Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2003
Case ReportsPostobstructive pulmonary oedema during anaesthesia in children with mucopolysaccharidoses.
We present case reports of five patients with severe forms of mucopolysaccharidoses who developed postobstructive pulmonary oedema during anaesthesia. The difficulties of anaesthesia in these patients and the particular predisposition that these patients exhibit for the development of postobstructive pulmonary oedema is discussed.
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Paediatric anaesthesia · Jun 2003
Case ReportsLife threatening unilateral pulmonary overinflation might be more successfully treated by contralateral selective intubation than by emergency pneumonectomy.
During a period of 3 years, three infants were admitted to our hospital for unilateral emergency pneumonectomy due to life threatening overinflation of one lung, preventing adequate ventilation of the unaffected contralateral side. All three patients were able to be stabilized by unilateral selective bronchial intubation of the unaffected lung after bronchoscopy, ruling out a flap valve mechanism. No emergency pneumonectomies were required. ⋯ The overinflated lobes were removed later by elective surgery, thus not exposing the children to a potentially dangerous emergency operation. These results are in contrast with reports in the literature. Emergency pneumonectomy in neonates and infants due to overinflation of one lung may be avoided by selective unilateral intubation of the main stem bronchus of the compressed lung.
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Paediatric anaesthesia · Jun 2003
Case ReportsDifferential lung ventilation in an infant using LMA and a long tracheal tube.
This is a case report of differential lung ventilation in an infant using a conventional laryngeal mask airway (LMATM) and a commercially available longer paediatric tracheal tube. This 2-month-old infant had her left-sided congenital diaphragmatic hernia repaired on the sixth day of her life, and had been mechanically ventilated. ⋯ To avoid hyperinflating the right middle lobe, and to expand the right lower lobe without providing a high airway pressure on the left lung, the dependent lung (i.e. left lung) was ventilated with an LMA, and the right lower lobe was expanded with a long tracheal tube inserted through the LMA via the swivel connector. This combination of a conventional LMA and a commercially available longer paediatric tracheal tube could be another way of providing differential ventilation in infants.