Anchor Fast endotracheal tube securing device for a pediatric patient during therapeutic hypothermia
Yano, T.; Miyazato, T.; Nagahama, M.; Koshida, T.; Nagano, T.; Yonaha, T.; Oshikawa, M.; Taniguchi, M.; Shirasaka, T.; Tsuneyoshi, I.
Masui. Japanese Journal of Anesthesiology 63(1): 84-87
2014
ISSN/ISBN: 0021-4892 PMID: 24558938 Document Number: 671942
A 5-year-old girl was admitted to our hospital after resuscitation from cardiac arrest due to near-drowning accident in a river. On admission, Glasgow Coma Scale score was 7; arterial blood pressure was 113/73 mm Hg; heart rate was 157 beats x min(-1), and percutaneous oxygen saturation was 99% on 10 l x min(-1) of oxygen. The patient was intubated with a 5.0 mm internal diameter endotracheal tube, and therapeutic hypothermia was started for neural protection. Hypothermia in the target temperature of 34 degrees C was maintained for 24 hours using Arctic Sun System. Although the patient had been sedated with fentanyl 0.6-1.2 microg x kg(-1) x hr(-1), midazolam 0.2-0.4 mg x kg(-1) x hr(-1) and dexmedetomidine 0.6-1.0 mirog x kg(-1) x hr(-1), agitation increased during the rewarming period following hypothermia. To avoid accidental extubation, we used Anchor Fast as a device for securing oral endotracheal tube. Anchor Fast kept the tube position properly even though the patient was turned or moved. Seventy-two hours later, she was rewarmed and extubated as scheduled. Ten days after admission, she was discharged without any neurological deficits.