Related Experiment Video
Updated: Jun 29, 2025
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Airway Management of Critically Ill Pediatric Patients with Suspected or Proven Coronavirus Disease 2019 Infection:
Franco Díaz1,2,3, Pablo Cruces1,3,4
1Unidad de Paciente Crítico Pediátrico, Hospital el Carmen de Maipú, Santiago, Chile.
Insights
Advanced airway management, including endotracheal intubation, is critical for critically ill children with COVID-19. This article details the unique challenges and considerations for pediatric intubation during the pandemic.
Area of Science:
- Pediatric Critical Care Medicine
- Infectious Diseases
- Respiratory Medicine
Background:
- Critically ill children with COVID-19 require advanced airway management, particularly endotracheal intubation, for conditions like shock or respiratory failure.
- Pediatric intubation presents unique physiological and pathophysiological challenges, amplified by airborne pathogens such as SARS-CoV-2.
- Existing COVID-19 guidelines offer limited in-depth guidance on endotracheal intubation for acutely ill children.
Purpose of the Study:
- To highlight the specific challenges and potential pitfalls of endotracheal intubation in critically ill pediatric patients with COVID-19.
- To provide a focused discussion on advanced airway management strategies relevant to pediatric COVID-19 cases.
- To address the gap in current literature regarding pediatric endotracheal intubation during the COVID-19 pandemic.
Main Methods:
- Review and synthesis of existing literature on pediatric airway management.
- Analysis of physiological and pathophysiological factors influencing pediatric intubation in the context of COVID-19.
- Discussion of clinical considerations and potential complications specific to pediatric endotracheal intubation during the pandemic.
Main Results:
- Endotracheal intubation in critically ill children with COVID-19 is complex due to pediatric-specific physiology and disease pathophysiology.
- Airborne pathogen presence, like SARS-CoV-2, adds significant risk to the intubation procedure.
- Current pediatric COVID-19 guidelines lack detailed recommendations for endotracheal intubation.
Conclusions:
- Advanced airway management, specifically endotracheal intubation, is a critical yet challenging aspect of pediatric intensive care unit care for COVID-19 patients.
- There is a need for more detailed, evidence-based guidelines addressing the nuances of endotracheal intubation in critically ill children during infectious disease outbreaks.
- Understanding the unique challenges is essential for optimizing patient outcomes and ensuring safe intubation practices in pediatric COVID-19 cases.
Abstract:
Advanced airway management of critically ill children is crucial for novel coronavirus disease 2019 (COVID-19) management in the pediatric intensive care unit, whether due to shock and hemodynamic collapse or acute respiratory failure. In this article, intubation is challenging due to the particularities of children's physiology and the underlying disease's pathophysiology, especially when an airborne pathogen, like COVID-19, is present. Unfortunately, published recommendations and guidelines for COVID-19 in pediatrics do not address in-depth endotracheal intubation in acutely ill children. We discussed the caveats and pitfalls of intubation in critically ill children.
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