An update on pediatric airway management
Int Anesthesiol Clin
© 2016 Wolters Kluwer Health, Inc. The pediatric airway can at times present a challenge to manage and this is particularly true when this skill is infrequently performed.1 During the past decade, the additions and advancements in airway technology have enhanced our ability to manage the airways of infants and children safely. Indeed, current technology has been a "game changer" in the overall approach to the airway in this patient population. There is no question that the technology is good and continues to get better, but the fact still remains that we must recognize and understand the nuances of the pediatric airway. Probably one of the best ways to understand how much progress has occurred in pediatric airway management is through the information gained from the ASA Closed Claims Database.2,3 Before the 1990s, recurrent findings indicated that the ability to oxygenate or ventilate was the biggest issue.3 However, a more recent review of pediatric anesthesia claims from 1990 to 2000 demonstrated a decreasing trend of respiratory occurrences.4 This update will examine features of the pediatric airway, direct laryngoscopy versus videolaryngoscopy, the issue of cuffed versus uncuffed endotracheal tubes (ETTs), and diagnostic techniques for airway assessment. What have we learned about the pediatric airway in the past decade? Without a doubt, what we have learned and the information that we continue to acquire about the pediatric airway should enable us to manage it more safely.
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School of Medicine