Optimizing Surgical Conditions with the Use of a Modified Spontaneous Respiration, Intravenous Anesthesia and High-Flow Nasal Oxygen for Pediatric Laser Laryngeal Surgery
Optimizing Surgical Conditions with the Use of a Modified Spontaneous Respiration, Intravenous Anesthesia and High-Flow Nasal Oxygen for Pediatric Laser Laryngeal Surgery作者机构：Maimonides Medical Center Department of Anesthesiology Brooklyn NY USA Northwell Staten Island University Hospital New York USA
出 版 物：《Open Journal of Anesthesiology》 (麻醉学期刊（英文）)
年 卷 期：2023年第13卷第11期
页 面：234-240页
学科分类：1002[医学-临床医学] 100213[医学-耳鼻咽喉科学] 10[医学]
主 题：STRIVE Pediatric Direct Laryngoscopy Laryngomalacia
摘 要：The use of SponTaneous Respiration using IntraVEnous anesthesia and High-flow nasal oxygen (STRIVE-Hi) in laryngeal surgery has become more widely reported. This method eliminates the endotracheal tube as a fuel for a potential fire. However, little has been published on its use in the pediatric population. Our case report describes its use in a 2-year-old undergoing micro-direct laryngoscopy with CO2 assisted supraglottoplasty and rigid bronchoscopy for airway obstruction from congenital laryngomalacia. The STRIVE-Hi technique was modified for the pediatric patient by using a lower flow through the nasal cannula (4 L). No major changes in SpO2 were detected during the 30-minute procedure. With back up airway safety equipment in place, STRIVE is proving to be a safe technique with major advantages when used in this unique scenario.
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