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Paediatr Anaesth. 2008 Jul;18(7):658-62. doi: 10.1111/j.1460-9592.2008.02584.x. Epub 2008 May 8.

Emergency use of a size 1 laryngeal mask airway in a ventilated neonate with an undiagnosed type IV laryngotracheo-oesophageal cleft.

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Department of Anaesthesia, Princess Margaret Hospital for Children, Perth, WA, Australia.


The perioperative management of a neonate with a type IV laryngotracheo-oesophageal cleft and exomphalos major is described. Following an otherwise uncomplicated exomphalos repair, this baby became increasingly and inexplicably difficult to ventilate through an endotracheal tube. The emergency use of a laryngeal mask airway as a rescue maneuver allowed positive pressure ventilation, and subsequent diagnosis of the airway abnormality. The difficulties in management of the two co-existing conditions are discussed.

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