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Erschienen in: Der Anaesthesist 2/2006

01.02.2006 | Allgemeinanästhesie

Management der oberen Atemwege beim spontan atmenden Kind

Eine Herausforderung für den Anästhesisten

verfasst von: Dr. B. S. von Ungern-Sternberg, T. O. Erb, F. J. Frei

Erschienen in: Die Anaesthesiologie | Ausgabe 2/2006

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Zusammenfassung

Partielle und totale Atemwegsobstruktionen treten bei spontan atmenden, bewusstlosen oder anästhesierten Kindern häufig auf und können eine adäquate Sauerstoffversorgung gefährden. Das Offenhalten der oberen Atemwege ist daher die wichtigste und effektivste Maßnahme in dieser Situation: Kinn hochheben („chin lift“), Unterkiefer nach vorne verschieben („jaw thrust“, Esmarch-Handgriff) und kontinuierlich positiver Atemwegsdruck („continuous positive airway pressure“, CPAP) öffnen nachgewiesenermaßen den Atemweg. Neben diesen einfachen Atemwegsmanövern führen auch verschiedene Lagerungstechniken (Seitenlage oder Rückenlage unter Einnahme der „Schnüffelposition“) zu einer besseren Öffnung und Stabilität des oberen Atemwegs.
Literatur
1.
Zurück zum Zitat Abernethy LJ, Allan PL, Drummond GB (1990) Ultrasound assessment of the position of the tongue during induction of anaesthesia. Br J Anaesth 65: 744–748PubMed Abernethy LJ, Allan PL, Drummond GB (1990) Ultrasound assessment of the position of the tongue during induction of anaesthesia. Br J Anaesth 65: 744–748PubMed
2.
Zurück zum Zitat Arai YC, Fukunaga K, Ueda W et al. (2005) The endoscopically measured effects of airway maneuvers and the lateral position on airway patency in anesthetized children with adenotonsillar hypertrophy. Anesth Analg 100: 949–952CrossRefPubMed Arai YC, Fukunaga K, Ueda W et al. (2005) The endoscopically measured effects of airway maneuvers and the lateral position on airway patency in anesthetized children with adenotonsillar hypertrophy. Anesth Analg 100: 949–952CrossRefPubMed
3.
Zurück zum Zitat Arens R, McDonough JM, Costarino AT et al. (2001) Magnetic resonance imaging of the upper airway structure of children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 164: 698–703PubMed Arens R, McDonough JM, Costarino AT et al. (2001) Magnetic resonance imaging of the upper airway structure of children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 164: 698–703PubMed
4.
Zurück zum Zitat Arens R, McDonough JM, Corbin AM et al. (2003) Upper airway size analysis by magnetic resonance imaging of children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 167: 65–70CrossRefPubMed Arens R, McDonough JM, Corbin AM et al. (2003) Upper airway size analysis by magnetic resonance imaging of children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 167: 65–70CrossRefPubMed
5.
Zurück zum Zitat Arens R, Sin S, McDonough JM et al. (2005) Changes in upper airway size during tidal breathing in children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 171: 1298–1304CrossRefPubMed Arens R, Sin S, McDonough JM et al. (2005) Changes in upper airway size during tidal breathing in children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 171: 1298–1304CrossRefPubMed
6.
Zurück zum Zitat Brouillette RT, Thach BT (1979) A neuromuscular mechanism maintaining extrathoracic airway patency. J Appl Physiol 46: 772–779PubMed Brouillette RT, Thach BT (1979) A neuromuscular mechanism maintaining extrathoracic airway patency. J Appl Physiol 46: 772–779PubMed
7.
Zurück zum Zitat Bruppacher H, Reber A, Keller JP et al. (2003) The effects of common airway maneuvers on airway pressure and flow in children undergoing adenoidectomies. Anesth Analg 97: 29–34CrossRefPubMed Bruppacher H, Reber A, Keller JP et al. (2003) The effects of common airway maneuvers on airway pressure and flow in children undergoing adenoidectomies. Anesth Analg 97: 29–34CrossRefPubMed
8.
Zurück zum Zitat Drage MP, Nunez J, Vaughan RS et al. (1996) Jaw thrusting as a clinical test to assess the adequate depth of anaesthesia for insertion of the laryngeal mask. Anaesthesia 51: 1167–1170PubMed Drage MP, Nunez J, Vaughan RS et al. (1996) Jaw thrusting as a clinical test to assess the adequate depth of anaesthesia for insertion of the laryngeal mask. Anaesthesia 51: 1167–1170PubMed
9.
