Pediatrik Hava Yolu Yönetiminde Anestezi

Murat Türkeün Ilgınel

Review

Pediatrik Hava Yolu Yönetiminde Anestezi

Year 2019, Volume: 28 Issue: 3, 211 - 219, 30.09.2019

Murat Türkeün Ilgınel

Abstract

Perioperatif hava yolu komplikasyonu insidansında azalma gözlenmesine rağmen hala pediatrik hastalarda hava yoluna bağlı komplikasyonlar en önemli perioperatif morbidite nedenidir. Pediatrik hastalarda beklenmedik zor hava yolu görülme olasılığı düşük olmasına rağmen görülmesi halinde major mortalite ve morbidite ile sonuçlanabilir. Bu derlemede pediyatrik hava yolu yönetiminin önemi ve anestezi uygulamaları sırasında karşılaşılabilecek olası komplikasyonlar, tedavileri ve The Association of Paediatric Anaesthetists of Great Britain and Ireland (APA) tarafından hazırlanan ve üç farklı senaryoda pediatrik grupta havayolu yönetimi senaryoları irdelenmiştir.

Keywords

Zor Havayolu, çocuk havayolu, çocuk entübasyon

References

1. Jimenez N, Posner KL, Cheney FW, Caplan RA, Lee L, Domino KB. An update on pediatric anesthesia liability: a closed claims analysis. Anesth Analg 2007; 104: 147–53.
2. Holm-Knudsen RJ, Rasmussen LS. Paediatric airway management: basic aspects. Acta Anaesthesiol Scand 2009; 53: 1–9.
3. Westerkamp AC, de Geus AF, Molenbuur B, Meyer P, Wietasch JKG, Struys MM, et al. Comparing perioperative complications of paediatric and adult anaesthesia: A retrospective cohort study of 81267 cases. Eur J Anaesthesiol. 2018; 35:280-8.
4. Goni-Zaballa M, Perez-Ferrer A, Charco-Mora P. Difficult airway in a pediatric patient with Klippel-Feil syndrome and unexpected lingual tonsil. Minerva Anesthesiol. 2012; 78:254-7.
5. Suh SH, Okutani R, Nakasuji M, Nakata K. Anesthesia in a patient with mucopolysaccharidosis type VI (Maroteaux-Lamy syndrome). J Anesth. 2010; 24:945-8.
6. Cook TM, Woodall N, Frerk C. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011; 106:617-31.
7. Wheeler DS, Wong HR, Shanley THP, Pediatric Critical Care Medicine, Basic Science and Clinical Evidence. New York, Springer, 2007.
8. Tobias JD. Pediatric airway anatomy may not be what we thought: implications for clinical practice and the use of cuffed endotracheal tubes. Pediatr Anesth. 2015; 25: 9-19.
9. Fearon B, MacDonald RE, Smith C, Mitchell D. LXXXI Airway Problems in Children following Prolonged Endotracheal Intubation. Annals of Otology, Rhinology & Laryngology, 1966; 75:975-86.
10. Litman RS, Weissend EE, Shibata D, Westesson PL. Developmental changes of laryngeal dimensions in unparalyzed, sedated children. The Journal of the American Society of Anesthesiologists. 2003; 98:41-5.
11. Brambrink AM, Braun U. Airway management in infants and children. Best Pract Res Clin Anaesthesiol. 2005; 19:675-97.
12. Fiadjoe JE, Nishisaki A, Jagannathan N, Hunyady AI, Greenberg RS, Reynold PI, et al. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med 2016; 4: 37–48.
13. Inouse S, Tamaki Y, Sonobe S, Egawa J, Kawaguchi M. A pediatric case developing critical abdominal distension caused by a combination of humidified high-flow nasal cannula oxygen therapy and nasal airway. JA Clin Rep. 2018; 4:4.
14. Klucka J, Stourac P, Stoudek R, Toukalkova M, Harazim H, Kosinova M. Contraversies in pediatric perioperative airways. Biomed Res Int. 2015; id368761.
15. Lee YK, Shin ES, Shim JY, Min KJ, Kim JM, LeeSH. Developing a scoring guide for the Appraisal of Guidelines for Research and Evaluation II instrument in Korea: a modified Delphi consensus process. J Korean Med Sci. 2013; 28: 190–4.
16. Jagannathan N, Sohn LE, Sawardekar A, Gordon J, Shah RD, Mukherji II, et al. A randomized trial comparing the Ambu ® Aura-i ™ with the air-Q ™ intubating laryngeal airway as conduits for tracheal intubation in children. Paediatr Anaesth. 2012; 22:1197-204.
17. Theiler LG, Kleine-Brueggeney M, Luepold B, Stucki F, Seiler S, Urwyler N, et al. Performance of the pediatric sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children. Anesthesiology. 2011; 115:102-10.
