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ISSN 0484-7903 (Print)

2008, Number 3

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Rev Mex Anest 2008; 31 (3)

Subglottic stenosis secondary to endotracheal intubation in pediatric patients and airway management; presentation of two cases

Castillo ZC, Castillo PL

Language: Spanish
References: 11
Page: 201-205
PDF size: 73.04 Kb.


ABSTRACT

Introduction: The acquired subglottic stenosis secondary to prolonged endotracheal intubation affect airway in patients pediatric should obstruction and reduced airflow in upper airway, result: hypoxemia, hypercarbia, respiratory acidosis and difficulty respiratory. The management anesthetic in patients is able complicated treat of intubation because a reduced cavity and who in occasions not accountant with sounding endotracheal and/or laryngeal mask airway of number appropriate, are to have though use resources alternative. Report two cases of patients with subglottic stenosis between 70 and 80%. Submit anesthetics technical with management airway in base of use sounding endotracheal and laryngeal mask airway ProSeal. Conclusions: The management anesthetic in patients with subglottic stenosis is important maintenance airway; avoid obstruction, desaturation and laryngoespasm. The laryngeal mask airway ProSeal is an alternative in subglottic stenosis.


REFERENCES

  1. Cotton RT. Pediatric laringotracheal stenosis. J Pediatr Surg 1984;19:699-704.

  2. Cotton RT. Management and prevention of subglottic stenosis in infants and children. In: Bluestone CD, Stool SE, Kenna MA, eds. Pediatric Otolaryngology, USA, WB Saunders company. 1996:1373-1389.

  3. Álvarez-Neri H, Penchyna-Grub J, Porras-Hernández JD. Primary cricotracheal resection with thyrotracheal anastomosis for the treatment of severe subglottic stenosis in children and adolescents. Ann Otol Rhinol Laryngol. 2005;114: 2-6.

  4. Menighini L, Zadra N, Metrangolo S. Post-intubation subglottic stenosis in children. Risk-factors and prevention in pediatric intensive care. Minerva Anesthesiol 2000;66:467-472.

  5. Blum HR, Mcgowan XF. Chronic upper airway obstruction and cardiac dysfunction: anatomy, pathophysiology and anesthetic implications. Paediatric Anaesthesia 2004;14:75-83.

  6. Myer III CM, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube side. Ann Otol Rhinol Laryngol 1994;103:319-324.

  7. Kettrick RG, Ludwing S. Resuscitation: pediatric basic and advanced life support. In: Fleisher GR, Ludwing S, eds. Textbook of pediatric emergency medicine. Baltimore, MD: Williams & Wilkins, 1983;pp1-30.

  8. Doyle DJ. O´Grady FK. Física y vías respiratorias. En: Benumof JL Clínicas de Anestesiología de Norteamérica. Problemas de vías respiratorias: Parte 1. 1995;13(2):251-277.

  9. Bock KR, Silver P, Rom M. Reduction in tracheal lumen due to endotracheal intubation and its calculated clinical significance. Chest 2000;118:468-472.

  10. Brain AIJ, Verghese C, Strube PJ. The LMA ProSeal -a laringeal mask with an oesophageal vent. Br J Anaesth 2000;84:650-654.

  11. Wheeler M. ProSealÔ laryngeal mask airway in 120 pediatric surgical patients: a prospective evaluation of characteristics and performance. Paediatric Anaesthesia 2006;16:297-301.




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