Severe intraoperative bronchospasm treated with a vibrating-mesh nebulizer.
Bronchospasm and status asthmaticus are two of the most dreaded complications that a pediatric anesthesiologist may face. With the occurrence of severe bronchospasm and the inability to ventilate, children are particularly vulnerable to apnea and ensuing hypoxia because of their smaller airway size, smaller lung functional residual capacity, and higher oxygen consumption rates than adults. Nebulized medication delivery in intubated children is also more difficult because of smaller endotracheal tube internal diameters. This case demonstrates the potentially lifesaving use of a vibrating-mesh membrane nebulizer connected to the anesthesia circuit for treating bronchospasm.
Chairman, Department of Anesthesiology, Jacobi Medical Center, Bronx, NY, USA.
Leonard R
LR
Golden
Helen Ann
HA
DeSimone
Farhad
F
Yeroshalmi
Mindaugas
M
Pranevicius
Mana
M
Saraghi
D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D000068600:Albuterol, Ipratropium Drug Combination; D000769:Anesthesia, Inhalation / Q000295:instrumentation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001249:Asthma / Q000150:complications; D001986:Bronchial Spasm / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D007442:Intubation, Intratracheal; D009241:Ipratropium / Q000008:administration & dosage*; D008738:Methyl Ethers / Q000008:administration & dosage; D009330:Nebulizers and Vaporizers; D009609:Nitrous Oxide / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage / Q000097:blood; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D011229:Preanesthetic Medication; D000077149:Sevoflurane; D013990:Tidal Volume / Q000187:drug effects
D000336:Aerosols; D000068600:Albuterol, Ipratropium Drug Combination; D018685:Anesthetics, Inhalation; D001993:Bronchodilator Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D009241:Ipratropium; D009609:Nitrous Oxide; D000420:Albuterol; D010100:Oxygen