Zurück zum Zitat Drummond GB (1989) Influence of thiopentone on upper airway muscles. Br J Anaesth 63: 12–21PubMed Drummond GB (1989) Influence of thiopentone on upper airway muscles. Br J Anaesth 63: 12–21PubMed
10.
Zurück zum Zitat Drummond GB (1996) Comparison of sedation with midazolam and ketamine: effects on airway muscle activity. Br J Anaesth 76: 663–667PubMed Drummond GB (1996) Comparison of sedation with midazolam and ketamine: effects on airway muscle activity. Br J Anaesth 76: 663–667PubMed
11.
Zurück zum Zitat European Resuscitation Council (2000) Part 9: pediatric basic life support. Resuscitation 46: 301–341CrossRefPubMed European Resuscitation Council (2000) Part 9: pediatric basic life support. Resuscitation 46: 301–341CrossRefPubMed
12.
Zurück zum Zitat Evans RG, Crawford MW, Noseworthy MD et al. (2003) Effect of increasing depth of propofol anesthesia on upper airway configuration in children. Anesthesiology 99: 596–602CrossRefPubMed Evans RG, Crawford MW, Noseworthy MD et al. (2003) Effect of increasing depth of propofol anesthesia on upper airway configuration in children. Anesthesiology 99: 596–602CrossRefPubMed
13.
Zurück zum Zitat Fink BR (1957) Roentgenographic studies of the oropharyngeal airway. Anesthesiology 18: 711–718PubMed Fink BR (1957) Roentgenographic studies of the oropharyngeal airway. Anesthesiology 18: 711–718PubMed
14.
Zurück zum Zitat Frei FJ, Erb TO, Jonmarker C et al. (2004) Kinderanästhesie, 3. Aufl. Springer, Berlin Heidelberg New York Tokyo, S 241 Frei FJ, Erb TO, Jonmarker C et al. (2004) Kinderanästhesie, 3. Aufl. Springer, Berlin Heidelberg New York Tokyo, S 241
15.
Zurück zum Zitat George CF, Millar TW, Kryger MH (1988) Sleep apnea and body position during sleep. Sleep 11: 90–99PubMed George CF, Millar TW, Kryger MH (1988) Sleep apnea and body position during sleep. Sleep 11: 90–99PubMed
16.
Zurück zum Zitat Hammer J, Reber A, Trachsel D et al. (2001) Effect of jaw-thrust and continuous positive airway pressure on tidal breathing in deeply sedated infants. J Pediatr 138: 826–830CrossRefPubMed Hammer J, Reber A, Trachsel D et al. (2001) Effect of jaw-thrust and continuous positive airway pressure on tidal breathing in deeply sedated infants. J Pediatr 138: 826–830CrossRefPubMed
17.
Zurück zum Zitat Heiberg J (1874) A new expedient in administering chloroform. Med Times Gaz 10: 36 Heiberg J (1874) A new expedient in administering chloroform. Med Times Gaz 10: 36
18.
Zurück zum Zitat Holinger LD (1980) Etiology of stridor in the neonate, infant and child. Ann Otol Rhinol Laryngol 89: 397–400PubMed Holinger LD (1980) Etiology of stridor in the neonate, infant and child. Ann Otol Rhinol Laryngol 89: 397–400PubMed
19.
Zurück zum Zitat Hudgel DW, Hendricks C (1988) Palate and hypopharynx – Sites of inspiratory narrowing of the upper airway during sleep. Am Rev Respir Dis 138: 1542–1547PubMed Hudgel DW, Hendricks C (1988) Palate and hypopharynx – Sites of inspiratory narrowing of the upper airway during sleep. Am Rev Respir Dis 138: 1542–1547PubMed
20.
Zurück zum Zitat Hwang JC, St John WM, Bartlett D Jr (1983) Respiratory-related hypoglossal nerve activity: influence of anesthetics. J Appl Physiol 55: 785–792PubMed Hwang JC, St John WM, Bartlett D Jr (1983) Respiratory-related hypoglossal nerve activity: influence of anesthetics. J Appl Physiol 55: 785–792PubMed
21.
Zurück zum Zitat Isono S, Tanaka A, Nishino T (2002) Lateral position decreases collapsibility of the passive pharynx in patients with obstructive sleep apnea. Anesthesiology 97: 780–785CrossRefPubMed Isono S, Tanaka A, Nishino T (2002) Lateral position decreases collapsibility of the passive pharynx in patients with obstructive sleep apnea. Anesthesiology 97: 780–785CrossRefPubMed
22.
