- MeSH
- Esophagus injuries MeSH
- Intubation, Intratracheal * classification methods nursing MeSH
- Intubation classification methods MeSH
- Cannula classification MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Carbon Dioxide analysis MeSH
- Trachea injuries MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Review MeSH
Introduction: During the last 40 years equipment has been improved with smaller instruments and sufficient size working channels. This has ensured that bronchoscopy offers therapeutic and interventional options.Areas covered: We provide a review of recent advances and clinical challenges in pediatric bronchoscopy. This includes single-use bronchoscopes, endobronchial ultrasound, and cryoprobe. Bronchoscopy in persistent preschool wheezing and asthma is included. The indications for interventional bronchoscopy have amplified and included balloon dilatation, endoscopic intubation, the use of airway stents, whole lung lavage, closing of fistulas and air leak, as well as an update on removal of foreign bodies. Others include the use of laser and microdebrider in airway surgery. Experience with bronchoscope during the COVID-19 pandemic has been included in this review. PubMed was searched for articles on pediatric bronchoscopy, including rigid bronchoscopy as well as interventional bronchoscopy with a focus on reviewing literature in the past 5 years.Expert opinion: As the proficiency of pediatric interventional pulmonologists continues to grow more interventions are being performed. There is a scarcity of published evidence in this field. Courses for pediatric interventional bronchoscopy need to be developed. The COVID-19 experience resulted in safer bronchoscopy practice for all involved.
- MeSH
- Asthma MeSH
- Bronchoscopy methods MeSH
- Bronchoscopes * MeSH
- Foreign Bodies surgery MeSH
- COVID-19 surgery MeSH
- Child MeSH
- Intubation methods MeSH
- Humans MeSH
- Child, Preschool MeSH
- Stents * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Child, Preschool MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- MeSH
- Intubation * methods standards MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Practice Guideline MeSH
Anestezie představuje složitou situaci v léčbě pacientů s nervosvalovými chorobami. Obavy z prolomení křehké rovnováhy mohou vést k odkládání potřebných zákroků na jedné straně a závažným rizikům při nesprávném postupu na straně druhé. Myastenie je onemocnění, kde nehrozí riziko maligní hypertermie, je zde změněná citlivost k periferním myorelaxanciím. V premedikaci se raději vyhýbáme benzodiazepinům a po zákroku vždy pacienta umístíme na monitorované lůžko s možností umělé ventilace. U svalových dystrofií a myotonické dystrofie nepodáváme suxamethonium a nepoužíváme volatilní plyny pro riziko rabdomyolýzy. Taktéž u této skupiny není riziko maligní hypertermie. Maligní hypertermie je farmakogenetická porucha, která se manifestuje abnormální hypermetabolickou odpovědí při expozici halogenovanými inhalačními anestetiky (halothan, isofluran, desflurane, sevofluran) nebo periferními svalovými relaxanciemi depolarizačního typu (suxamethonium). Vzácně může vzniknout i po fyzické, nadměrné stresové nebo tepelné zátěži. Souvisí s elektromechanickým spřažením a nejčastěji vzniká při mutacích v ryanodinovém receptoru, vzácně při některých jiných mutacích v genech, které souvisejí s metabolizmem kalcia.
fragile balance can lead to postponing of necessary interventions, but on the other hand, it can lead to serious risks with improper approaches. Myasthenia is a disease where there is no risk of malignant hyperthermia, and there is an altered sensitivity to peripheral myorelaxants. We prefer to avoid benzodiazepines as a premedication, and after the procedure we always place the patient on a monitored bed with the possibility of artificial ventilation. We do not give suxamethonium to muscular dystrophy and myotonic dystrophy patients and do not use volatile gases due to risk of rhabdomyolysis. There is also no risk of malignant hyperthermia in this group. Malignant hyperthermia is a pharmacogenetic disorder manifested by abnormal hypermetabolic response when exposed to halogenated inhalation anesthetics (halothane, isoflurane, desflurane, sevoflurane) or peripheral muscle relaxants of the depolarizing type (suxamethonium). It can rarely occur even after physical, excessive or heat stress. It is associated with electromechanical coupling and most often occurs with mutations in the ryanodine receptor, but rarely with some other mutations in the genes that are related to calcium metabolism.
