Reply to Schmitz et al. regarding ‘Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically suctioned volumes’

Abstract

The first stopcock works as a pressure-relief port, and the second stopcock is attached to a pressure gauge to measure the applied gas pressure. A similar, selfassembled device has also been reported for the administration of emergency jet ventilation in pediatric patients (3). We confirm that the CPAP-delivery device can be connected to the bronchoscope working channel or suction port. When delivering oxygen through this device, the plateau pressure, which is dominantly determined by the flow rate of supplied oxygen, did not increase even when the distal end of the system was occluded. Pressure delivered to the alveoli is strictly controlled, and therefore, complications such as alveolar rupture and subsequent tension pneumothorax can be avoided during a bronchoscopic procedure.As it is a challenge for anesthesiologists to maintain oxygenation during bronchoscopic procedures in pediatric patients, we should utilize as many methods as possible to insufflate oxygen to patients. Although oxygen supply without sufficient gas egress has a potential risk of barotrauma, wall source oxygen insufflation through a bronchoscope can still be used as a safe and efficient method by adding pressure-relief port to the oxygen supply system such as CPAP-delivery device. FundingThis research was carried out without funding.