ABSTRACT
Pulmonary ventilation can occasionally and unexpectedly become difficult during anaesthesia. Children with chronic disease may have contributory problems that can be detected and assessed beforehand. There are also conditions that prevent effective breathing afterwards. This chapter discusses the mechanisms of difficult or problematic ventilation together with the common causative diseases, important pharmacological treatment and mechanical support. The management of specific and important problems are covered and the reader will find several links with related subjects such as the respiratory system (Chapter 2) and thoracic surgery (Chapter 39). Further information can be found in texts and reviews of intensive care [1,2]. Rather than a review of the intensive care of pulmonary disease this chapter brings together information that an anaesthetist must understand in order to manage a ventilation problem successfully before, during or after anaesthesia.