Zurück zum Zitat Isono S, Tanaka A, Ishikawa T et al. (2005) Sniffing position improves pharyngeal airway patency in anesthetized patients with obstructive sleep apnea. Anesthesiology 103: 489–494CrossRefPubMed Isono S, Tanaka A, Ishikawa T et al. (2005) Sniffing position improves pharyngeal airway patency in anesthetized patients with obstructive sleep apnea. Anesthesiology 103: 489–494CrossRefPubMed
23.
Zurück zum Zitat Issa FG, Sullivan CE (1984) Upper airway closing pressures in obstructive sleep apnea. J Appl Physiol 57: 520–527PubMed Issa FG, Sullivan CE (1984) Upper airway closing pressures in obstructive sleep apnea. J Appl Physiol 57: 520–527PubMed
24.
Zurück zum Zitat Johnstone RE (1999) Laryngospasm treatment – An explanation. Anesthesiology 91: 581–582CrossRef Johnstone RE (1999) Laryngospasm treatment – An explanation. Anesthesiology 91: 581–582CrossRef
25.
Zurück zum Zitat Keidan I, Fine GF, Kagawa T et al. (2000) Work of breathing during spontaneous ventilation in anesthetized children: a comparative study among the face mask, laryngeal mask airway and endotracheal tube. Anesth Analg 91: 1381–1388CrossRefPubMed Keidan I, Fine GF, Kagawa T et al. (2000) Work of breathing during spontaneous ventilation in anesthetized children: a comparative study among the face mask, laryngeal mask airway and endotracheal tube. Anesth Analg 91: 1381–1388CrossRefPubMed
26.
Zurück zum Zitat Kuna ST, Bedi DG, Ryckman C (1988) Effect of nasal airway positive pressure on upper airway size and configuration. Am Rev Respir Dis 138: 969–975PubMed Kuna ST, Bedi DG, Ryckman C (1988) Effect of nasal airway positive pressure on upper airway size and configuration. Am Rev Respir Dis 138: 969–975PubMed
27.
28.
Zurück zum Zitat Leiter JC, Knuth SL, Krol RC et al. (1985) The effect of diazepam on genioglossal muscle activity in normal human subjects. Am Rev Respir Dis 132: 216PubMed Leiter JC, Knuth SL, Krol RC et al. (1985) The effect of diazepam on genioglossal muscle activity in normal human subjects. Am Rev Respir Dis 132: 216PubMed
29.
Zurück zum Zitat Liistro G, Stanescu D, Dooms G et al. (1988) Head position modifies upper airway resistance in men. J Appl Physiol 64: 1285–1288PubMed Liistro G, Stanescu D, Dooms G et al. (1988) Head position modifies upper airway resistance in men. J Appl Physiol 64: 1285–1288PubMed
30.
Zurück zum Zitat Litman RS, Kottra JA, Berkowitz RJ et al. (1998) Upper airway obstruction during midazolam/nitrous oxide sedation in children with enlarged tonsils. Pediatr Dent 20: 318–320PubMed Litman RS, Kottra JA, Berkowitz RJ et al. (1998) Upper airway obstruction during midazolam/nitrous oxide sedation in children with enlarged tonsils. Pediatr Dent 20: 318–320PubMed
31.
Zurück zum Zitat Litman RS, Weissend EE, Shrier DA et al. (2002) Morphologic changes in the upper airway of children during awakening from propofol administration. Anesthesiology 96: 607–611CrossRefPubMed Litman RS, Weissend EE, Shrier DA et al. (2002) Morphologic changes in the upper airway of children during awakening from propofol administration. Anesthesiology 96: 607–611CrossRefPubMed
32.
Zurück zum Zitat Litman RS, Wake N, Chan LM et al. (2005) Effect of lateral positioning on upper airway size and morphology in sedated children. Anesthesiology 103: 484–488CrossRefPubMed Litman RS, Wake N, Chan LM et al. (2005) Effect of lateral positioning on upper airway size and morphology in sedated children. Anesthesiology 103: 484–488CrossRefPubMed
33.
Zurück zum Zitat Mathew OP (1985) Maintenance of upper airway patency. J Pediatr 106: 863–869PubMed Mathew OP (1985) Maintenance of upper airway patency. J Pediatr 106: 863–869PubMed
34.
