title: Noninvasive positive-pressure ventilation facilitates tracheal extubation after laryngotracheal reconstruction in children.
abstract: Tracheal extubation after laryngotracheal reconstruction in children may be complicated by postoperative tracheal edema and pulmonary dysfunction. The replacement of a tracheal tube in this situation may exacerbate the existing injury to the tracheal mucosa, complicating subsequent attempts at tracheal extubation. We present two cases where noninvasive positive-pressure ventilation was employed to treat partial airway obstruction and respiratory failure in two children following laryngotracheal reconstruction. Noninvasive positive-pressure ventilation served as a bridge between mechanical ventilation via a tracheal tube and spontaneous breathing, providing airway stenting and ventilatory support while tracheal edema and pulmonary dysfunction were resolved. Under appropriate conditions, noninvasive positive-pressure ventilation may be useful in the management of these patients.
authors.affiliation: Department of Pediatrics, Georgetown University Medical Center, Washington, DC 20007-2197, USA. hertzogj@gunet.georgetown.edu
authors.forename: J H
authors.initials: JH
authors.lastname: Hertzog
authors.forename: L B
authors.initials: LB
authors.lastname: Siegel
authors.forename: G J
authors.initials: GJ
authors.lastname: Hauser
authors.forename: H J
authors.initials: HJ
authors.lastname: Dalton
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007829:Laryngostenosis / Q000601:surgery*; D007830:Larynx / Q000601:surgery; D008297:Male; D008397:Masks; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000628:therapy; D019651:Plastic Surgery Procedures; D012131:Respiratory Insufficiency / Q000628:therapy; D014132:Trachea / Q000601:surgery