The ‘Can't Intubate Can't Oxygenate’ scenario in Pediatric Anesthesia: a comparison of different devices for needle cricothyroidotomy

Stacey, Jonathan; Heard, Andrew; Chapman, Gordon; Wallace, C. J.; Hegarty, Mary; Vijayasekaran, Shyan; Ungern‐Sternberg, Britta S. von

doi:10.1111/pan.12048

Cited by 39 publications

(38 citation statements)

References 11 publications

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“…However, Stacey et al reported that cannula tracheostomy in a model comparable to an infant’s airway was still difficult and not performed without complication [5]. Because little evidence exists to guide the management of the “can’t intubate, can’t oxygenate” scenario in pediatric anesthesia [1], weight may not predict appropriate timing for general anesthesia in an infant.…”

Section: Discussionmentioning

confidence: 99%

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When can we give general anesthesia to an infant with anticipated difficult airway management caused by facial vascular malformation?

et al. 2017

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A 13-month-old infant weighing 8.3 kg with a height of 72.3 cm visited our hospital for surgical resection of facial vascular malformation detected at birth. Because we anticipated the patient would have difficult airway management and massive perioperative bleeding, we postponed surgery to discuss the appropriate timing and general anesthesia approach with anesthesiologists at other institutions, while explaining the risk of general anesthesia and bleeding to the parents. When the patient was 21 months old and 10 kg, he started bleeding while undressing, when his lips touched his clothes. Because the cricothyroid membrane puncture kit (QuickTrach Child™ (VBM Medizintechnik GmbH, Sulz am Neckar, Germany)) can be used on infants weighing over 10 kg, we decided to give him general anesthesia. The infant was successfully intubated by Airwayscope™ and the lesion was surgically removed in accordance with the preoperative plan. The procedure took 65 min and created 8 g of bleeding. The infant had no postoperative bleeding or respiratory complications. There is no data on the timing of safe anesthesia management in infants with difficult airway management. Thus, taking the time to discuss the case with surgeons, other anesthesiologists, and the parents can be helpful.

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Section: Discussionmentioning

confidence: 99%

“…To date, there is little clinical or experimental evidence to guide the management of the “can’t intubate, can’t oxygenate” (CICO) scenario in pediatric anesthesia particularly regarding the infant or neonate [1]. We describe here an infant with facial vascular malformation.…”

Section: Introductionmentioning

confidence: 99%

When can we give general anesthesia to an infant with anticipated difficult airway management caused by facial vascular malformation?

et al. 2017

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“…have mentioned that cricothyroidotomy can be dangerous in children and a surgical tracheostomy is the method of choice. [222324] During tracheostomy, attempt should be made to maintain oxygenation by keeping the upper airway patent and continuously administering 100% oxygen.…”

Section: Emergency Surgical Airway Accessmentioning

confidence: 99%

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in Paediatrics

et al. 2016

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The All India Difficult Airway Association guidelines for the management of the unanticipated difficult tracheal intubation in paediatrics are developed to provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in children between 1 and 12 years of age. The incidence of unanticipated difficult airway in normal children is relatively rare. The recommendations for the management of difficult airway in children are mostly derived from extrapolation of adult data because of non-availability of proven evidence on the management of difficult airway in children. Children have a narrow margin of safety and mismanagement of the difficult airway can lead to disastrous consequences. In our country, a systematic approach to airway management in children is lacking, thus having a guideline would be beneficial. This is a sincere effort to protocolise airway management in children, using the best available evidence and consensus opinion put together to make airway management for children as safe as possible in our country.

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“…Los estudios iniciales en modelos animales sugieren que la cricoidotomía quirúrgica puede ser superior a la técnica con aguja en pacientes preescolares 16,17 ; incluso en pacientes adultos, la cricoidotomía con aguja también ha mostrado poco éxito 18,19 , aunque sigue siendo una alternativa dentro del algoritmo de la vía aérea para proveer oxigenación por unos minutos. Estas técnicas son medidas desesperadas que no pueden hacernos olvidar que lo más importante siempre es mantener la ventilación y la oxigenación, antes que lograr la intubación de la tráquea.…”

Section: Obstrucción Funcional De La Vía Aéreaunclassified

“…La ventilación con máscara facial puede ser optimizada al utilizar dispositivos como las cánulas orofaríngea o nasofaríngea, la ventilación a 4 manos o el uso de un dispositivo supraglótico como la máscara laríngea 17 . Un cirujano debe estar presente en aquellos pacientes que cursan con gran edema de la vía aérea o que tienen antecedentes claros y conocidos de ventilación con máscara facial difícil y cuando la oxigenación se deteriora con rapidez.…”

Section: Vía Aérea Difícil Esperada O Anticipadaunclassified

Algoritmo para el manejo de la vía aérea difícil en pediatría

Marín

Engelhardt

2014

Revista Colombiana de Anestesiología

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información del artículo Historia del artículo: Recibido el 7 de octubre de 2013 Aceptado el 28 de mayo de 2014 On-line el 21 de julio de 2014 Palabras clave: Manejo de la vía aérea Niño Literatura de revisión como asunto Algorítmos Complicaciones intraoperatorias r e s u m e n Objetivo: Describir una serie de actividades estructuradas para el manejo de la vía aérea difícil en pediatría y sugerir un algoritmo que se adapte a las condiciones de cada niño.Materiales y métodos: Revisión de las bases de datos de la literatura médica (PubMed, Bireme y MD Consult) con una búsqueda con las palabras clave: algoritmo, vía aérea difícil, niños y pediatría, de artículos publicados en los últimos 10 años y que fueran revisión de tema, revisión sistemática o algoritmos. Los artículos fueron revisados por los autores principales.El diseño del algoritmo está basado en un consenso informal de anestesiólogos pediátricos y en la revisión de la literatura publicada, adaptado a la disponibilidad de los recursos y a la experiencia en nuestro medio.Resultados: Como resultado presentamos una propuesta de un algoritmo sencillo, con pasos secuenciales y en un solo sentido para el manejo de la vía aérea difícil en pediatría. Se hace un énfasis especial en situaciones como la vía aérea sospechosa y se presenta una sugerencia de los equipos y dispositivos necesarios para aplicar el algoritmo, los cuales pueden ser adaptados en cada institución.Conclusión: Esta revisión sintetiza el manejo de la vía aérea difícil en pediatría y es la primera propuesta realizada en Latinoamérica. a b s t r a c tObjective: To describe a series of activities structured for managing the difficult airway in pediatrics and to suggest an algorithm adapted to the individual child's conditions. * Autor para correspondencia.Correo electrónico: echeverrypiedad@hotmail.com (P.C. Echeverry Marín). http://dx.

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The ‘Can't Intubate Can't Oxygenate’ scenario in Pediatric Anesthesia: a comparison of different devices for needle cricothyroidotomy

Cited by 39 publications

References 11 publications

When can we give general anesthesia to an infant with anticipated difficult airway management caused by facial vascular malformation?

When can we give general anesthesia to an infant with anticipated difficult airway management caused by facial vascular malformation?

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in Paediatrics

Algoritmo para el manejo de la vía aérea difícil en pediatría

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