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Role of Pediatric Airway Expert and Videolaryngoscope in Perioperative Airway Management of an Anticipated Difficult Pediatric Airway - We Fail, We Learn, We Evolve

Darshana Rathod, Kamlesh Kumari, Jyothi Koteswara Rao, Tanvi Meshram and Shilpa Goyal

The difficult airway associated with Pierre Robin Sequence (PRS) is a known challenge for anaesthesiologists. These challenges increase manifold in redo surgeries. A 44 days old infant with PRS underwent glossopexy, the airway was secured using videolaryngoscope and external laryngeal manipulation. When the child was extubated in the Pediatric intensive care unit on the third postop day, the sutures from primary surgery got loosened causing the tongue to fall and obstruct the airway. The child was posted for the same surgery in a short time because of eventful extubation offering us an even more challenging airway. We are reporting the perioperative role of a pediatric airway expert in this case of anticipated airway difficulty.

Conclusion: We suggest that the day-to-day practice can be altered and improved based on bad past experiences. A multidisciplinary approach including a pediatric airway expert and a videolaryngoscope can be a game-changer in case of extubation of a difficult airway patient.

We emphasize the presence of a pediatric airway expert and videolaryngoscope in the pediatric/neonatal intensive care unit during the management of the anticipated pediatric difficult airway.