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Difficult or impossible facemask ventilation in children with difficult tracheal intubation:a retrospective analysis of the PeDI registry

Authors :
Garcia-Marcinkiewicz, Annery G.
Lee, Lisa K.
Haydar, Bishr
Fiadjoe, John E.
Matava, Clyde T.
Kovatsis, Pete G.
Peyton, James
Stein, Mary L.
Park, Raymond
Taicher, Brad M.
Templeton, Thomas W.
Bruins, Benjamin B.
Stricker, Paul
Laverriere, Elizabeth K.
Lockman, Justin L.
Struyk, Brian
Ward, Christopher
Nishisaki, Akira
Kodavatiganti, Ramesh
Daly Guris, Rodrigo J.
Sequera-Ramos, Luis
Teen, Mark S.
Oke, Ayodele
Hsu, Grace
Lingappan, Arul
Egbuta, Chinyere
Flynn, Stephen
Sarmiento, Lina
Goldfarb, Tally
Kiss, Edgar E.
Olomu, Patrick N.
Szmuk, Peter
Mireles, Sam
Murray, Andrea
Whyte, Simon
Jain, Ranu
Matuszczak, Maria
Hunyady, Agnes
Bosenberg, Adrian
Tham, See
Low, Daniel
Holmes, Christopher
Sabato, Stefan
Dalesio, Nicholas
Greenberg, Robert
Lucero, Angela
Reynolds, Paul
Lewis, Ian
Schrock, Charles
de Graaff, Jurgen C.
Garcia-Marcinkiewicz, Annery G.
Lee, Lisa K.
Haydar, Bishr
Fiadjoe, John E.
Matava, Clyde T.
Kovatsis, Pete G.
Peyton, James
Stein, Mary L.
Park, Raymond
Taicher, Brad M.
Templeton, Thomas W.
Bruins, Benjamin B.
Stricker, Paul
Laverriere, Elizabeth K.
Lockman, Justin L.
Struyk, Brian
Ward, Christopher
Nishisaki, Akira
Kodavatiganti, Ramesh
Daly Guris, Rodrigo J.
Sequera-Ramos, Luis
Teen, Mark S.
Oke, Ayodele
Hsu, Grace
Lingappan, Arul
Egbuta, Chinyere
Flynn, Stephen
Sarmiento, Lina
Goldfarb, Tally
Kiss, Edgar E.
Olomu, Patrick N.
Szmuk, Peter
Mireles, Sam
Murray, Andrea
Whyte, Simon
Jain, Ranu
Matuszczak, Maria
Hunyady, Agnes
Bosenberg, Adrian
Tham, See
Low, Daniel
Holmes, Christopher
Sabato, Stefan
Dalesio, Nicholas
Greenberg, Robert
Lucero, Angela
Reynolds, Paul
Lewis, Ian
Schrock, Charles
de Graaff, Jurgen C.
Source :
Garcia-Marcinkiewicz , A G , Lee , L K , the PeDI Collaborative , Haydar , B , Fiadjoe , J E , Matava , C T , Kovatsis , P G , Peyton , J , Stein , M L , Park , R , Taicher , B M , Templeton , T W , Bruins , B B , Stricker , P , Laverriere , E K , Lockman , J L , Struyk , B , Ward , C , Nishisaki , A , Kodavatiganti , R , Daly Guris , R J , Sequera-Ramos , L , Teen , M S , Oke , A , Hsu , G , Lingappan , A , Egbuta , C , Flynn , S , Sarmiento , L , Goldfarb , T , Kiss , E E , Olomu , P N , Szmuk , P , Mireles , S , Murray , A , Whyte , S , Jain , R , Matuszczak , M , Hunyady , A , Bosenberg , A , Tham , S , Low , D , Holmes , C , Sabato , S , Dalesio , N , Greenberg , R , Lucero , A , Reynolds , P , Lewis , I , Schrock , C & de Graaff , J C 2023 , ' Difficult or impossible facemask ventilation in children with difficult tracheal intubation : a retrospective analysis of the PeDI registry ' , British Journal of Anaesthesia , vol. 131 , no. 1 , pp. 178-187 .
Publication Year :
2023

Abstract

Background: Difficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic factors are associated with difficult mask ventilation in paediatric patients who also had difficult tracheal intubation. Methods: We queried a multicentre registry for children who experienced “difficult” or “impossible” facemask ventilation. Patient and case factors known before mask ventilation attempt were included for consideration in this regularised multivariable regression analysis. Incidence of complications, and frequency and efficacy of rescue placement of a supraglottic airway device were also tabulated. Changes in quality of mask ventilation after injection of a neuromuscular blocking agent were assessed. Results: The incidence of difficult mask ventilation was 9% (483 of 5453 patients). Infants and patients having increased weight, being less than 5th percentile in weight for age, or having Treacher-Collins syndrome, glossoptosis, or limited mouth opening were more likely to have difficult mask ventilation. Anaesthetic induction using facemask and opioids was associated with decreased risk of difficult mask ventilation. The incidence of complications was significantly higher in patients with “difficult” mask ventilation than in patients without. Rescue placement of a supraglottic airway improved ventilation in 71% (96 of 135) of cases. Administration of neuromuscular blocking agents was more frequently associated with improvement or no change in quality of ventilation than with worsening. Conclusions: Certain abnormalities on physical examination should increase suspicion of possible difficult facemask ventilation. Rescue use of a supraglottic airway device in children with difficult or impossible mask ventilation should be strongly considered.

Details

Database :
OAIster
Journal :
Garcia-Marcinkiewicz , A G , Lee , L K , the PeDI Collaborative , Haydar , B , Fiadjoe , J E , Matava , C T , Kovatsis , P G , Peyton , J , Stein , M L , Park , R , Taicher , B M , Templeton , T W , Bruins , B B , Stricker , P , Laverriere , E K , Lockman , J L , Struyk , B , Ward , C , Nishisaki , A , Kodavatiganti , R , Daly Guris , R J , Sequera-Ramos , L , Teen , M S , Oke , A , Hsu , G , Lingappan , A , Egbuta , C , Flynn , S , Sarmiento , L , Goldfarb , T , Kiss , E E , Olomu , P N , Szmuk , P , Mireles , S , Murray , A , Whyte , S , Jain , R , Matuszczak , M , Hunyady , A , Bosenberg , A , Tham , S , Low , D , Holmes , C , Sabato , S , Dalesio , N , Greenberg , R , Lucero , A , Reynolds , P , Lewis , I , Schrock , C & de Graaff , J C 2023 , ' Difficult or impossible facemask ventilation in children with difficult tracheal intubation : a retrospective analysis of the PeDI registry ' , British Journal of Anaesthesia , vol. 131 , no. 1 , pp. 178-187 .
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1383760544
Document Type :
Electronic Resource