title: Emergency use of a size 1 laryngeal mask airway in a ventilated neonate with an undiagnosed type IV laryngotracheo-oesophageal cleft.
abstract: The perioperative management of a neonate with a type IV laryngotracheo-oesophageal cleft and exomphalos major is described. Following an otherwise uncomplicated exomphalos repair, this baby became increasingly and inexplicably difficult to ventilate through an endotracheal tube. The emergency use of a laryngeal mask airway as a rescue maneuver allowed positive pressure ventilation, and subsequent diagnosis of the airway abnormality. The difficulties in management of the two co-existing conditions are discussed.
authors.affiliation: Department of Anaesthesia, Princess Margaret Hospital for Children, Perth, WA, Australia. phillip.russell@rch.org.au
authors.forename: Philip
authors.initials: P
authors.lastname: Russell
authors.forename: Neil
authors.initials: N
authors.lastname: Chambers
authors.forename: Jean
authors.initials: J
authors.lastname: du Plessis
authors.forename: Shyan
authors.initials: S
authors.lastname: Vijayasekeran
mesh_terms: D000015:Abnormalities, Multiple; D000142:Acidosis, Respiratory / Q000209:etiology / Q000601:surgery; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery; D001919:Bradycardia / Q000209:etiology / Q000601:surgery; D004632:Emergency Medical Services / Q000379:methods*; D004947:Esophagus / Q000002:abnormalities*; D006554:Hernia, Umbilical / Q000150:complications / Q000601:surgery; D006612:High-Frequency Ventilation / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D007830:Larynx / Q000002:abnormalities*; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods; D035583:Rare Diseases; D012121:Respiration, Artificial / Q000379:methods; D014132:Trachea / Q000002:abnormalities*; D014138:Tracheoesophageal Fistula / Q000150:complications* / Q000601:surgery; D014139:Tracheostomy