Caruso Thomas J, Janik Luke S, Fuzaylov Gennadiy
Department of Anesthesia, Critical Care, and Pain Medicine, Shriners Hospital for Children, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Paediatr Anaesth. 2012 May;22(5):462-8. doi: 10.1111/j.1460-9592.2012.03795.x. Epub 2012 Jan 19.
There are approximately 10,000 pediatric burn survivors in the United States each year, many of whom will present for reconstructive surgery after severe burns in the head and neck (1). These recovered burn victims, who are beyond the acute phase of injury, often have significant scarring and contractures in the face, mouth, nares, neck, and chest, which can make airway management challenging and potentially lead to a 'cannot intubate, cannot ventilate' scenario (2). Although numerous cases have been presented in the literature on this topic (3-17), there are no comprehensive review articles on the unique challenges of airway management in the recovered pediatric burn patient with distorted airway anatomy. This article aims to provide a comprehensive review of airway management in such patients, focusing on challenges encountered during mask ventilation and tracheal intubation, as well as the role of surgical release of neck contractures to facilitate tracheal intubation. Lessons learned from all reported cases identified in a thorough literature search are incorporated into this review.
美国每年约有10000名小儿烧伤幸存者，其中许多人在头颈部严重烧伤后需要进行重建手术(1)。这些度过急性期的烧伤康复患者，面部、口腔、鼻孔、颈部和胸部往往有明显的瘢痕和挛缩，这可能使气道管理具有挑战性，并可能导致“无法插管、无法通气”的情况(2)。尽管文献中已报道了许多关于该主题的病例(3 - 17)，但尚无关于气道解剖结构扭曲的小儿烧伤康复患者气道管理独特挑战的综合综述文章。本文旨在全面综述此类患者的气道管理，重点关注面罩通气和气管插管过程中遇到的挑战，以及颈部挛缩手术松解在促进气管插管方面的作用。通过全面文献检索确定的所有报告病例中吸取的经验教训都纳入了本综述。
