This paper provides the background, available evidence base, and justification for each step in the resultant guidelines and gives a rationale for their use.

The intranucleolar distribution ofphosphoproteins B23 and C23 was visualized simultaneously by post-embedding immunoelectron microscopy in HeLa cell nudeoli, using specific antibodies. The data show that proteins B23 and C23 co-localize to the same nudeolar compartments, i.e., the dense fibrillar component and the granular component. Neither ofthe two antibodies is significantly associated with the fibrillar centers in these cells, although the fibrillar centers appear positive after silver staining. These findings suggest 1 Supported by the Swiss National Science Foundation (grant 3.355-0.86). MB is the recipient ofa fellowship from the Fondation pour des Bourses d'Etudes

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SummaryWe describe a technique involving the use of a laryngeal mask airway, fibreoptic bronchoscope and a guide wire to manage the intubation of a child who was known to be a dificult intubation. The technique is simple, atraumatic, permits the use of an adult bronchoscope for infants and children, and allows control of the airway and ventilation throughout the period of intubation.

Cuffed tracheal tubes are rarely routinely used in children, particularly in the under 8 yr age group, in specialist paediatric centres in the UK. When used, it is predominantly for a specific indication, and the monitoring of intracuff pressure is not routine. Current expert consensus is that complications are equally as common when using a cuffed as an uncuffed tube.

A computerized database was set up to study the incidence and outcome of complications of nasotracheal intubation in a paediatric hospital. We studied 2953 intensive care admissions over a 4-yr period. The overall complication rate was 8%. Accidental extubation and tube blockage were the most frequent events, accounting for a mean of 3.5% and 2.6% of the complications per year, respectively. Complications were more common in smaller children and there were differences between fields of intensive care. None of the complications was fatal or resulted in serious sequelae. None of the children in the study showed clinical symptoms of acquired subglottic stenosis before discharge from hospital, and none has been readmitted for this condition subsequently.

SummaryThe

Three-dimensional printing of a model of the airway of a small child aided planning of bronchial intubation and single-lung ventilation. Three-dimensional printing of airway structures may have wider application in anaesthesia practice.