Extubation in children with difficult airways

Luis Sequera-Ramos, Alec Zhu, Benjamin Kiesel, Narasimhan Jagannathan

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

There are some unique considerations when caring for the airway in infants and small children. They have relatively larger oropharyngeal structures (tongue, tonsils, and adenoids), and a large and floppy epiglottis, which can predispose to upper airway obstruction. A larger occiput may increase the neck flexion observed while in supine position as compared with adults, which can also lead to airway obstruction. The shorter and narrower trachea may increase the risk for tracheal tube malposition after intubation, and has a greater risk for secretions, edema, or foreign body to produce disproportionate negative effects in airflow resistance. Children run the highest risk of problems from stridor and glottic edema because of their smaller diameter airways. Post-extubation stridor incidence ranges from 2% in children having elective surgical procedures to 40% in pediatric trauma and burn victims. Additionally, infants have less physical space in the oropharynx and within the tracheal tube for an advanced bridging technique such as SGA devices and/or airway exchange catheter.

Original languageEnglish (US)
Title of host publicationManagement of the Difficult Pediatric Airway
PublisherCambridge University Press
Pages161-168
Number of pages8
ISBN (Electronic)9781316658680
ISBN (Print)9781108492584
DOIs
StatePublished - Sep 10 2019

ASJC Scopus subject areas

  • Medicine(all)

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