儿科气道和气管插管概念的演变

Tariq Wani, M. Sundaram, Joseph Tobias
{"title":"儿科气道和气管插管概念的演变","authors":"Tariq Wani, M. Sundaram, Joseph Tobias","doi":"10.4103/jpcc.jpcc_91_23","DOIUrl":null,"url":null,"abstract":"The tenets of airway anatomy and management continue to be reevaluated and challenged as our knowledge increases. This has led to a better understanding of the pediatric airway and its critical differences from adults. This evolving understanding of the pediatric airway size and shape has significant clinical implications to airway management in the operating room, emergency department, and the intensive care unit. The first significant change in clinical practice was the transition to the routine use of cuffed endotracheal tubes (ETTs). This was facilitated by the availability of the Microcuff® with a polyurethane cuff and a redesigned position of the cuff on the shaft of the ETT without the Murphy's eye. Additional attention to the design and the location of the cuff on the ETT may be necessary as well as to markings for depth of intubation on the shaft of the ETT to ensure that the cuff is placed fully below the cricoid ring following endotracheal intubation. Inflation of the cuff with high intracuff pressures within the cricoid ring may compromise perfusion of the tracheal mucosa and result in airway injury.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":"47 1","pages":"265 - 268"},"PeriodicalIF":0.0000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evolution of the concepts of pediatric airway and endotracheal intubation\",\"authors\":\"Tariq Wani, M. Sundaram, Joseph Tobias\",\"doi\":\"10.4103/jpcc.jpcc_91_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The tenets of airway anatomy and management continue to be reevaluated and challenged as our knowledge increases. This has led to a better understanding of the pediatric airway and its critical differences from adults. This evolving understanding of the pediatric airway size and shape has significant clinical implications to airway management in the operating room, emergency department, and the intensive care unit. The first significant change in clinical practice was the transition to the routine use of cuffed endotracheal tubes (ETTs). This was facilitated by the availability of the Microcuff® with a polyurethane cuff and a redesigned position of the cuff on the shaft of the ETT without the Murphy's eye. Additional attention to the design and the location of the cuff on the ETT may be necessary as well as to markings for depth of intubation on the shaft of the ETT to ensure that the cuff is placed fully below the cricoid ring following endotracheal intubation. Inflation of the cuff with high intracuff pressures within the cricoid ring may compromise perfusion of the tracheal mucosa and result in airway injury.\",\"PeriodicalId\":34184,\"journal\":{\"name\":\"Journal of Pediatric Critical Care\",\"volume\":\"47 1\",\"pages\":\"265 - 268\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Critical Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jpcc.jpcc_91_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Critical Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jpcc.jpcc_91_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

随着我们知识的增长,气道解剖和管理的原则不断受到重新评估和挑战。这使我们对小儿气道及其与成人气道的重要区别有了更深入的了解。对小儿气道大小和形状不断发展的认识对手术室、急诊科和重症监护室的气道管理具有重要的临床意义。临床实践中的第一个重大变化是向常规使用带袖带的气管导管 (ETT) 过渡。聚氨酯充气罩囊 Microcuff® 的出现以及重新设计的充气罩囊在 ETT 轴上的位置(没有墨菲眼)为这一转变提供了便利。可能有必要对 ETT 上充气罩囊的设计和位置以及 ETT 轴上的插管深度标记给予更多关注,以确保在气管插管后将充气罩囊完全置于环甲膜环下方。充气罩囊在环状环内压力过高时可能会影响气管粘膜的灌注并导致气道损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evolution of the concepts of pediatric airway and endotracheal intubation
The tenets of airway anatomy and management continue to be reevaluated and challenged as our knowledge increases. This has led to a better understanding of the pediatric airway and its critical differences from adults. This evolving understanding of the pediatric airway size and shape has significant clinical implications to airway management in the operating room, emergency department, and the intensive care unit. The first significant change in clinical practice was the transition to the routine use of cuffed endotracheal tubes (ETTs). This was facilitated by the availability of the Microcuff® with a polyurethane cuff and a redesigned position of the cuff on the shaft of the ETT without the Murphy's eye. Additional attention to the design and the location of the cuff on the ETT may be necessary as well as to markings for depth of intubation on the shaft of the ETT to ensure that the cuff is placed fully below the cricoid ring following endotracheal intubation. Inflation of the cuff with high intracuff pressures within the cricoid ring may compromise perfusion of the tracheal mucosa and result in airway injury.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
42
审稿时长
8 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信