Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2006
Cuff filling volumes and pressures in pediatric laryngeal mask airways.
Hyperinflation of LMA cuffs carries the risk of airway morbidity by exerting pressure on laryngeal and pharyngeal structures. Cuff hyperinflation in LMAs can result from nitrous oxide diffusion into the LMA cuff and from deliberate manual cuff inflation. ⋯ Since the volume of air which is effectively required depends on several factors and varies between patients, the cuffs should be inflated only with the minimum volume of air required to form an effective seal with the respiratory and gastrointestinal tracts and the cuff pressure should be controlled.
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Paediatric anaesthesia · Jan 2006
Performance of a novel pressure release valve for cuff pressure control in pediatric tracheal tubes.
Acute and chronic hyperinflation of tracheal tube cuffs represents a persistent risk factor for airway damage in children when cuffed tracheal tubes are used. In order to overcome this particular risk, a cuff pressure (CP) pop-off valve has been designed to avoid CP exceeding 20 cmH(2)O. ⋯ These preliminary results show that the CP pop-off valve limits the effect of rapid, potentially dangerous manual cuff inflation maneuvers and reliably prevents CP exceeding the predetermined level of 20 cmH(2)O when exposed to nitrous oxide.
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Arthrogryposis multiplex congenita (AMC) is a congenital symptom complex characterized by multiple joint contractures. AMC results from fetal akinesia due to extrinsic factors (oligohydramnios) or primary neurogenic or myopathic conditions of the fetus. ⋯ The perioperative care of patients with AMC should consider not only the physical manifestations of the disease process, but also the implications of the underlying neuromuscular disease. The most common perioperative issues included difficulties with airway management, problematic intravenous access, and intraoperative hyperthermia.