[Airway obstruction after tracheostomy in a neurologically impaired child].
A 14-year-old boy neurologically impaired was scheduled for tracheostomy under general anesthesia because of the prolonged tracheal intubation. He had twice received artificial respiration under tracheal intubation for aspiration pneumonia. During emergence from anesthesia, bucking occurred and suddenly the patient's lungs could not be ventilated. Neither anesthetic circuit nor tracheostomy tube were not functioning well, and airway obstruction was not relieved by manual and positive pressure ventilation within 40 mmHg. SpO2 gradually decreased to 48%, resulting in bradicardia. However, it became possible to inflate the lungs immediately because of the respiratory effort decreased. SpO2 rapidly increased to normal range and heart rate recovered. The patient was suspected of having tracheomalacia as a result of flexible bronchoscopy performed through tracheostomy tube, revealing slight collapse of the trachea. Tracheomalacia can be a cause of sudden difficult ventilation in neurologically impaired children.
Kawase
Mizuho
M
Matsumoto Dental University, Nagano 399-0781.
Arakura
Kumiko
K
Kawase
Soichiro
S
Shiozawa
Riyo
R
Inoue
Yasuro
Y
D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology*; D000768:Anesthesia, General; D001982:Bronchial Diseases / Q000209:etiology; D001999:Bronchoscopy; D019988:Children with Disabilities; D006801:Humans; D007431:Intraoperative Complications; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D012121:Respiration, Artificial; D014139:Tracheostomy