Safety and efficacy of rescue flexible bronchoscopic intubation using the Bentson floppy-tip guidewire via a supraglottic airway in critically ill children.

Abstract:

:Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation. We describe the safety and experience of this in a broad range of critically ill children. Thirteen patients, median (IQR [range]) (9.0 (5.0-10.0 [4.0-12.0]) kg and 15.4 (12.1-23.2 [3.3-49.7]) months) underwent emergency tracheal intubation using this technique, after unsuccessful attempts at intubation using standard laryngoscopy blades. All intubations were successful at the first attempt using this technique and no airway trauma or significant clinical deteriorations were recorded.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Cross D,Nyman A,James P,Durward A

doi

10.1111/anae.14008

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1365-1370

issue

11

eissn

0003-2409

issn

1365-2044

journal_volume

72

pub_type

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