Höhne C, Haack M, Machotta A, Kaisers U
Kliniken für Anästhesiologie und operative Intensivmedizin, Charitè-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin.
Anaesthesist. 2006 Jul;55(7):809-19; quiz 820. doi: 10.1007/s00101-006-1045-0.
Airway management in newborns, infants, and children is a challenge to anesthesia practitioners due to the particular anatomic and physiological characteristics. The larynx is positioned more cephalad, the occiput is protuberant, and the neck is short, which makes a special position for anesthesia induction necessary. The high respiratory frequency due to high oxygen demand and carbon dioxide production has to be taken into consideration during manual as well as mechanical ventilation. Different devices are available for airway management. Simple mask ventilation can be improved by a Wendl tube. The classic laryngeal mask can be recommended as a safe airway device in many indications, specifically in children with an upper respiratory airway infection. If intubation is indicated, an optimal size and position of the endotracheal tube has to be provided. Fiberoptic endotracheal intubation is recommended if a difficult airway is known or anticipated due to a craniofacial syndrome.
由于新生儿、婴儿和儿童特殊的解剖和生理特征，气道管理对麻醉医生来说是一项挑战。喉部位置更靠上，枕部突出，颈部较短，这使得麻醉诱导需要特殊体位。在人工通气和机械通气过程中，必须考虑到由于高氧需求和二氧化碳产生导致的高呼吸频率。有多种设备可用于气道管理。使用温德尔管可改善简易面罩通气。经典喉罩在许多情况下可作为安全的气道装置推荐使用，特别是在上呼吸道感染的儿童中。如果需要插管，必须确保气管导管尺寸合适且位置正确。如果已知或预计由于颅面综合征导致气道困难，推荐使用纤维光导气管插管。
