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Endoscopic Screening for Laryngotracheal Complications in Children Following Prolonged Mechanical Ventilation Maintained Through Endotracheal Intubation: A Cross-Sectional Pilot Project.
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
A simulated 'can't intubate, can't oxygenate' manikin crossover study investigating a modified front-of-neck access airway device.
Anaesth Intensive Care
December 2024
Department of Anaesthesia, Royal Hobart Hospital, Hobart, Australia.
A 'can't intubate, can't oxygenate' (CICO) situation is an uncommon and time-critical emergency. Many institutions have adopted a 'scalpel-bougie-endotracheal tube (ETT)' technique based on evidence produced by the 4th National Audit Project of the Royal College of Anaesthetists and 2015 Difficult Airway Society guidelines. We made a modification to the traditional 'scalpel-bougie-ETT' technique, using a shortened bougie and replacing the ETT with a cuffed Melker airway in a preassembled device (called 'Secure Airway for Front-of-neck Emergencies' (SAFE airway device)), which we felt might reduce cognitive load on a single operator in an emergency CICO situation.
View Article and Find Full Text PDFExchange rates of second generation Microcuff® pediatric endotracheal tubes in children weighing more than 3 kg : A retrospective audit.
Anaesthesiologie
December 2024
Department of Anesthesia, University Children's Hospital, Lenggstrasse 30, 8008, Zurich, Switzerland.
Background: Cuffed endotracheal tubes (cETT) pose the potential advantage of an infrequent need for reintubation in pediatric patients compared to uncuffed tubes. The aim of this study was to investigate tube exchange rates using second generation Microcuff® pediatric endotracheal tubes (PET) with an adapted sizing recommendation in a large single institution cohort of children and to identify potential variables associated with an elevated risk of tube exchange.
Methods: Patient data obtained from the electronic patient data management system of the Department of Anesthesia, University Children's Hospital Zurich, Switzerland, were retrospectively assessed for demographic and anthropometric information, size of the internal tube diameter used for positive pressure ventilation and divergence from the size recommendation chart.
Neonatal Airway Management and Outcomes Following Fetoscopic Endoluminal Tracheal Occlusion (FETO): A Single-Center Descriptive Analysis.
J Surg Res
December 2024
Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital and Baylor, College of Medicine, Houston, Texas; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas. Electronic address:
Article Synopsis
- Congenital diaphragmatic hernia is a serious condition that can lead to issues like underdeveloped lungs and high blood pressure, but a procedure called fetoscopic endoluminal tracheal occlusion (FETO) has shown to improve patient survival despite some complications like tracheomegaly (enlarged trachea).
- A study analyzed 34 patients who underwent FETO, finding that tracheomegaly was present in 24 of them, with most needing intubation right after birth, some requiring a transition to cuffed endotracheal tubes (ETTs) due to concerns like air leaks.
- The findings suggest that larger or cuffed ETTs may be more beneficial for
Design considerations for development of cuffed endotracheal tube for small airways.
Paediatr Anaesth
November 2024
Research and Development, Acute Care & Monitoring, Medtronic, Athlone, Ireland.
Article Synopsis
- * Neonates and pediatric patients have specific airway structures and functional needs that influence the design of ETTs, making it important to cater to these requirements.
- * While historically uncuffed ETTs were preferred for children under eight, advancements in cuffed ETT design now allow for safer use in smaller, more delicate airways.
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