Reber Adrian
Department of Anaesthesiology and Intensive Care Medicine, Hospital of Zollikerberg, Zollikerberg, Switzerland.
Curr Opin Anaesthesiol. 2004 Jun;17(3):217-21. doi: 10.1097/00001503-200406000-00004.
Paediatric airway problems are among the most challenging clinicians will face throughout their career. Clinicians unaccustomed to dealing with children tend to approach paediatric airway problems with a disproportionate amount of fear that is often engendered by inexperience, and this fear can interfere with performance. Understanding the differences between the infant upper airway and the airway in older children is important to properly manage the airway.
Airway manoeuvres and the important tools used for airway management, such as the laryngeal mask airway, the fibreoptic bronchoscope and the new intubating fibreoptic stylets for managing the difficult paediatric airway, have been elucidated in the literature.
Planning, preparation, and teamwork are essential, and must include an awareness of problems that might occur in the recovery period. Special clinical situations such as management of the child with impending airway obstruction are discussed.
儿科气道问题是临床医生在整个职业生涯中面临的最具挑战性的问题之一。不习惯于处理儿童问题的临床医生在面对儿科气道问题时,往往会因缺乏经验而产生过度的恐惧,这种恐惧会影响其表现。了解婴儿上气道与大龄儿童气道之间的差异对于正确管理气道很重要。
文献中已阐明了气道操作以及用于气道管理的重要工具,如喉罩气道、纤维支气管镜和用于处理儿科困难气道的新型光纤插管探条。
规划、准备和团队协作至关重要,并且必须包括对恢复期可能出现的问题的认识。文中讨论了特殊临床情况,如即将发生气道阻塞患儿的管理。