选修儿科光纤插管指南
Summary
我们描述的指引，以执行在儿科患者安全及有效率的选修纤维插管，同时保持自主呼吸。
Abstract
光纤插管在小儿患者往往是必需的，尤其是在困难的航空公司综合征患者即皮埃尔罗宾综合症。小宝宝将饱和度非常快，如果通风中断，主要是高代谢率。我们描述指引执行一个安全的纤维插管，而整个过程中保持自主呼吸。需要使用泵异丙酚，芬太尼，格隆，红色橡胶导管，金属insuflation钩，afrin，润滑剂和利多卡因喷雾的步骤所示。
Protocol
1。设备的准备工作 MED为融合异丙酚输注泵经鼻管加热床垫下放置将相机连接到范围和检查的方向三个动作影响范围，通过查看： 输入和输出。 轮换使用两手机动。 屈曲和扩大范围的一角。 2。附加设备芬太尼0.5〜1.0微克/公斤 12F红色橡胶吸痰管格隆0.1-0.2毫克金属腹钩 Afrin鼻腔喷?…
Discussion
光纤在儿科患者困难气道插管可能是一个具有挑战性的任务1,2和颅面dysmorphisms存在气管插管3带来了额外的挑战。儿科患者在执行此过程比成年人在儿童患者，使操纵纤维更困难，因为任何小的firberoptic范围内的尖端运动运行接触黏膜的风险，主要是因为较小的航空公司，它是比较困难的鼻咽部/气管。这将防止呼吸道良好的可视化，并导致纤维的范围，以获得更好的图像执行来回?…
Divulgations
The authors have nothing to disclose.
Acknowledgements
这项工作是由美国密歇根儿童医院麻醉科部门。
Materials
- Med fusion pump for propofol infusion
- Fentanyl 0.5-1.0 mcg/kg
- 12F red rubber suction catheter
- Glycopyrrolate 0.1-0.2 mg
- Metal insufflation hook
- Afrin nasal spray
- Lubricant
- Lidocaine 2% or 4% for spraying nares
References
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Tags
Elective Pediatric Fiberoptic IntubationGuidelinesDifficult AirwaysSyndromic PatientsPierre Robin SyndromeDesaturationVentilation InterruptionHigh Metabolic RateSafe ProcedureSpontaneous BreathingPropofol PumpFentanylGlycopyrrolateRed Rubber CatheterMetal Insufflation HookAfrinLubricantLidocaine Spray
Citer Cet Article
Kaddoum, R. N., Ahmed, Z., D’Augsutine, A. A., Zestos, M. M. Guidelines for Elective Pediatric Fiberoptic Intubation. J. Vis. Exp. (47), e2364, doi:10.3791/2364 (2011).