Zurück zum Zitat Mathru M, Esch O, Lang J et al. (1996) Magnetic resonance imaging of the upper airway. Effects of propofol anesthesia and nasal continuous positive airway pressure in humans. Anesthesiology 84: 273–279CrossRefPubMed Mathru M, Esch O, Lang J et al. (1996) Magnetic resonance imaging of the upper airway. Effects of propofol anesthesia and nasal continuous positive airway pressure in humans. Anesthesiology 84: 273–279CrossRefPubMed
35.
Zurück zum Zitat Meier S, Geiduschek J, Paganoni R et al. (2002) The effect of chin lift, jaw thrust, and continuous positive airway pressure on the size of the glottic opening and on stridor score in anesthetized, spontaneously breathing children. Anesth Analg 94: 494–499CrossRefPubMed Meier S, Geiduschek J, Paganoni R et al. (2002) The effect of chin lift, jaw thrust, and continuous positive airway pressure on the size of the glottic opening and on stridor score in anesthetized, spontaneously breathing children. Anesth Analg 94: 494–499CrossRefPubMed
36.
Zurück zum Zitat Meurice JC, Marc I, Carrier G et al. (1996) Effects of mouth opening on upper airway collapsibility in normal sleeping subjects. Am J Respir Crit Care Med 153: 255–259PubMed Meurice JC, Marc I, Carrier G et al. (1996) Effects of mouth opening on upper airway collapsibility in normal sleeping subjects. Am J Respir Crit Care Med 153: 255–259PubMed
37.
Zurück zum Zitat Montravers P, Dureuil B, Desmonts JM (1992) Effects of i.v. midazolam on upper airway resistance. Br J Anaesth 68: 27–31PubMed Montravers P, Dureuil B, Desmonts JM (1992) Effects of i.v. midazolam on upper airway resistance. Br J Anaesth 68: 27–31PubMed
38.
Zurück zum Zitat Morikawa S, Safar P, Decarlo J (1961) Influence of the head-jaw position upon upper airway patency. Anesthesiology 22: 265–270PubMed Morikawa S, Safar P, Decarlo J (1961) Influence of the head-jaw position upon upper airway patency. Anesthesiology 22: 265–270PubMed
39.
Zurück zum Zitat Moynihan RJ, Brock-Utne JG, Archer JH et al. (1993) The effect of cricoid pressure on preventing gastric insufflation in infants and children. Anesthesiology 78: 652–656PubMed Moynihan RJ, Brock-Utne JG, Archer JH et al. (1993) The effect of cricoid pressure on preventing gastric insufflation in infants and children. Anesthesiology 78: 652–656PubMed
40.
Zurück zum Zitat Murashima K, Fukutome T (1998) Effect of jaw-thrust manoeuvre on the laryngeal inlet. Anaesthesia 53: 203–204PubMed Murashima K, Fukutome T (1998) Effect of jaw-thrust manoeuvre on the laryngeal inlet. Anaesthesia 53: 203–204PubMed
41.
Zurück zum Zitat Nandi PR, Charlesworth CH, Taylor SJ et al. (1991) Effect of general anaesthesia on the pharynx. Br J Anaesth 66: 157–162PubMed Nandi PR, Charlesworth CH, Taylor SJ et al. (1991) Effect of general anaesthesia on the pharynx. Br J Anaesth 66: 157–162PubMed
42.
Zurück zum Zitat Rajan GR (1999) Supraglottic obstruction versus true laryngospasm: the best treatment. Anesthesiology 91: 581CrossRef Rajan GR (1999) Supraglottic obstruction versus true laryngospasm: the best treatment. Anesthesiology 91: 581CrossRef
43.
Zurück zum Zitat Reber A, Paganoni R, Frei FJ (1999) Airway obstruction due to arytenoid prolapse in a child. Acta Anaesthesiol Scand 43: 104–106CrossRefPubMed Reber A, Paganoni R, Frei FJ (1999) Airway obstruction due to arytenoid prolapse in a child. Acta Anaesthesiol Scand 43: 104–106CrossRefPubMed
44.
Zurück zum Zitat Reber A, Wetzel SG, Schnabel K et al. (1999) Effect of combined mouth closure and chin lift on upper airway dimensions during routine magnetic resonance imaging in pediatric patients sedated with propofol. Anesthesiology 90: 1617–1623CrossRefPubMed Reber A, Wetzel SG, Schnabel K et al. (1999) Effect of combined mouth closure and chin lift on upper airway dimensions during routine magnetic resonance imaging in pediatric patients sedated with propofol. Anesthesiology 90: 1617–1623CrossRefPubMed
45.
