1 ,3

,
45
Nose breathers

3-4 , 4-5 2 , 5-6

ADULT

INFANT

Image from:
http://www.hadassah.org.il/NR/rdonlyres/59B531BDEECC-4FOE-9E8114B9B29D139B1945/AirwayManagement.ppt

CC > FRC

2 6 - 7 ml/ kg /min
VA (100 150 ml/kg/min)
VA = VT * RR

VA/ FRC = 4,5 / 1


Poiseuille
R = 8nl/ r4

16x

3x

!!!

Change in work of breathing after placement of an appropriate endotracheal tube

in extremely low birth weight infants (<1000 g), premature infants (1500 g),
full-term infants, children, and adults



(, , )

/
( , )

( , / )

(, )
( )
(, )
(, .)

(, , )
,

()

C hin
O pening
P revious Intubation or OSA
U vula
R ange

1 - 4

5-7
8-10
12 ,
14 ,
16 - ,



&




(Pierre Robin, Treacher Collins, Goldenhar)
(Apert, Crouzon)
(Hunter, Beckwith-Wiedemann, Down)

/
-

 Pierre Robin

 Treacher Collins

 Apert

 Crouzon

 Down

 Beckwith-Wiedemann

 Hunter

Monitoring

??????

ETT(mm ID)

(cm)

1kg

2.5

1- 2.5kg

3.0

7- 9

- 6

3.0 3.5

10

6-12

3.5 4.0

11

<2

4.0 -5.0

12

>2 :
Uncuffed ETT: ( /4) + 4
Cuffed ETT: ( /4) +3
ETT : ETT x 3

 cuff cuff
20-25 cm H2O
<8

, .

Micro-cuff ETT

E clamp
C clamp

Image from: http://www.hadassah.org.il/NR/rdonlyres/59B531BD-EECC-4FOE-9E81-14B9B29D139B1945/AirwayManagement.ppt

, ,
Image from: http://www.hadassah.org.il/NR/rdonlyres/59B531BD-EECC-4FOE-9E81-14B9B29D139B1945/AirwayManagement.ppt

LMA
Patient weight LMA size
(kg)

<5
5-10
10-20
20-30
30-50
50-70
70-100

1
1.5
2
2.5
3
4
5

Cuff volume (ml)

4
7
10
14
20
30
40

1.4% (Kheterpal et al. Anesthesiology 2006: 22,660 anesthetics)

2.2% (Kheterpal et al. Anesthesiology 2009: 50,000 anesthetics)
5% (Langeron et al. Anesthesiology 2000: 1,502 anesthetics)

2.1%
(Tait et al. Anesthesiology 2008: 2,025 anesthetics)

Childrens Hospital of Philadelphia,2006

8800

0.42%
0.08%
0.02%

1.1 3.8%

??? ( p.os. 30- 40 g/kg 90 min)
:

( )
2
!!!

Gold standard

/ airway exchanger

Paediatric Difficult Airway Guidelines, 2012

Difficult mask ventilation during routine induction of
anaesthesia in a child aged 1 to 8 years
Unanticipated difficult tracheal intubation during routine
induction of anaesthesia in a child aged 1 to 8 years
Cannot intubate and cannot ventilate (CICV) in a paralysed
anaesthetised child aged 1 to 8 years

Croup
Normal inspiratory
stretch/collapse
(crying)

1.
2.
3.
4.
5.
Dynamic collapse
.
at inlet
Bronchiolitis/asthma

Broselow Tape

Broselow Tape

8 (6-36 kg)
Broselow-Luten Emergency
System