Document Detail


New airway device for ventilation and monitoring in pediatric patients undergoing MRI study.
MedLine Citation:
PMID:  22187339     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
A method of administering continuous positive airway pressure via a new airway device to prevent upper airway obstruction and preserve spontaneous respiration under total intravenous anesthesia has been adapted for children undergoing deep sedation for MRI studies. Presented herein is a retrospective study of 45 pediatric patients, ages 5 months to 7 years, who underwent an MRI study under general anesthesia using a modified nasal vestibule airway (NVA(®)), a pressure-sealing nasal cannula that can be used in conjunction with an anesthesia circuit to deliver nasal-CPAP during anesthesia. After inhalation induction of anesthesia with sevoflurane, an intravenous infusion of propofol was used to maintain anesthesia. A NVA(®), downsized to fit the nasal vestibule of the child, was inserted, taped in place, and connected to a Mapleson F circuit. An extra long extension of corrugated tubing, a SNOR-SCOPE(®) circuit stethoscope, and the fluctuations of a reservoir bag allowed monitoring and assisted respirations from the foot of the MRI table. Other monitors included CO(2) sampled at the mouth and the fluctuations of a PORTEX(®) disposable pressure gauge. The records of 45 pediatric patients were reviewed. No significant anesthesia complications were found. A new approach is offered to maintain airway patency, monitoring and spontaneous respirations in pediatric patients undergoing MRI study. This pressure-sealing nasal cannula can deliver CPAP under anesthesia while avoiding the requirement of an invasive airway and facilitating additional monitoring and control not possible with an ordinary nasal cannula. This NVA may be used in other locations in pediatric patients where endotracheal intubation is not necessary or impossible.
Authors:
Alexander S Matveevskii; Mohamed Mahmoud
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-21
Journal Detail:
Title:  Journal of clinical monitoring and computing     Volume:  -     ISSN:  1573-2614     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806357     Medline TA:  J Clin Monit Comput     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2001, Cincinnati, OH, 45209, USA, alexander.matveevskii@cchmc.org.
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