Bronchoscopy in Children.

Bronchoscopy signifies the instrumentation of the airway with a bronchoscope to visualize the airway beyond the scope of a laryngoscope, for diagnostic and therapeutic purposes. Pediatric bronchoscopy includes two endoscopic techniques, flexible and rigid bronchoscopy. This article presents an overview of bronchoscopy in the pediatric population with respect to its indications, utility and contraindications.

High-Frequency Ventilation: Excellent Rescue.

High-frequency ventilation (HFV) is a type of mechanical ventilation which utilizes a respiratory rate greater than four times the normal value and very small tidal volumes.1,2 This combination of small tidal volumes delivered for very short periods of time creates the lowest possible distal airway and alveolar pressures produced by a mechanical ventilator and exhalation is passive. It is an upcoming but promising modality.

Perioperative Myocardial Infarction.

Myocardial infarction (MI) is defined by the World Health Organization Criteria, which includes typical ischemic chest pain, ECG criteria and raised cardiac enzymes. The perioperative period induces large, unpredictable and nonphysiological alterations in coronary plaque morphology, function and progression, and may trigger a mismatch of myocardial oxygen supply and demand. Perioperative MI (PMI) is one of the most important predictors of short- and long-term morbidity and mortality associated with noncardiac surgery. Inability to fulfil the criteria, different symptomatology and numerous differential diagnoses makes PMI our subject of detailed discussion.1

Dexmedetomidine and Anesthesia.

The α2-adrenoceptors (ARs) by virtue of their sedative, analgesic, sympatholytic, anesthetic-sparing and hemodynamicstabilizing properties, have been used as an adjunct to local anesthetics for prolongation of effect. Dexmedetomidine a stereoisomer of medetomidine a highly selective α2-adrenergic receptor (AR) agonist with a relatively high ratio of α2/ α1-activity (1620:1 as compared to 220:1 for clonidine). It has recently been introduced in anesthesia practice. It is currently being used for continuous intravenous sedation in the intensive care setting and procedural sedation in nonintubated patients.