18. Bradley AE, White MC, Engelhardt T, Bayley G, Beringer RM. Current UK practice of pediatric supraglottic airway devices a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland. Paediatr Anaesth. 2013; 23:1006–9.
19. Luce V, Harkouk H, Brasher C, Michelet D, Hilly J, Maesani M, et al. Supraglottic airway devices vs tracheal intubation in children: a quantitative meta-analysis of respiratory complications. Paediatr Anaesth. 2014; 24:1088–98.
20. Acquaviva MA, Horn ND, Gupta SK. endotracheal ıntubation versus laryngeal mask airway for esophagogastroduodenoscopy in children. J Pediatr Gastroenterol Nutr. 2014; 59:54–6.
21. Ramesh S, Jayanthi R. Supraglottic airway devices in children. Indian J Anaesth. 2011; 55:476-82.
22. Ozmete O, Sener M, Calıskan E, Kipri M, Ariboğan A. The use of flexible laryngeal mask airway for Adenoidectomies: An experience of 814 Pediatric patients. Pak J Med Sci. 2017; 33: 823-8.
23. Weber T, Salvi N, Orliaguet G, Wolf A. Cuffed vs non-cuffed endotracheal tubes for pediatric anesthesia. Paediatr Anaesth. 2009; 19:46–54.
24. Taylor C, Subaiya L, Corsino D. Pediatric cuffed endotracheal tubes: an evolution of care. Ochsner J. 2011; 11:52–6.
25. Sathyamoorthy M, Lerman J, Okhomina VI, penman AD. Use of cuffed tracheal tubes in neonates, infants and children: A practice survey of members of the Society of Pediatric Anesthesia. Journal of Clinical Anesthesia. 2016; 33:266–72.
26. Tobias JD, Schwartz L, Rice J, Jatana K, Kang DR. Cuffed endotracheal tubes in in fants and child ren: should we routinely measure the cuff pressure? Int J Pediatr Otorhinolaryngol. 2012;76:61-3.
27. Stricker PA, Fiadjoe JE, Litman RS. Neonatal Airway Management. In: Lerman J, editor. Neonatal Anesthesia. New York, Springer, 2015; p157.
28. De Wit M, Peelen LM, Van Wolfswinkel L, de Graaff JC. The incidence of postoperative respiratory complications: A retrospective analysis of cuffed vs uncuffed tracheal tubes in children 0-7 years of age. Paediatr Anaesth. 2018; 28:210-7.
29. Khandelwal N, Khorsand S, Mitchell SH, Joffe AM. Head-elevated patient positioning decreases complications of emergent tracheal intubation in the ward and intensive care unit. Anesth Analg. 2016; 122:1101-7.
30. Hanouz JL, Lammens S, Tasle M, Lesage A, Gerard JL, Plaud B. Preoxygenation by spontaneous breathing or noninvasive positive pressure ventilation with and without positive end-expiratory pressure: a randomised controlled trial. Eur J Anaesthesiol. 2015; 32:881-7.
31. Humphreys S, Lee-Archer P, Reyne G, Long D, Williams T, Schibler A. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in children: a randomized controlled trial. Br J Anaesth. 2017; 118:232-8.
32. Oliveira JESL, Cabrera D, Barrionuevo P, Johnson RL, Erwin PJ, Murad MH, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med. 2017; 70:483-94.
33. Long E, Cincotta DR, Grindlay J, Sabato S, Fauteux-Lamarre E, Beckerman D, et al. On behalf of the Pediatric research in Emergency Departments International Collaborative (PREDICT). Aquality improvement initiative to increase the safety of pediatric emargency airway managent. Pediatric Anesthesia. 2017; 27:1271–7.
34. Fiadjoe JE, Kovatsis P. Videolaryngoscopes in pediatric anesthesia: What’s new? Minerva Anestesiol. 2014; 80:76–82.
35. Kovatsis PG. Continuous ventilation during flexible fiberscopic-assisted intubation via supraglottic airways. Paediatr Anaesth. 2016; 26:457–8.
36. Burjeck NE, Nishisaki A, Fiadjoe J, Adams HD, Peeples KN, Radman VT, et al. Videolaryngoscopy versus fiber-optic intubation through a supraglottic airway in children with a difficult airway: an analysis from the multicenter pediatric difficult ıntubation registry. Anesthesiology. 2017; 127:432-40.
37. Jagannathan N, Shivazad A, Kolan M. Tracheal extubation in children with difficult airways: a descriptive cohort analysis. Pediatric Anesthesia. 2016; 26:372-7.

