Pediatric tracheomalacia and the perioperative anesthetic management of thoracoscopic posterior tracheopexy

Paediatr Anaesth. 2018 Sep;28(9):768-773. doi: 10.1111/pan.13420. Epub 2018 Jul 1.

Abstract

Tracheomalacia is a broad term used to describe an abnormally compliant trachea that can lead to exaggerated collapse and obstruction with expiration. We describe the perioperative management of a complex pediatric patient undergoing a posterior tracheopexy which is a relatively new surgical treatment, with a novel surgical approach-thoracoscopy. This procedure has competing surgical and anesthetic needs and presents unique challenges to the physicians involved in caring for these patients. We also review the current literature on pediatric tracheomalacia and examine the newest treatment options to highlight the potential anesthetic challenges and pitfalls associated with management.

Keywords: 1-lung ventilation; infant; newborn; tracheal diseases; tracheobronchomalacia; tracheomalacia/diagnosis; tracheomalacia/surgery.

Publication types

  • Case Reports

MeSH terms

  • Anesthesia / methods*
  • Anesthetics / administration & dosage
  • Bronchoscopy / methods*
  • Child, Preschool
  • Female
  • Humans
  • Perioperative Care / methods
  • Thoracoscopy / methods*
  • Trachea / physiopathology*
  • Trachea / surgery*
  • Tracheomalacia / classification
  • Tracheomalacia / diagnosis*
  • Tracheomalacia / physiopathology
  • Tracheomalacia / surgery*

Substances

  • Anesthetics

Supplementary concepts

  • Congenital tracheomalacia