From the Department of Anesthesiology, Aichi Children's Health and Medical Center, Obu City, Japan.
Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
A A Pract. 2024 Jul 24;18(7):e01829. doi: 10.1213/XAA.0000000000001829. eCollection 2024 Jul 1.
Accurate diagnosis and optimal management of sudden intraoperative ventilatory failure is crucial in children. Herein, we report the case of a newborn who underwent pacemaker implantation immediately after birth via cesarean delivery. The vernix caseosa caused a partial tracheal obstruction and was dislodged during tracheal tube suctioning, leading to complete obstruction of the tracheal tube. Diagnosis of tracheal tube obstruction was challenging because the obstruction occurred immediately after airway suctioning, which is performed to rule out tracheal tube obstruction. Anesthesiologists must consider airway obstruction from high-viscosity vernix caseosa as a possibility immediately after airway suctioning in newborns.
准确诊断和优化管理新生儿术中突发呼吸衰竭至关重要。在此，我们报告了一例新生儿在经剖宫产娩出后即刻行起搏器植入术的病例。胎脂导致部分气管阻塞，并在气管导管吸引时脱落，导致气管导管完全阻塞。气管导管阻塞的诊断具有挑战性，因为阻塞发生在气道吸引之后，而气道吸引是为了排除气管导管阻塞。麻醉师必须考虑到，在新生儿进行气道吸引后，高粘度胎脂可能导致气道阻塞。