Anesthesia in Pediatric Airway Management

Year 2019, Volume: 28 Issue: 3, 211 - 219, 30.09.2019

Murat Türkeün Ilgınel

Abstract

Despite the decrease in the incidence of perioperative airway complications, airway-related complications are still the most important cause of perioperative morbidity in pediatric patients. Unexpectedly difficult airways in pediatric patients may result in major mortality and morbidity if seen, although this is unlikely to occur. In this review, the importance of pediatric airway management, possible complications that may arise during pediatric anesthesia administration, treatments, and the airway management scenarios in the pediatric group, which were prepared by The Association of Pediatric Anaesthetists of Great Britain and Ireland (APA) in three different scenarios, have been examined.

Keywords

Difficult airway, Paediatric airway, Paediatric intubation

References

1. Jimenez N, Posner KL, Cheney FW, Caplan RA, Lee L, Domino KB. An update on pediatric anesthesia liability: a closed claims analysis. Anesth Analg 2007; 104: 147–53.
2. Holm-Knudsen RJ, Rasmussen LS. Paediatric airway management: basic aspects. Acta Anaesthesiol Scand 2009; 53: 1–9.
3. Westerkamp AC, de Geus AF, Molenbuur B, Meyer P, Wietasch JKG, Struys MM, et al. Comparing perioperative complications of paediatric and adult anaesthesia: A retrospective cohort study of 81267 cases. Eur J Anaesthesiol. 2018; 35:280-8.
4. Goni-Zaballa M, Perez-Ferrer A, Charco-Mora P. Difficult airway in a pediatric patient with Klippel-Feil syndrome and unexpected lingual tonsil. Minerva Anesthesiol. 2012; 78:254-7.
5. Suh SH, Okutani R, Nakasuji M, Nakata K. Anesthesia in a patient with mucopolysaccharidosis type VI (Maroteaux-Lamy syndrome). J Anesth. 2010; 24:945-8.
6. Cook TM, Woodall N, Frerk C. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011; 106:617-31.
7. Wheeler DS, Wong HR, Shanley THP, Pediatric Critical Care Medicine, Basic Science and Clinical Evidence. New York, Springer, 2007.
8. Tobias JD. Pediatric airway anatomy may not be what we thought: implications for clinical practice and the use of cuffed endotracheal tubes. Pediatr Anesth. 2015; 25: 9-19.
9. Fearon B, MacDonald RE, Smith C, Mitchell D. LXXXI Airway Problems in Children following Prolonged Endotracheal Intubation. Annals of Otology, Rhinology & Laryngology, 1966; 75:975-86.
10. Litman RS, Weissend EE, Shibata D, Westesson PL. Developmental changes of laryngeal dimensions in unparalyzed, sedated children. The Journal of the American Society of Anesthesiologists. 2003; 98:41-5.
11. Brambrink AM, Braun U. Airway management in infants and children. Best Pract Res Clin Anaesthesiol. 2005; 19:675-97.
12. Fiadjoe JE, Nishisaki A, Jagannathan N, Hunyady AI, Greenberg RS, Reynold PI, et al. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med 2016; 4: 37–48.
13. Inouse S, Tamaki Y, Sonobe S, Egawa J, Kawaguchi M. A pediatric case developing critical abdominal distension caused by a combination of humidified high-flow nasal cannula oxygen therapy and nasal airway. JA Clin Rep. 2018; 4:4.
14. Klucka J, Stourac P, Stoudek R, Toukalkova M, Harazim H, Kosinova M. Contraversies in pediatric perioperative airways. Biomed Res Int. 2015; id368761.
15. Lee YK, Shin ES, Shim JY, Min KJ, Kim JM, LeeSH. Developing a scoring guide for the Appraisal of Guidelines for Research and Evaluation II instrument in Korea: a modified Delphi consensus process. J Korean Med Sci. 2013; 28: 190–4.
16. Jagannathan N, Sohn LE, Sawardekar A, Gordon J, Shah RD, Mukherji II, et al. A randomized trial comparing the Ambu ® Aura-i ™ with the air-Q ™ intubating laryngeal airway as conduits for tracheal intubation in children. Paediatr Anaesth. 2012; 22:1197-204.
17. Theiler LG, Kleine-Brueggeney M, Luepold B, Stucki F, Seiler S, Urwyler N, et al. Performance of the pediatric sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children. Anesthesiology. 2011; 115:102-10.
18. Bradley AE, White MC, Engelhardt T, Bayley G, Beringer RM. Current UK practice of pediatric supraglottic airway devices a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland. Paediatr Anaesth. 2013; 23:1006–9.
