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[Difficult Airway Management in a Low Birth Weight Infant Using an Upper Gastrointestinal Endoscope]

Yoko Sada, Akihiro Taniguchi, Yoshikazu Miyamoto

    Masui. the Japanese Journal of Anesthesiology
    |October 24, 2018
    PubMed

    Insights

    An upper gastrointestinal endoscope successfully enabled tracheal intubation in a low birth weight infant with a difficult airway. This approach provided clear visualization, overcoming challenges from congenital anomalies and secretions.

    Area of Science:

    • Pediatric Anesthesiology
    • Neonatal Intensive Care
    • Medical Device Technology

    Background:

    • Difficult airway management in neonates presents significant challenges.
    • Congenital anomalies like Goldenhar syndrome can complicate airway visualization.
    • Standard intubation techniques may be insufficient in complex neonatal cases.

    Observation:

    • A 1.8 kg neonate with micrognathia and facial clefts required surgical repair.
    • Direct laryngoscopy and the Pentax Airway Scope failed to visualize the larynx.
    • Copious secretions and a narrow oral cavity further impeded intubation attempts.

    Findings:

    • An upper gastrointestinal endoscope, with insufflation and suction, provided excellent visualization of the vocal cords.
    • Successful nasotracheal intubation was achieved using the gastrointestinal endoscope.
    • This device proved effective in a case of Cormack-Lehane grade 4 difficulty.

    Implications:

    • Upper gastrointestinal endoscopy is a viable rescue technique for neonatal difficult airway intubation.
    • This method offers a valuable alternative when conventional tools fail.
    • Enhanced visualization and secretion management are key benefits for neonatal airway procedures.

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