Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2010
Upper airway size and configuration during propofol-based sedation for magnetic resonance imaging: an analysis of 138 infants and children.
Propofol is widely used for pediatric sedation. However, increasing depth of propofol sedation is associated with airway narrowing and obstruction. The aim of this study was to objectively assess airway patency during a low-dose propofol-based sedation regimen by measuring upper airway size and configuration with magnetic resonance imaging (MRI) in spontaneously breathing infants and children. ⋯ Airway patency was maintained in all infants and children sedated with this low-dose propofol-based sedation regimen.
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Paediatric anaesthesia · Nov 2010
Cannot ventilate-cannot intubate an infant: surgical tracheotomy or transtracheal cannula?
An unanticipated difficult airway is very uncommon in infants. The recommendations for managing the cannot ventilate-cannot intubate (CVCI) situation in infants and small children are based on difficult airway algorithms for adults. These algorithms usually recommend placement of a transtracheal cannula or performing a surgical tracheotomy as a last resort. In this study, we compared the success rate and time used for inserting a transtracheal cannula vs performing a modified surgical tracheotomy in a piglet model. ⋯ We found placement of a transtracheal cannula to be significantly less successful than the modified surgical tracheotomy in a piglet model. We question whether placement of a transtracheal cannula should be recommended in infants in a cannot ventilate-cannot intubate situation.
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Paediatric anaesthesia · Nov 2010
Letter Case ReportsAnother cause of hypercapnia during induction of anesthesia.