scholarly journals Preoperative simulation of endotracheal intubation for selection of proper tube size in pediatric patients

2021 ◽  
Author(s):  
Jong Wook Song
Keyword(s):  
Endotracheal Intubation ◽  
Pediatric Patients ◽  
Tube Size ◽  
Preoperative Simulation ◽  
Selection Of

scholarly journals Uncuffed Endotracheal Tube Experience in Pediatric Patients with Laparotomy and Laparoscopic Surgeries

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sema Şanal Baş ◽  
Gülay Erdoğan Kayhan ◽  
Meryem Onay ◽  
Yeliz Kılıç
Keyword(s):  
Mechanical Ventilation ◽  
Side Effects ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Pediatric Patients ◽  
Mechanical Parameters ◽  
Significant Difference ◽  
Tube Exchange ◽  
Endotracheal Tube Size ◽  
Selection Of

Aim. The aim of this study is to compare endotracheal tube leak, tube selection, mechanical ventilation, and side effects in the use of uncuffed tubes in both laparoscopic and laparotomy surgeries in pediatric patients. Material and Method. Patients who underwent laparotomy (LT group) or laparoscopic (LS group) surgery between 1 and 60 months. In the selection of uncuffed tubes, it was also planned to start endotracheal intubation with the largest uncuffed tube and to start intubation with a small uncuffed tube if the tube encounters resistance and does not pass. Mechanical parameters, endotracheal tube size, tube changes, and side effects are recorded. Results. A total of 102 patients, 38 females and 64 males, with a mean age of 10.9±8.1 months, body weight 7.1±3.7 kg, and height 67±15 cm, were included. 54 patients underwent laparoscopic surgery, and 48 patients underwent laparotomy. Tube exchange was performed in a total of 18 patients. In patients who underwent tube exchange, 11 patients were intubated with a smaller ETT number and others endotracheal intubation; when the MV parameters were TVe<8 ml/kg and ETT leak>20%, a larger uncuffed tube was used due to PIP 30 cmH2O pressure. Patients with aspiration were not found in the LT and LS groups. There was no difference in the intergroup evaluation for postoperative side effects such as cough, laryngospasm, stridor, and aspiration. Conclusion. There was no significant difference between the groups in terms of tube changes and side effects. So that we can start with the largest possible uncuffed tube to decrease ETT leak, both laparotomy and laparoscopic operations in children can be achieved with safe mechanical ventilation and target tidal volume.

scholarly journals Ultrasound evaluation of complications after cardiovascular surgery in pediatric patients: A case series

2020 ◽  
Vol 1 (1) ◽  
pp. 108 ◽  
Author(s):  
Takahiro Hosokawa ◽  
Sio Suzuki ◽  
Yutaka Tanami ◽  
Yumiko Sato ◽  
Yoshihiro Ko ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Early Diagnosis ◽  
Radiation Exposure ◽  
Pediatric Patients ◽  
Cardiovascular Surgery ◽  
Case Series ◽  
Early Initiation ◽  
Site Infection ◽  
Ultrasound Evaluation ◽  
Selection Of

In contrast to computed tomography, ultrasound can be performed without radiation exposure, repeatedly performed by the patients’ bedside. Hence, in this case series, we describe the evaluation of complications including hematoma, superficialsurgical site infection, mediastinitis, and pseudoaneurysm associated mediastinitis using ultrasound in pediatric patients after cardiovascular surgery. To our knowledge, no previous reports have evaluated such complications using ultrasound. Ultrasound may be useful for the early diagnosis of these complications, and in the selection of subsequent examinations such as computed tomography, resulting in the early initiation of intervention.

Enteral and parenteral nutrition considerations in pediatric patients

2019 ◽  
Vol 76 (19) ◽  
pp. 1492-1510
Author(s):  
Mary Petrea Cober ◽  
Kathleen M Gura
Keyword(s):  
Best Practices ◽  
Parenteral Nutrition ◽  
Pediatric Patients ◽  
Medication Administration ◽  
Nutrition Support ◽  
Disease States ◽  
Pediatric Populations ◽  
Enteral And Parenteral Nutrition ◽  
Indications For Use ◽  
Selection Of

Abstract Purpose Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. Summary The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. Conclusion The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.

Laryngopharyngeal complaints following short-term endotracheal intubation: peculiarities of males and females

2012 ◽  
Vol 19 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Iveta PAULAUSKIENĖ ◽  
Eugenijus LESINSKAS
Keyword(s):  
Endotracheal Intubation ◽  
Female Group ◽  
Short Term ◽  
Cuff Volume ◽  
Vocal Fatigue ◽  
Tube Size ◽  
Globus Pharyngeus ◽  
Throat Pain ◽  
Male Group ◽  
Throat Clearing

Background. Laryngopharyngeal complaints are classified as minor post-intubation complications. They cause great discomfort, have some influence on the quality of life and can limit patient’s casual activity. The extent of complaints ranges from 12 to 65%. Undesirable complications can be avoided by ascertaining factors that are able to provoke or decrease laryngopharyngeal symptoms after endotracheal intubation. In this study, we assessed predominant laryngopharyngeal symptoms following a short-term endotracheal intubation and their peculiarities subject to gender, and we estimated the most important influencing factors. Materials and methods. 218 patients were examined before endotracheal anesthesia, 1–2 and 24 hours after extubation. The following laryngopharyngeal complaints were recorded: hoarseness, vocal fatigue, globus pharyngeus, throat pain and throat clearing. These factors were also assessed in relation to endotracheal intubation parameters: endotracheal tube size, cuff volume and pressure, number of intubation attempts, length of anesthesia, experience of anesthesiologist and additional parameters: smoking, allergy, GERD symptoms, laryngitis and singing skills subject to gender. Results. All laryngopharyngeal symptoms increased significantly in 2 hours after extubation and remained increased after 24 hours in both male and female groups. In 1–2 hours after extubation, females complained of throat pain more than males (61.3 vs. 42.9%; p = 0,014). The following significant relations were found 1–2 hours after extubation: between throat pain and length of anesthesia, globus pharyngeus and tube size and cuff volume in the male group; between globus pharyngeus, vocal fatigue and smoking, throat clearing and cuff volume in the female group. After 24 hours, the relation was noticed between vocal fatigue and cuff volume and number of intubation attempts, globus pharyngeus and length of anesthesia, between hoarseness and number of intubation attempts and between throat pain and singing skills in the male group. Some relation between throat clearing and cuff volume remained for 24 hours after extubation, smoking had influence on hoarseness and vocal fatigue in the female group. Conclusions. Laryngopharyngeal symptoms remain an important cause of discomfort for 24 hours after extubation. Females complain of laryngeal and pharyngeal symptoms more than males and throat pain following extubation is also more frequent in females. The most important parameters of short-term endotracheal intubation that influence laryngopharyngeal complaints are as follows: cuff volume, length of anesthesia and number of intubation attempts that affect males more than females. Smoking affects females more, though singing skills are more significant in the male group.

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