Browsing by Author "Milenovic, Miodrag (36612130700)"

[No abstract available]

Background/Objectives: Prediction of a difficult airway during pre-anesthetic evaluation is of great importance because it enables an adequate anesthetic approach and airway management. As there is a scarcity of prospective studies evaluating the role of anthropometric measures of the face and neck in predicting difficult airways in infants with an apparently normal airway, we aimed to identify the aforementioned predictors of difficult facemask ventilation and intubation in infants. Methods: A prospective, observational study that included 97 infants requiring general endotracheal anesthesia was conducted. Anthropometric and specific facial measurements were obtained before ventilation and intubation. Results: The incidence of difficult facemask ventilation was 15.5% and 38.1% for difficult intubation. SMD (sternomental distance), TMA (tragus-to-mouth angle distance), NL (neck length) and mouth opening were significantly lower in the difficult facemask ventilation group. HMDn (hyomental distance in neutral head position), HMDe (hyomental distance in neck extension), TMD (thyromental distance), SMD, mandibular development and mouth opening were significantly different in the intubation difficulty group compared to the non-difficult group. HMDn and HMDe showed significantly greater specificities for difficult intubation (83.8% and 76.7%, respectively), while higher sensitivities were observed in TMD, SMD and RHSMD (ratio of height to SMD) (89.2%, 75.7%, and 70.3%, respectively). Regarding difficult facemask ventilation, TMA showed greater sensitivity (86.7%) and SMD showed greater specificity (80%) compared to other anthropometric parameters. In a multivariate model, BMI (body mass index), COPUR (Colorado Pediatric Airway Score), BOV (best oropharyngeal view) and TMA were found to be independent predictors of difficult intubation, while BMI, ASA (The American Society Physical Status Classification System), CL (Cormack–Lehane Score), TMA and SMD predicted difficult facemask ventilation. Conclusions: Preoperative airway assessment is of great importance for ventilation and intubation. Patient’s overall condition and facial measurements can be used as predictors of difficult intubation and ventilation. © 2024 by the authors.

[No abstract available]

Burns are the eleventh leading cause of deaths in childhood and the fifth most common cause of non-fatal childhood injury, and most often occur in children under 4. 80% to 90% of all severe burns occur in low to middle income countries. Anaesthesiologists are crucial members of the multi-disciplinary team caring for children with burns. Provision of adequate analgesia, sedation, anesthesia and intensive care treatment are roles of anaesthesiologists and non-physician anaesthetists. There are several anaesthetic challenges with managing the child with burns such as a potential difficult airway, challenging intravascular line placement, water and electrolyte disturbances, altered temperature regulation, sepsis, cardiovascular and respiratory insufficiency, altered pharmacokinetic and pharmacodynamics pathways. The majority of critical adverse events in burn injured patients are associated with the airway and hemodynamic instability. The specific anaesthetic technique required depends on the individual patient pathophysiology condition. With the progress in burn care trauma protocols and with the development of multidisciplinary teams at special burn units, outcomes have improved over the past two decades. This review provides insights into existing therapeutic approaches for the management of paediatric burns. © 2023, World Federation of Societies of Anesthesiologists. All rights reserved.