Bronchospasm in Paediatrics
Due to the unique anatomy of paediatric airways, this unfortunately makes them more prone to airway complications such as bronchospasm.
Why is this so? 🤔
Paediatrics, particularly smaller children and infants, use different lung mechanics when breathing, which can make them more susceptible to the development of smooth muscle constriction and wheezing. Further to this, their airways often tend to have a much lower tolerance for irritants such as high airway pressures or mechanical stimulation.
What to look out for: 👀
🟢 The younger the child, the higher the incidence rate of bronchospasm
🟢 Children with asthma 💨
🟢 Children who were born premature 🍼
🟢 Children exposed to second-hand smoke 🚬
🟢 Children who have previously experienced bronchospasm 😤
🟢 Current or recent URTI (Upper Respiratory Tract Infection) or bronchiolitis 🤧
🟢 Gas induction 💨
🟢 Children requiring intubation* 🩺
- Because of the mechanical stimulation of intubation
- Increased pressure due to intubation of narrow airways. In paediatrics, airway size is already small, which is then further reduced with the introduction of an ETT (Endotracheal Tube), creating higher airway pressures
Bronchospasm management for paediatrics: 🧑⚕️
The clinical features and management of bronchospasm in kids is not too dissimilar from adult management, however, there are a few important considerations:
🟠 Children have far less reserve than adults, so will deteriorate far more rapidly in the event of bronchospasm
🟠 The dosing for medications in children, as in all scenarios, will be weight-based, so it’s always advisable to calculate drug dosing for crisis scenarios prior to commencing anaesthesia 💊
For a recap on bronchospasm in general, check out our previous blog post 👉 Bronchospasm Blog Post
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References:
Edwards, L.R., Broger, J. (2023). Paediatric Bronchospasm.Stat Pearls. https://www.ncbi.nlm.nih.gov/books/NBK546685/
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