- MeSH
- Anesthesia * methods adverse effects MeSH
- gamma-Cyclodextrins therapeutic use MeSH
- Intubation methods MeSH
- Humans MeSH
- Malignant Hyperthermia diagnosis drug therapy pathology MeSH
- Myasthenia Gravis drug therapy physiopathology MeSH
- Myotonic Dystrophy complications physiopathology MeSH
- Neuromuscular Blockade MeSH
- Intraoperative Care MeSH
- Postoperative Care MeSH
- Preoperative Care MeSH
- Preanesthetic Medication MeSH
- Sugammadex MeSH
- Muscular Dystrophies * complications physiopathology MeSH
- Check Tag
- Humans MeSH
TotalTrack VLM je nová pomůcka k zajištění průchodnosti dýchacích cest u pacientů s předpokládanou obtížnou intubací. Jedná se o intubační laryngeální masku druhé generace, která má přídatný kanál na drenáž žaludečního obsahu. Po připojení k optickému kabelu umožní zobrazení vchodu do hrtanu. Současně lze provádět po celou dobu intubace oxygenaci a ventilaci pacienta. Prezentujeme první dva případy tracheální intubace pomocí TotalTrack VLM na našem pracovišti. První pacient měl antepozici hrtanu se zvětšenou epiglottis a byla nutná repozice masky, u druhé pacientky proběhla intubace na první pokus s použitím bougie.
TotalTrack VLM is a new tool for airway management in patients with anticipated difficult intubation. This device is a second generation intubating laryngeal mask with an additional channel for drainage of the gastric contents. The mask allows direct visualization of the larynx using an optical cable. Simultaneously, both oxygenation and ventilation may be provided during attempts for tracheal intubation. We present the first two cases of tracheal intubation using TotalTrack VLM in our department. The first patient had anterior larynx malposition with enlarged epiglottis and repositiong of the mask was required, while the second patient was intubated at the first attempt with the use of a gum-elastic bougie.
- Keywords
- TotalTrack VLM,
- MeSH
- Pulmonary Disease, Chronic Obstructive MeSH
- Intubation methods MeSH
- Laryngeal Masks * utilization MeSH
- Humans MeSH
- Prostatic Neoplasms surgery MeSH
- Nephrectomy methods nursing MeSH
- Perioperative Care methods MeSH
- Prostatectomy methods nursing MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Cíl: Cílem práce je srovnání výsledků léčby monokanalikulární (MI) a bikanalikulární (BI) silikonové intubace při vrozené neprůchodnosti slzovodu (VNS). Metodika: MI dolním kanálkem a BI byly provedeny v celkové anestézii u dětí s VNS ve věku 7–24 měsíců. K operaci byly indikovány děti po neúspěšné konzervativní léčbě a 2 a více sondážích. Kanyly byly odstraněny za 3 měsíce po intubaci a výsledky byly hodnoceny 6 měsíců po intubaci. Výsledky: Bylo provedeno 139 MI u 114 dětí a 119 BI u 88 dětí. Léčebný efekt 6 měsíců po intubaci je u MI 135/139 (97,1 %), u BI 114/119 (95,8 %) a mezi MI a BI nebyl zjištěn statisticky významný rozdíl (p = 0,737). Závěr: Intubace silikonovou kanylou při VNS je účinná léčebná metoda bez rozdílu v léčebném efektu mezi MI a BI. Klíčová slova: vrozená neprůchodnost slzovodu (VNS), monokanalikulární intubace (MI), bikanalikulární intubace (BI)
Purpose: To compare the success rate of monocanalicular (MI) and bicanalicular intubation (BI) in congenital nasolacrimal duct obstruction (CNLDO). Methods: MI through the inferior canaliculus and BI were performed under general anaesthesia in children from 7 to 24 months old with CNLDO. Only children after unsuccessful conservative therapy and two and more probings were included in the study. The tubes were removed 3 months after intubation and the therapeutic success was evaluated 6 months after intubation. Results: There were performed 139 MI in 114 children and 119 BI in 88 children. The success rate 6 months after intubation is 135/139 (97.1%) in MI, 114/119 (95.8%) in BI and the difference in therapeutic results between MI and BI is not significant (p = 0.737). Conclusion: Silicone intubation is an effective procedure for treating CNLDO without difference in therapeutic success between MI and BI. Key words: congenital nasolacrimal duct obstruction (CNLDO), monocanalicular intubation (MI), bicanalicular intubation (BI)
- MeSH
- Respiratory Aspiration prevention & control therapy MeSH
- Respiratory Therapy * methods standards MeSH
- Diagnostic Techniques, Respiratory System standards instrumentation MeSH
- Airway Extubation methods nursing MeSH
- Intubation methods nursing MeSH
- Intensive Care Units standards organization & administration MeSH
- Respiratory Care Units * methods standards MeSH
- Humans MeSH
- Nervous System Diseases diagnosis complications therapy MeSH
- Ventilator Weaning methods standards nursing MeSH
- Reference Books, Medical MeSH
- Respiratory Insufficiency complications prevention & control therapy MeSH
- Tracheostomy methods nursing MeSH
- Continuous Positive Airway Pressure methods MeSH
- Respiration, Artificial * methods standards instrumentation MeSH
- Intermittent Positive-Pressure Ventilation methods MeSH
- Positive-Pressure Respiration methods MeSH
- Check Tag
- Humans MeSH