19. Luce V, Harkouk H, Brasher C, Michelet D, Hilly J, Maesani M, et al. Supraglottic airway devices vs tracheal intubation in children: a quantitative meta-analysis of respiratory complications. Paediatr Anaesth. 2014; 24:1088–98.
20. Acquaviva MA, Horn ND, Gupta SK. endotracheal ıntubation versus laryngeal mask airway for esophagogastroduodenoscopy in children. J Pediatr Gastroenterol Nutr. 2014; 59:54–6.
21. Ramesh S, Jayanthi R. Supraglottic airway devices in children. Indian J Anaesth. 2011; 55:476-82.
22. Ozmete O, Sener M, Calıskan E, Kipri M, Ariboğan A. The use of flexible laryngeal mask airway for Adenoidectomies: An experience of 814 Pediatric patients. Pak J Med Sci. 2017; 33: 823-8.
23. Weber T, Salvi N, Orliaguet G, Wolf A. Cuffed vs non-cuffed endotracheal tubes for pediatric anesthesia. Paediatr Anaesth. 2009; 19:46–54.
24. Taylor C, Subaiya L, Corsino D. Pediatric cuffed endotracheal tubes: an evolution of care. Ochsner J. 2011; 11:52–6.
25. Sathyamoorthy M, Lerman J, Okhomina VI, penman AD. Use of cuffed tracheal tubes in neonates, infants and children: A practice survey of members of the Society of Pediatric Anesthesia. Journal of Clinical Anesthesia. 2016; 33:266–72.
26. Tobias JD, Schwartz L, Rice J, Jatana K, Kang DR. Cuffed endotracheal tubes in in fants and child ren: should we routinely measure the cuff pressure? Int J Pediatr Otorhinolaryngol. 2012;76:61-3.
27. Stricker PA, Fiadjoe JE, Litman RS. Neonatal Airway Management. In: Lerman J, editor. Neonatal Anesthesia. New York, Springer, 2015; p157.
28. De Wit M, Peelen LM, Van Wolfswinkel L, de Graaff JC. The incidence of postoperative respiratory complications: A retrospective analysis of cuffed vs uncuffed tracheal tubes in children 0-7 years of age. Paediatr Anaesth. 2018; 28:210-7.
29. Khandelwal N, Khorsand S, Mitchell SH, Joffe AM. Head-elevated patient positioning decreases complications of emergent tracheal intubation in the ward and intensive care unit. Anesth Analg. 2016; 122:1101-7.
30. Hanouz JL, Lammens S, Tasle M, Lesage A, Gerard JL, Plaud B. Preoxygenation by spontaneous breathing or noninvasive positive pressure ventilation with and without positive end-expiratory pressure: a randomised controlled trial. Eur J Anaesthesiol. 2015; 32:881-7.
31. Humphreys S, Lee-Archer P, Reyne G, Long D, Williams T, Schibler A. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in children: a randomized controlled trial. Br J Anaesth. 2017; 118:232-8.
32. Oliveira JESL, Cabrera D, Barrionuevo P, Johnson RL, Erwin PJ, Murad MH, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med. 2017; 70:483-94.
33. Long E, Cincotta DR, Grindlay J, Sabato S, Fauteux-Lamarre E, Beckerman D, et al. On behalf of the Pediatric research in Emergency Departments International Collaborative (PREDICT). Aquality improvement initiative to increase the safety of pediatric emargency airway managent. Pediatric Anesthesia. 2017; 27:1271–7.
34. Fiadjoe JE, Kovatsis P. Videolaryngoscopes in pediatric anesthesia: What’s new? Minerva Anestesiol. 2014; 80:76–82.
35. Kovatsis PG. Continuous ventilation during flexible fiberscopic-assisted intubation via supraglottic airways. Paediatr Anaesth. 2016; 26:457–8.
36. Burjeck NE, Nishisaki A, Fiadjoe J, Adams HD, Peeples KN, Radman VT, et al. Videolaryngoscopy versus fiber-optic intubation through a supraglottic airway in children with a difficult airway: an analysis from the multicenter pediatric difficult ıntubation registry. Anesthesiology. 2017; 127:432-40.
37. Jagannathan N, Shivazad A, Kolan M. Tracheal extubation in children with difficult airways: a descriptive cohort analysis. Pediatric Anesthesia. 2016; 26:372-7.

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Details

Primary Language	Turkish
Journal Section	Review
Authors	Murat Türkeün Ilgınel 0000-0001-9183-9124
Publication Date	September 30, 2019
Acceptance Date	July 17, 2018
Published in Issue	Year 2019 Volume: 28 Issue: 3

Cite

AMA	Ilgınel MT. Pediatrik Hava Yolu Yönetiminde Anestezi. aktd. September 2019;28(3):211-219.

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