tracheal pressure in combination with the dynostatic calculation of alveolar pressure provides an on-line monitoring of the effects of ventilatory mode in terms of volume-dependent compliance, tracheal peak pressure and true positive end expiratory pressure.