Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, India.
Paediatr Anaesth. 2022 Oct;32(10):1169-1171. doi: 10.1111/pan.14523. Epub 2022 Jul 13.
Tracheoesophageal fistula offers concrete difficulties for anesthesiologists, which comprise associated congenital anomalies and more importantly the problems concerning ventilation and oxygenation. Among all the types of tracheoesophageal fistula, ventilatory problems are frequently encountered with type C fistula. Effective ventilation can be a challenge in such cases where the endotracheal tube invariably ventilates the fistula causing stomach inflation and respiratory compromise. Thorough knowledge and experience are of utmost importance when it comes to the successful airway management and better survival of neonates undergoing tracheoesophageal fistula repair. We report a case of a 3-day-old neonate, diagnosed with type C tracheoesophageal fistula and esophageal atresia posted for thoracoscopic repair. We want to highlight our experience of percutaneous needle gastrostomy done using an intravenous cannula, as a rescue measure for stomach decompression, to manage life-threatening hypoxia.
气管食管瘘给麻醉医生带来了具体的困难,包括相关的先天性异常,更重要的是通气和氧合问题。在所有类型的气管食管瘘中,C 型瘘常伴有通气问题。在这种情况下,由于气管内导管始终会通过瘘管通气,导致胃膨胀和呼吸窘迫,有效的通气可能是一个挑战。在进行气管食管瘘修复的新生儿的气道管理和更好的生存中,彻底的知识和经验是至关重要的。我们报告了一例 3 天大的新生儿,诊断为 C 型气管食管瘘和食管闭锁,行胸腔镜修复。我们想强调我们使用静脉套管针行经皮针穿刺胃造口术的经验,作为一种挽救措施,用于胃减压,以应对危及生命的缺氧。