![]() ![]() Hypercarbia, tachypnea, increased work of breathing, wheezing, and a prolonged expiratory phase are characteristic. Alteration in ventilation can also be secondary to muscle weakness, altered mental status, exposure to toxins, or iatrogenic oversedation. There exists a reduced lung compliance and a V/Q mismatch increasing physiologic dead space. The pathophysiologic phenomenon consists of alteration in ventilation. Some causes of hypoxia are airway obstruction, hypoventilation, ventilation/perfusion mismatch, hemoglobinopathies, abnormal pulmonary diffusion, and intracardiac right to left shunt. Clinically, the patient presents with respiratory distress, tachypnea, increased work of breathing, and an increase in alveolar-arterial gradient. One of the most common indications of ETI. Classically, we can find patients with a Glasgow Coma Scale (GCS) score of 8 or less, or a deterioration in the GCS score from 14 to 10. Patient with neurological dysfunction secondary to trauma, seizures, metabolic disease, or toxic ingestion. During childhood, the most common cause is infections. Some examples are: (a) upper airway infectious (CROUP, bacterial tracheitis, etc.), (b) traumatisms, (c) congenital syndromes accompanied with macroglossia or micrognathia, (d) cystic hygroma, (e) branchial cleft cyst, (f) thyroglossal duct cyst, and (g) those patients with a large anterior mediastinal mass (non-Hodgkin lymphoma, acute leukemia, etc.). In this category, integrity of airway is affected by different infectious, anatomical and neurological diseases. ![]() We include a section of devices that could help permeate the airway of pediatric patients with a difficult airway and recent results of studies conducted regarding the association between the level of previous training in pediatric ETI and success rates. In addition, we will discuss important anatomical particularities of the children’s airway. In this chapter, we will summarize the most practical recommendations of ETI technique in children. ![]() Airway’s management can be defined as the performance of maneuvers and the use of devices that enable a correct and safe ventilation to patients that need this care.Įndotracheal intubation (ETI) is one of the procedures that every physician attending critically ill pediatric patients must not only know but also getting the skills and experience necessaries to effectively perform. Management and securing permeability of airway are mandatory in a critically ill child with severe trauma or any other situation that threatens his or her life. ![]()
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