New Insights into Mechanical Ventilation During Paediatric Anaesthesia
Perioperative ventilation of small children submitted to major surgery has always been a challenge to anaesthesiologists. Most of the difficulties are related to the anaesthetic equipment itself which should be simultaneously able to ventilate the lungs correctly and at the same time deliver inhaled anaesthetics agents. Personal experience and knowledge of the peculiarities of the respiratory system of small children are also important. The natural problems involving superior airway assessment are not the main subject of this chapter. Our purpose is to present a brief review of the main differences between the respiratory system of children and adults, relevant anaesthetic practice, as well as the traditional paediatric breathing circuits employed routinely to administer inhalation agents and promote adequate gas exchange. After that, our discussion will be centred on the real benefit of new ventilatory modalities, available in modern work-station anaesthesia machines, such as pressure-controlled ventilation, low flow anaesthesia, and closed breathing circuits.
KeywordsChest Wall Tidal Volume Lung Volume Functional Residual Capacity Peak Inspiratory Pressure
Unable to display preview. Download preview PDF.
- 1.Muller NL, Bryan AC (1979) Chest wall mechanics and respiratory muscles in infants. Pediatric Clin North Am 26 (3): 503–516Google Scholar
- 2.Keens TG, Ianuzzo CD (1979) Development of fatigue resistant muscle fibers in human ventilatory musculature. Am Rev Resp Dis[Suppl]119: 139–141Google Scholar
- 5.Fisher JB, Carlo AW, Doershuk CF (1990) Pulmonary function from infancy through adolescence. In: Scarpelli ME (ed) 2’ edn Pulmonary physiology. Lea & Febiger, Philadelphia New York, pp 421–445Google Scholar
- 6.Nelson NM (1966) Neonatal pulmonary function. Pediatric Clin North Am 13 (3): 769–799Google Scholar
- 11.Doershuk CF, Fisher BJ, Matthews LW (1974) Specific airway resistance from the perinatal period into adulthood. Am Ver Resp Dis 109: 452–457Google Scholar
- 15.Mushin WW, Jones PL (eds) (1987) Physics for the anesthetist. 4th edn. Blackwell Scientific, Boston New York, p 375Google Scholar
- 19.Lockwood GG (1994) Techniques of mechanical ventilation in closed and low flow systems. Anesth Intensive Care 22: 419–425Google Scholar
- 20.Baker AB (1994) Low flow and closed circuits. Anesth Intensive Care 22: 341–342Google Scholar
- 21.Simionescu R (1986) Safety of low flow anesthesia. Circulation 3: 7–9Google Scholar
- 24.Smith RM (1980) Anesthesia for infants and children. 4th edn. CV Mosby, St Louis, pp 128–151Google Scholar