Prevention of Gastric Distention during Anesthesia for Newborns with Tracheoesophageal Fistulas

Salem, M. Ramez; Wong, A Y; Lin, Yu-Hua; Firor, Hugh V.; Bennett, Edward J.

doi:10.1097/00000542-197301000-00020

Cited by 58 publications

(17 citation statements)

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“…Salem et al [5] described a technique to occlude TEF before surgical ligation during induction of anesthesia. Placement of a tracheal tube just a few millimeters above the carina prevented gastric overdistension.…”

Section: Discussionmentioning

confidence: 99%

Esophageal atresia and severe respiratory failure—cuffed pediatric tracheal tubes as an additional therapeutic option?

Ehlen

Bachour

Wiebe

et al. 2005

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Esophageal atresia and severe respiratory failure—cuffed pediatric tracheal tubes as an additional therapeutic option?

Ehlen

Bachour

Wiebe

et al. 2005

Journal of Pediatric Surgery

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“…As a consequence, the loss of ventilation and the progressive gastric distension will worsen the respiratory distress syndrome, also facilitating gastroesophageal reflux and inhalation, increasing the risk of gastric perforation with high mortality rate. 8 For VLBW neonates with EA/TEF and respiratory distress, several maneuvers have been suggested to prevent or to stop the air leak through the fistula, including gastric division, 9 silastic banding of the distal esophagus, 10 distal positioning of the endotracheal tube with the bevel pointing anteriorly, 11 antegrade 12 or retrograde 13,14 occlusion of the fistula with a Fogarty balloon, water-seal gastrostomy, 15 and high-frequency ventilation. 16 Most recent series suggest early thoracotomy with ligation of the fistula.…”

Section: General Patients' Characteristicsmentioning

confidence: 99%

Difficult esophageal atresia: Trick and treat

Conforti

Morini

Bagolan

2014

Seminars in Pediatric Surgery

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“…A few authors have emphasized the value of preoperative gastrostomy under local anesthesia to allow intermittent positive pressure ventilation (IPPV) during definitive esophageal repair [7]. However, the disadvantage of this approach is the risk of preferential escape of the inspired air through the stomach and aggravation of the gastroesophageal (GE) reflux due to distortion of the angle of His.…”

Section: Introductionmentioning

confidence: 99%

Temporary transgastric fistula occlusion as salvage procedure in neonates with esophageal atresia with wide distal fistula and moderate to severe pneumonia

et al. 2005

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A method to achieve distal fistula occlusion by inflating the balloon of a catheter placed at the gastroesophageal junction via a transgastric route was tried in seven consecutive neonates with esophageal atresia and wide distal fistula. Due to associated moderate or severe pneumonia, these infants were at poor anesthetic risk for the definitive repair. The procedure was done under local anesthesia with mild sedation and took an average of half an hour for completion. Another feeding tube was negotiated through another gastrotomy across the pylorus to allow early enteral feeds. Temporary transgastric fistula occlusion (TTFO) allowed better ventilation of the hypocompliant lungs (by increasing resistance at the fistulous end), prevented lung injury due to aspiration of the refluxing gastric juices, and facilitated optimal ventilation by preventing epigastric distension. All study subjects survived this procedure except for one of our earlier study subjects who died of massive pneumothorax that was a procedure-related complication. None of the remaining subjects required mechanical ventilation either after TTFO or after the definitive esophageal repair that was carried out 5-7 days subsequent to TTFO, except for one other neonate with right lung aplasia who began deteriorating 48 h after thoracotomy and died of cardiac failure. There were no anastomosis-related problems among the survivors over a 12-month follow-up. The gratifying results of our study prompt us to suggest that this procedure deserves attention, and its role should be explored for salvaging neonates with type C esophageal atresia with wide fistula and pneumonia in developing countries with few neonatal intensive care services.

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Prevention of Gastric Distention during Anesthesia for Newborns with Tracheoesophageal Fistulas

Cited by 58 publications

References 0 publications

Esophageal atresia and severe respiratory failure—cuffed pediatric tracheal tubes as an additional therapeutic option?

Esophageal atresia and severe respiratory failure—cuffed pediatric tracheal tubes as an additional therapeutic option?

Difficult esophageal atresia: Trick and treat

Temporary transgastric fistula occlusion as salvage procedure in neonates with esophageal atresia with wide distal fistula and moderate to severe pneumonia

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