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Respir Care ; 57(4): 627-30, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22005668

RESUMO

Pierre-Robin syndrome (PRS) is often associated with difficulty in endotracheal intubation. We present the use of percutaneous dilational tracheotomy (PDT) for airway management of a newborn with PRS and a glossopharyngeal web. A 2-day-old term newborn with PRS and severe obstructive dyspnea was evaluated by the anesthesiology team for airway management. A direct laryngoscopy revealed a glossopharyngeal web extending from the base of the tongue to the posterior pharyngeal wall. The infant was spontaneously breathing through a 2 mm diameter fistula in the center of this web. It was decided that endotracheal intubation was impossible, and a PDT was planned. The trachea of the newborn was cannulated, using a 20 gauge peripheral venous catheter and a 0.71 mm guide wire was introduced through this catheter. Using 5 French, 7 French, 9 French, and 11 French central venous catheter kit dilators, staged tracheotomy stoma dilation was performed. By inserting a size 3.0 tracheotomy cannula, PDT was successfully completed in this newborn. This case describes the successful use of PDT for emergency airway management of a newborn with PRS and glossopharyngeal web.


Assuntos
Faringe/patologia , Síndrome de Pierre Robin/complicações , Língua/patologia , Traqueotomia/métodos , Manuseio das Vias Aéreas , Dilatação , Dispneia/complicações , Dispneia/terapia , Serviços Médicos de Emergência , Feminino , Humanos , Recém-Nascido , Intubação Intratraqueal , Máscaras Laríngeas , Mandíbula/cirurgia , Osteotomia
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