Abstract
Surgical endoscopy in the neonate requires a high level of technical skills, diagnostic acumen, and proper instrumentation to ensure a safe outcome. Prenatal development and physiological response to anesthetic agents will be dependent on the patient’s age and associated medical comorbidities. Neonatal laryngoscopy and bronchoscopy can be quite challenging for care providers because of this increased risk of hypoxemia. Neonates requiring bronchoscopy for respiratory failure are innately at higher surgical risk, secondary to possible underlying congenital anomalies and/or the precipitating factors that occur during the endoscopic evaluation of their airway. In addition, specific sizes of the laryngoscopes and bronchoscopes utilized must be available and functioning properly, preferably in at least duplicate sizes. Neonatal airway distress is apparent in the first minutes or hours of life. Therefore, the first attempts to secure and maintain the airway in the delivery room or the neonatal intensive care unit (NICU) provide essential information for the airway team (anesthesiologists, otolaryngologists, pediatric surgeons, respiratory therapists, and perioperative nurses). A thorough cardiac and pulmonary evaluation should be performed to assess for congenital abnormalities that may prevent or limit proper oxygenation of the neonate’s blood. Hypoventilation may result from combined factors including the primary airway pathology, associated anomalies, anesthesia, airway manipulation, or trauma, in addition to those specific factors related to the physiology of neonates. Premature neonates are even more susceptible and vulnerable to these challenges.
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Abdallah, C., White, J.R., Reilly, B.K. (2019). Neonatal Laryngoscopy and Bronchoscopy. In: Preciado, D., Verghese, S. (eds) Anesthetic Management for the Pediatric Airway . Springer, Cham. https://doi.org/10.1007/978-3-030-04600-2_6
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DOI: https://doi.org/10.1007/978-3-030-04600-2_6
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