%0 Journal Article
%T La v¨ªa a¨¦rea pedi¨¢trica: algunos conceptos para tener en cuenta en el manejo anest¨¦sico The pediatric airway: Concepts to bear in mind during anesthetic management
%A ¨¢ngela R¨ªos Medina
%A Luz Mar¨ªa G¨®mez
%A Oscar Aguirre Ospina
%A Federico Ocampo
%J Revista Colombiana de Anestesiolog¨ªa
%D 2012
%I Sociedad Colombiana de Anestesiolog¨ªa
%X Introducci¨®n: Uno de los aspectos de mayor relevancia en anestesiolog¨ªa pedi¨¢trica es el manejo de la v¨ªa a¨¦rea (VA). Las diferencias anat¨®micas de esta poblaci¨®n hacen que sea m¨¢s susceptible a efectos adversos de dispositivos dise ados para su manejo. Muchas de las descripciones anat¨®micas actuales se basan en hallazgos de hace m¨¢s de medio siglo derivados de disecciones en cad¨¢veres. Desde hace casi una d¨¦cada hay estudios de im¨¢genes de VA en ni os que identifican la glotis como la porci¨®n m¨¢s angosta, y la laringe m¨¢s cil¨ªndrica que c¨®nica. Estos hallazgos tienen impacto al escoger dispositivos de manejo de VA. M¨¦todos: Se realiz¨® una revisi¨®n de nuevos conceptos anat¨®micos de VA pedi¨¢trica y se analizaron pros y contras del uso de tubos endotraqueales con y sin bal¨®n. Resultados y conclusiones: El mayor conocimiento de la anatom¨ªa pedi¨¢trica permite usar dispositivos acordes a las caracter¨ªsticas de la VA del ni o. El desarrollo de tubos con bal¨®n en la pr¨¢ctica pedi¨¢trica es m¨¢s frecuente, aunque no hay consenso actual para su utilizaci¨®n. En lo que concuerdan las publicaciones es en estandarizar dise os y medir la presi¨®n del bal¨®n. Introduction: One 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. Methods:The 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 conclusions: The 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.
%K Anestesia
%K Manejo de la v¨ªa a¨¦rea
%K Anatom¨ªa
%K Pediatr¨ªa
%K Anesthesia
%K Airway management
%K Anatomy
%K Pediatrics
%U http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-33472012000300007