La vía aérea pediátrica: algunos conceptos para tener en cuenta en el manejo anestésico

Abstract

IntroductionOne of the primary aspects of pediatric anesthesia is airway management. Because of the anatomic differences, this population is more vulnerable to adverse effects produced by the devices designed for their management. Many of the anatomic descriptions are based on knowledge developed mainly as a result of cadaveric dissections. Imaging of the pediatric airway has been available for almost a decade, and it has shown that the glottis is the narrowest portion and that the larynx is more cylindrical than tapered. These findings impact the selection of airway management devices. MethodsThe new anatomic concepts pertaining to the pediatric airway were reviewed, and the advantages and disadvantages of the use of cuffed or uncuffed endotracheal tubes were analyzed. Results and conclusionsThe enhanced knowledge of the pediatric anatomy permits the use of devices suitable to the characteristics of the individual airway. The development of cuffed tubes for pediatric practice is advancing rapidly, although there is no current consensus for their use. However, publications coincide on the need to standardize designs and to measure cuff pressure.