We can help make better decisions ahead of time and probably spend less time in the operating room with a child under anesthesia if we have a good look at what that child's airway looks like before we start.
We can help make better decisions ahead of time and probably spend less time in the operating room with a child under anesthesia if we have a good look at what that child's airway looks like before we start.
QUAD #7 Anesthesia for Thoracoscopic Techniques with Dr. Nathaniel Tighe
▶Ep 20 · 0:53
quoteBirth history is really important and how big the child is.↗
▶Ep 20 · 0:53
clinicalBirth history and patient size are important preoperative considerations for esophageal atresia repair.↗
▶Ep 20 · 0:57
clinicalPhysiologic status from ventilation and cardiac standpoints is particularly important in preoperative assessment.↗
▶Ep 20 · 1:13
clinicalPreoperative visualization of the child's airway allows better decision-making and potentially less time under anesthesia.↗
▶Ep 20 · 1:13
quoteWe can help make better decisions ahead of time and probably spend less time in the operating room with a child under anesthesia if we have a good look at what that child's airway looks like before we start.↗
▶Ep 20 · 1:33
quoteAkinesis or keeping the kids still can be very challenging in these small children, especially when intraoperative neuromonitoring is involved.↗
▶Ep 20 · 1:33
clinicalAkinesis (keeping children still) can be very challenging in small children, especially when intraoperative neuromonitoring is involved.↗
▶Ep 20 · 2:25
clinicalIntraoperative neuromonitoring precludes the use of neuromuscular blocking drugs like rocuronium and vecuronium.↗
▶Ep 20 · 2:25
quoteAs far as the anesthetic goes, it precludes our use of neuromuscular blocking drugs like urouronium, Becuronium, and others.↗
▶Ep 20 · 3:00
clinicalPatients with compliance abnormalities often require higher peak inspiratory or mean airway pressures, resulting in the need for very high insufflation pressures.↗
▶Ep 20 · 3:20
clinicalLung isolation utility is restricted by patient size and airway anatomy and requires expertise and specialized equipment.↗
▶Ep 20 · 3:34
clinicalThree dimensions are important for lung isolation: tracheal diameter (particularly AP diameter), bronchial diameters, and the length of the right main stem bronchus between carina and right upper lobe takeoff.↗
▶Ep 20 · 3:34
quoteThere's 3 dimensions that are really important.↗
▶Ep 20 · 4:05
clinicalRegular endotracheal tube is the most common device for lung isolation in neonates because it is relatively straightforward to mainstem into the left bronchus, which has a good landing zone for the balloon.↗
▶Ep 20 · 4:05
quoteRegular old endotracheal tube is probably the most common in neonates because it's relatively straightforward to mainstem.↗
▶Ep 20 · 4:24
clinicalBronchial blockers or Fogarty catheters require enough space between the carina and right upper lobe takeoff for balloon placement.↗
▶Ep 20 · 4:39
clinicalIn kids with a pig bronchus, bronchial blocker placement becomes very difficult and may require selective lobar blockade.↗
▶Ep 20 · 4:58
clinicalBronchial blockers can be helpful in kids with abnormal parenchyma when higher ventilatory pressures are needed but higher insufflation pressures should be avoided.↗
▶Ep 20 · 5:55
quoteUnrepaired single ventricle kids are really sensitive to changes in their ventilation.↗
▶Ep 20 · 5:55
clinicalUnrepaired single ventricle patients are sensitive to changes in ventilation because they can have swings in circulation direction based on pulmonary vascular resistance.↗
▶Ep 20 · 6:18
clinicalInsufflation causes changes in preload, and patients with passive pulmonary circulations are particularly sensitive to this insufflation.↗
QUAD #7 Anesthesia for Thoracoscopic Techniques with Dr. Nathaniel Tighe
▶Ep 10 · 0:53
quoteBirth history is really important and how big the child is.↗
▶Ep 10 · 0:53
clinicalBirth history and patient size are important preoperative considerations for esophageal atresia repair.↗
▶Ep 10 · 0:57
clinicalPhysiologic status from ventilation and cardiac standpoints is particularly important in preoperative assessment.↗
▶Ep 10 · 1:13
clinicalPreoperative visualization of the child's airway allows better decision-making and potentially less time under anesthesia.↗
▶Ep 10 · 1:13
quoteWe can help make better decisions ahead of time and probably spend less time in the operating room with a child under anesthesia if we have a good look at what that child's airway looks like before we start.↗
▶Ep 10 · 1:33
quoteAkinesis or keeping the kids still can be very challenging in these small children, especially when intraoperative neuromonitoring is involved.↗
▶Ep 10 · 1:33
clinicalAkinesis (keeping children still) can be very challenging in small children, especially when intraoperative neuromonitoring is involved.↗
▶Ep 10 · 2:25
clinicalIntraoperative neuromonitoring precludes the use of neuromuscular blocking drugs like rocuronium and vecuronium.↗
▶Ep 10 · 2:25
quoteAs far as the anesthetic goes, it precludes our use of neuromuscular blocking drugs like urouronium, Becuronium, and others.↗
▶Ep 10 · 3:00
clinicalPatients with compliance abnormalities often require higher peak inspiratory or mean airway pressures, resulting in the need for very high insufflation pressures.↗
▶Ep 10 · 3:20
clinicalLung isolation utility is restricted by patient size and airway anatomy and requires expertise and specialized equipment.↗
▶Ep 10 · 3:34
clinicalThree dimensions are important for lung isolation: tracheal diameter (particularly AP diameter), bronchial diameters, and the length of the right main stem bronchus between carina and right upper lobe takeoff.↗
▶Ep 10 · 3:34
quoteThere's 3 dimensions that are really important.↗
▶Ep 10 · 4:05
clinicalRegular endotracheal tube is the most common device for lung isolation in neonates because it is relatively straightforward to mainstem into the left bronchus, which has a good landing zone for the balloon.↗
▶Ep 10 · 4:05
quoteRegular old endotracheal tube is probably the most common in neonates because it's relatively straightforward to mainstem.↗
▶Ep 10 · 4:24
clinicalBronchial blockers or Fogarty catheters require enough space between the carina and right upper lobe takeoff for balloon placement.↗
▶Ep 10 · 4:39
clinicalIn kids with a pig bronchus, bronchial blocker placement becomes very difficult and may require selective lobar blockade.↗
▶Ep 10 · 4:58
clinicalBronchial blockers can be helpful in kids with abnormal parenchyma when higher ventilatory pressures are needed but higher insufflation pressures should be avoided.↗
▶Ep 10 · 5:55
quoteUnrepaired single ventricle kids are really sensitive to changes in their ventilation.↗
▶Ep 10 · 5:55
clinicalUnrepaired single ventricle patients are sensitive to changes in ventilation because they can have swings in circulation direction based on pulmonary vascular resistance.↗
▶Ep 10 · 6:18
clinicalInsufflation causes changes in preload, and patients with passive pulmonary circulations are particularly sensitive to this insufflation.↗