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pediatric

Measurements:
  • Diameter inside the endotracheal tube (2):
    • Frühgeborene: nicht gecufft: Gestationsalter in Wochen/10.
    • Reife Neugeborene: nicht gecufft: 3.5.
    • Säuglinge: nicht gecufft: 3.5-4.0, gecufft: 3.0-3.5.
    • Kind 1-2. LJ: nicht gecufft: 4.0-4.5, gecufft: 3.5-4.0.
    • Kind >2. LJ: nicht gecufft: (Alter/4)+4, gecufft: Alter/4+3.5.
  • Tubustiefe:
    • oral (in cm): (Alter/2)+12; oder bis zum Alter von 12 Jahren: 3xInnendurchmesser (2).
    • nasal (in cm): (Alter/2)+15.
  • Weight: (2 x age)+4 = weight in kg (2).

Treatment (1):

  • Ventilation: for children <10 kg, adequate tidal volume are achieved with peak inspiratory pressure of 15-18 cmH2O. For larger children the volume control ventilation may be used and tidal volumes may be set at 8-10 ml/kg.
  • Fluids are given according to the 4:2:1-rule. Preoperative fluid deficits are typically administred with hourly maintenance requirements in aliquots of 50% in the first hour and 25% in the second and third hour.
  • Laryngospasm: lidocain, succinylcholine or rocuronium.
  • Postintubation croup: dexamethasone iv or inhalation of nebulized epinephrine.

Downloads/links: Kinderspickzettel

References:
  1. Morgan & Mikhail's Clinical Anesthesiology. McGraw-Hill. 2013.
  2. European Paediatric Life Support. Deutsche Version 1.