Articles: intubation.
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Paediatric anaesthesia · May 2021
Cuffed endotracheal tubes in neonates and infants of less than 3 kg body weight - A retrospective audit.
Large prospective clinical studies have shown that modern cuffed pediatric tracheal tubes can be used safely, even in children weighing ≥3 kg. There is a growing interest in their use in children weighing <3 kg so that they, too, can benefit from the potential advantages, particularly the high probability of these tubes fitting into and sealing the pediatric airway at the first intubation attempt. This study aimed to find a cut-off body weight for procedures requiring a cuffed tracheal tube to seal the airway in children weighing <3 kg and to evaluate the frequency and predictive factors for the requirement to place a cuffed instead of an uncuffed tracheal tube. ⋯ Half of the children weighing 2000-2999 g received a Microcuff® PET 3.0 mm ID, especially those with a body weight above 2700 g. Because of the anatomical dimensions in patients with a body weight of 2000-2999 g, cuffed tracheal tubes with smaller outer diameters may be required to better fit their airways.
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One-lung ventilation in children continues to present technical and sometimes physiologic challenges to the clinician. The rarity of these cases at any single institution, however, has led to very few prospective trials to guide best practices. As a result, most clinicians continue to be guided by local tradition and preference. ⋯ The Arndt bronchial blocker continues to represent the most well documented of these devices. Additionally, recent advances have occurred in our understanding of the relevant anatomic constraints of the lower pediatric airway. This review is intended to provide a comprehensive and practical update to practicing pediatric anesthesiologists to further their understanding of the modern practice of one-lung ventilation for thoracic surgery in children.
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J Clin Monit Comput · May 2021
Inadvertent strangulation of inflation line of the pilot balloon during submental endotracheal intubation: a rare complication.
Submental intubation is the preferred type of intubation in patients with complex maxillofacial fractures where oral or nasal intubation cannot be performed. It is also less invasive than tracheostomy in securing the airways. We report a case where an inadvertent strangulation of inflation line of the pilot balloon resulted in inadequate ventilation during submental intubation.