Anesthetic Management of a Tracheoesophageal Fistula in a Patient With a Large Uncorrected Aortopulmonary Window: A Case Report
We present the anesthetic management of a 1-day-old neonate with a postnatally diagnosed aortopulmonary window for correction of a TEF.
Discussion In the past, indications for tracheostomy were often because of infection, but today are more often due to need for chronic airway support and/or ventilation. Many more children and infants are having tracheostomies placed. Decannulation rates for these children are low due to concomitant complex chronic disease such as neurological, pulmonary and congenital heart diseases. Co-morbidies are common with 3-4 being average, and frequently also including chronic technology such as gastrostomy tubes or ventriculoperitoneal shunts. Approximately 8% of children do not survive the hospitalization where the tracheostomy ...
Extracardiac birth defects are associated with worse outcomes in congenital heart disease (CHD). The impact of esophageal atresia/trachea-esophageal fistula (EA/TEF) on outcomes after surgery for ductal-dependent CHD is unknown.
Discussion Bridling of nasoenteric feeding tubes is a safe and effective method for preventing unintended tube dislodgement, leading to improved patient care in the pediatric surgical population less than 1 year old. On the basis of our institution's results, ongoing continuing education for use and care of nasoenteric feeding tubes is recommended for the pediatric surgical population.
ConclusionsNearly one‐fifth of total laryngectomy patients are readmitted to the hospital within 30 days of discharge. Risk factors identified in this nationally representative cohort should be carefully considered during the postoperative period to reduce preventable readmissions after total laryngectomy. Level of Evidence2c Laryngoscope, 2017
Conclusions Patients with thoracic GI malformations have worse perioperative outcomes than controls, but their long-term survival does not seem to be significantly different. Abdominal GI malformations do not have a significant effect on outcomes. The presence of GI malformations should likely not preclude patients from undergoing congenital heart operations, but careful family counseling is necessary, especially for thoracic GI malformations.
er CD Abstract BACKGROUND: The goal of this study was to assess the effect of associated gastrointestinal malformations (GI) on the outcomes of patients undergoing congenital heart operations. METHODS: Neonates and infants with thoracic (esophageal atresia, tracheoesophageal fistula) and abdominal (duodenal stenosis/atresia, imperforate anus, Hirschsprung disease) GI malformations undergoing congenital heart operations between 1995 and 2015 were included. Two control groups were created, one for each group. Patients were matched by diagnosis, procedure, history of prematurity, presence of genetic syndrome, an...
Bronchomalacia is caused by deficiency in the bronchial cartilages and is defined as an appearance of deformity and a bronchial cross-sectional decrease of more than or equal to 50% during exhalation.1 Malacia may affect one or both bronchi and/or the trachea. Tracheobronchomalacia may be primary or secondary to external compression or prolonged intubation, especially with high-pressure ventilation.2 It is associated with esophageal atresia/tracheoesophageal fistula, congenital heart disease, and other syndromes and is part of the differential diagnosis in refractory asthma.1
We examined 54 patients with FA in the National Cancer Institute Inherited Bone Marrow Failure Syndrome Cohort for features of VACTERL‐H, including imaging studies (radiology and ultrasound). Eighteen of the fifty‐four patients had three or more VACTERL‐H features. The presence of VACTERL‐H association in 33% of those with FA is much higher than the previous estimate of 5% (P
Discussion Latex comes from the Hevea brasiliensis plants. There are multiple potentially allergenic polypeptides within the plant’s fluid called Heb b 1-13. True sensitizers are Heb b 1, 5 and 6. Heb b 8 and 12 are cross-reacting proteins. The type of the latex product and how it is prepared makes a difference in exposure to the latex allergens. Certain extruded latex products such as catheters and rubber stoppers have higher concentrations of true sensitizer allergens. Products made from molds such as gloves have higher concentrations of potential allergens than latex made in sheets such as such as dental dams. Use...
Conclusions We found the frequency of CHD in patients with GI malformations was very high, the most common presentation being ASD. Our study indicates the need for larger scale studies to determine the prevalence of CHD in patients with GI malformations in the Indian population.