Minerva anestesiologica
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Minerva anestesiologica · Jun 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Laryngeal mask vs tracheal tube in pediatric anesthesia in the presence of upper respiratory tract infection].
The aim of this report is to assess the incidence of postoperative respiratory complications in patients recently suffering from inflammation of the upper respiratory tract in whom a LMA or an uncuffed orotracheal tube have been used. ⋯ The frequency of ARE increases significantly in URI patients with both LMA and the tracheal tube, but with the former is far lower than with the latter. Despite the appearance of only minor and transient complications, it is confirmed that the tracheal intubation is an additional risk factor as a result of the mechanical airway simulation. In recent URI, it would seem appropriate to avoid tracheal intubation, if possible, preferring the LMA.
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Minerva anestesiologica · Jun 2000
Clinical Trial[Post-intubation subglottal stenosis in children: risk factors and prevention in pediatric intensive care].
Endotracheal intubation (EI) may result in significant injury to the larynx and trachea; subglottic stenosis is the most dangerous consequence of this injury in the pediatric age. It is well known that there are potential risk factors for post-intubation subglottic stenosis, and namely the underlying disease requiring EI, the age and body weight at EI, the duration and number of EI, the absence of sedation and the occurrence of infectious, hypotensive or hypoxic events during the period of EI and the traumatic EI. On the basis of our data an attempt is made to understand which factors are more important in the pathogenesis of this complication and whether post-intubation subglottic stenosis is a preventable complication of EI in children. ⋯ Prevention of post-intubation subglottic stenosis is possible through a better management of the EI and of the child with a tracheal tube. Sedation of intubated children and skill in the EI technique and in the tube size selection are very important. Many intubations can be avoided with a better attention to the tube fixation and to extubation criteria. Some children at high risk for this complication can be identified.