Zurück zum Zitat Reber A, Paganoni R, Frei FJ (2001) Effect of common airway manoeuvres on upper airway dimensions and clinical signs in anaesthetized, spontaneously breathing children. Br J Anaesth 86: 217–222CrossRefPubMed Reber A, Paganoni R, Frei FJ (2001) Effect of common airway manoeuvres on upper airway dimensions and clinical signs in anaesthetized, spontaneously breathing children. Br J Anaesth 86: 217–222CrossRefPubMed
46.
Zurück zum Zitat Reber A, Geiduschek JM, Bobbia SA et al. (2002) Effect of continuous positive airway pressure on the measurement of thoracoabdominal asynchrony and minute ventilation in children anesthetized with sevoflurane and nitrous oxide. Chest 122: 473–478CrossRefPubMed Reber A, Geiduschek JM, Bobbia SA et al. (2002) Effect of continuous positive airway pressure on the measurement of thoracoabdominal asynchrony and minute ventilation in children anesthetized with sevoflurane and nitrous oxide. Chest 122: 473–478CrossRefPubMed
47.
Zurück zum Zitat Reed WR, Roberts JL, Thach BT (1985) Factors influencing regional patency and configuration of the human infant upper airway. J Appl Physiol 58: 635–644PubMed Reed WR, Roberts JL, Thach BT (1985) Factors influencing regional patency and configuration of the human infant upper airway. J Appl Physiol 58: 635–644PubMed
48.
Zurück zum Zitat Roberts JT, Ali HH, Shorten GD (1993) Using the laryngeal indices caliper to predict difficulty of laryngoscopy with a Macintosh #3 laryngoscope. J Clin Anesth 5: 302–305CrossRefPubMed Roberts JT, Ali HH, Shorten GD (1993) Using the laryngeal indices caliper to predict difficulty of laryngoscopy with a Macintosh #3 laryngoscope. J Clin Anesth 5: 302–305CrossRefPubMed
49.
Zurück zum Zitat Roth B, Magnusson J, Johansson I et al. (1998) Jaw lift – A simple and effective method to open the airway in children. Resuscitation 39: 171–174CrossRefPubMed Roth B, Magnusson J, Johansson I et al. (1998) Jaw lift – A simple and effective method to open the airway in children. Resuscitation 39: 171–174CrossRefPubMed
50.
Zurück zum Zitat Ruben HM, Elam JO, Ruben AM et al. (1961) Investigation of upper airway problems in resuscitation. 1. Studies of pharyngeal x-rays and performance by laymen. Anesthesiology 22: 271–279PubMed Ruben HM, Elam JO, Ruben AM et al. (1961) Investigation of upper airway problems in resuscitation. 1. Studies of pharyngeal x-rays and performance by laymen. Anesthesiology 22: 271–279PubMed
51.
Zurück zum Zitat Safar P, Escarraga LA, Chang F (1959) Upper airway obstruction in the unconscious patient. J Appl Physiol 14: 760–764PubMed Safar P, Escarraga LA, Chang F (1959) Upper airway obstruction in the unconscious patient. J Appl Physiol 14: 760–764PubMed
52.
Zurück zum Zitat Schibler A, Henning R (2002) Positive end-expiratory pressure and ventilation inhomogeneity in mechanically ventilated children. Pediatr Crit Care Med 3: 124–128CrossRefPubMed Schibler A, Henning R (2002) Positive end-expiratory pressure and ventilation inhomogeneity in mechanically ventilated children. Pediatr Crit Care Med 3: 124–128CrossRefPubMed
53.
Zurück zum Zitat Schwab RJ, Gupta KB, Gefter WB et al. (1995) Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 152: 1673–1689PubMed Schwab RJ, Gupta KB, Gefter WB et al. (1995) Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 152: 1673–1689PubMed
54.
Zurück zum Zitat Schwab RJ, Pack AI, Gupta KB et al. (1996) Upper airway and soft tissue structural changes induced by CPAP in normal subjects. Am J Respir Crit Care Med 154: 1106–1116PubMed Schwab RJ, Pack AI, Gupta KB et al. (1996) Upper airway and soft tissue structural changes induced by CPAP in normal subjects. Am J Respir Crit Care Med 154: 1106–1116PubMed
55.
Zurück zum Zitat Shelton KE, Woodson H, Gay S et al. (1993) Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148: 462–466PubMed Shelton KE, Woodson H, Gay S et al. (1993) Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148: 462–466PubMed
56.
