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Review
. 2024 Apr-Jun;12(2):117-124.
doi: 10.4103/sjmms.sjmms_612_23. Epub 2024 Apr 5.

Delayed Sequence Intubation in Children, Why Not?

Ramón Eizaga Rebollar  1 , Paula Lozano Hierro  1 , Ana Mercedes Martínez-Almendros Fernández  1
Affiliations
Review

Delayed Sequence Intubation in Children, Why Not?

Ramón Eizaga Rebollar et al. Saudi J Med Med Sci. 2024 Apr-Jun.

Abstract

Tracheal intubation in pediatric patients is a clinical scenario that can quickly become an emergency. Complication rates can potentially reach up to 60% in rapid sequence intubation. An alternate to this is delayed sequence intubation, which may reduce potential complications-mostly hypoxemia-and can be especially useful in non-cooperative children. This technique consists of the prior airway and oxygenation optimization. This is done through sedation using agents that preserve ventilatory function and protective reflexes and continuous oxygen therapy-prior and after the anesthetic induction-using nasal prongs. The objective of this narrative review is to provide a broader perspective on delayed sequence intubation by defining the concept and indications; reviewing its safety, effectiveness, and complications; and describing the anesthetic agents and oxygen therapy techniques used in this procedure.

Keywords: Airway management; apneic oxygenation; child; delayed sequence intubation; pediatric anesthesia; pediatric critical care; rapid sequence intubation; sedation.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of delayed sequence intubation algorithm
See this image and copyright information in PMC

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