Paediatric anaesthesia
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Paediatric anaesthesia · May 2016
Randomized Controlled Trial Comparative StudyA randomized comparison of pediatric-sized Streamlined Liner of Pharyngeal Airway(™) and Laryngeal Mask Airway-Unique(™) in paralyzed children.
The pediatric-sized Streamlined Liner of Pharyngeal Airway (SLIPA) is a new supraglottic airway device for children. ⋯ In conclusion, both the SLIPA and the Laryngeal Mask Airway-Unique can be used effectively without severe complications in paralyzed children. Additionally, the SLIPA provides a better airway seal and better intraoperative position stability than the Laryngeal Mask Airway-Unique.
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Paediatric anaesthesia · May 2016
Changes in intracuff pressure of cuffed endotracheal tubes while positioning for adenotonsillectomy in children.
When using cuffed endotracheal tubes (cETTs), changes in head and neck position can lead to changes in intracuff pressure. ⋯ Both increases and decreases in the intracuff pressure may occur following positioning of the pediatric patient for adenotonsillectomy. An increase in intracuff pressure may result in a higher risk of damage to the tracheal mucosa. A decrease in the intracuff pressure can result in an air leak resulting in inadequate ventilation, increased risk of aspiration, and even predispose to airway fire if oxygen-enriched gases are used. Continuous intracuff pressure monitoring or rechecking the intracuff pressure after positioning for adenotonsillectomy may be indicated.
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Paediatric anaesthesia · May 2016
Bending the rules: a novel approach to placement and retrospective experience with the 5 French Arndt endobronchial blocker in children <2 years.
One-lung ventilation (OLV) is frequently employed to improve surgical exposure during video-assisted thoracoscopic surgery (VATS) and thoracotomy in adults and children. Because of their small size, children under the age of 2 years are not candidates for some of the methods typically used for OLV in adults and older children, such as a double-lumen endotracheal (DLT) tube or intraluminal use of a bronchial blocker. Due to this, the clinician is left with few options. One of the most robust approaches to OLV in infants and small children has been the extraluminal placement of a 5 French (5F) Arndt endobronchial blocker (AEB). ⋯ Our technique of placing a 35-45° bend in the AEB, extraluminal placement, and observed manipulation with a video-assisted flexible fiberoptic bronchoscope (FFB) within the trachea can be used to achieve consistent lung isolation in patients <2 undergoing thoracic surgery. When the use of a FFB proves unsuccessful, fluoroscopy can provide an alternative solution to successful placement. Significant respiratory derangements without long-term sequelae will occur in a majority of these patients during OLV. Several different approaches to intraoperative analgesia did not impede extubation in the early postoperative period.