Zurück zum Zitat Shorten GD, Armstrong DC, Roy WI et al. (1995) Assessment of the effect of head and neck position on upper airway anatomy in sedated paediatric patients using magnetic resonance imaging. Paediatr Anaesth 5: 243–248PubMed Shorten GD, Armstrong DC, Roy WI et al. (1995) Assessment of the effect of head and neck position on upper airway anatomy in sedated paediatric patients using magnetic resonance imaging. Paediatr Anaesth 5: 243–248PubMed
57.
Zurück zum Zitat Sivarajan M, Joy JV (1996) Effects of general anesthesia and paralysis on upper airway changes due to head position in humans. Anesthesiology 85: 787–793CrossRefPubMed Sivarajan M, Joy JV (1996) Effects of general anesthesia and paralysis on upper airway changes due to head position in humans. Anesthesiology 85: 787–793CrossRefPubMed
58.
Zurück zum Zitat Spann RW, Hyatt RE (1971) Factors affecting upper airway resistance in conscious man. J Appl Physiol 31: 708–712PubMed Spann RW, Hyatt RE (1971) Factors affecting upper airway resistance in conscious man. J Appl Physiol 31: 708–712PubMed
59.
Zurück zum Zitat Stauffer T, Jaslow D (2004) Not so basic airway maneuvers. Emerg Med Serv 33: 78–79 Stauffer T, Jaslow D (2004) Not so basic airway maneuvers. Emerg Med Serv 33: 78–79
60.
Zurück zum Zitat Strauss S, Lynn A, Bratton S et al. (1999) Ventilatory response to CO2 in children with obstructive sleep apnea from adenotonsillar hypertrophy. Anesth Analg 89: 328–332CrossRefPubMed Strauss S, Lynn A, Bratton S et al. (1999) Ventilatory response to CO2 in children with obstructive sleep apnea from adenotonsillar hypertrophy. Anesth Analg 89: 328–332CrossRefPubMed
61.
Zurück zum Zitat Tamura M, Ishikawa T, Kato R et al. (2004) Mandibular advancement improves the laryngeal view during direct laryngoscopy performed by inexperienced physicians. Anesthesiology 100: 598–601CrossRefPubMed Tamura M, Ishikawa T, Kato R et al. (2004) Mandibular advancement improves the laryngeal view during direct laryngoscopy performed by inexperienced physicians. Anesthesiology 100: 598–601CrossRefPubMed
62.
Zurück zum Zitat Tetzlaff JE, Patel R, Milmoe G (1991) Total airway obstruction with neck extension: airway management of a patient with pharyngeal tumor. J Clin Anesth 3: 406–408CrossRefPubMed Tetzlaff JE, Patel R, Milmoe G (1991) Total airway obstruction with neck extension: airway management of a patient with pharyngeal tumor. J Clin Anesth 3: 406–408CrossRefPubMed
63.
Zurück zum Zitat Todres ID, Khilnani P (1994) Critical upper airway obstruction in children. In: Roberts TJ (ed) Clinical management of the airway, 1st edn. Saunders, Philadelphia, pp 383 Todres ID, Khilnani P (1994) Critical upper airway obstruction in children. In: Roberts TJ (ed) Clinical management of the airway, 1st edn. Saunders, Philadelphia, pp 383
64.
Zurück zum Zitat von Ungern-Sternberg BS, Erb TO, Frei FJ (2005) Jaw thrust can deteriorate upper airway patency. Acta Anaesthesiol Scand 49: 583–585CrossRefPubMed von Ungern-Sternberg BS, Erb TO, Frei FJ (2005) Jaw thrust can deteriorate upper airway patency. Acta Anaesthesiol Scand 49: 583–585CrossRefPubMed
65.
Zurück zum Zitat von Ungern-Sternberg BS, Erb TO, Reber A et al. (2005) Opening the upper airway – Airway maneuvers in pediatric anesthesia. Paediatr Anaesth 15: 181–189CrossRefPubMed von Ungern-Sternberg BS, Erb TO, Reber A et al. (2005) Opening the upper airway – Airway maneuvers in pediatric anesthesia. Paediatr Anaesth 15: 181–189CrossRefPubMed
Metadaten
Titel
Management der oberen Atemwege beim spontan atmenden Kind
Eine Herausforderung für den Anästhesisten
verfasst von
Dr. B. S. von Ungern-Sternberg
T. O. Erb
F. J. Frei
Publikationsdatum
01.02.2006
Verlag
Springer-Verlag
Erschienen in
Die Anaesthesiologie / Ausgabe 2/2006
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-005-0946-7

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