Shigellosis caused by Shigella boydii in a preterm neonate, masquerading as necrotizing enterocolitis

A rare case of neonatal shigellosis caused by Shigella boydii in a preterm neonate, severe enough to necessitate intensive care support, is presented. The roles of breast-feeding, hand-washing and surveillance for enteric infections in the prevention of shigellosis in low risk settings such as a special care baby unit are highlighted.     

A randomised comparison of free‐handed vs air‐Q™ assisted fibreoptic‐guided tracheal intubation in children < 2 years of age

We prospectively compared free‐handed and air‐Q? assisted fibreoptic‐guided tracheal intubation in children < 2 years of age. Eighty healthy children were enrolled and randomly assigned to a technique (free‐handed or air‐Q assisted) and operator (trainee or attending). Time, number of attempts and manoeuvres required were assessed. There was no difference in median (IQR [range]) time to successful tracheal intubation between the free‐handed (52.2 (34.8–67.7 [19.7–108.0]) s), and the air‐Q assisted (60.3 (45.5–75.1 [28.1–129.0]) s; p = 0.13) groups, or the number of attempts needed. The air‐Q assisted group required fewer manoeuvres to optimise the laryngeal view (median (IQR [range]) 0 (0–1 [0–2])) than the free‐handed group (1 (1–1 [0–3]); p < 0.001). In conclusion, fibreoptic‐guided tracheal intubation times were similar with and without the use of the air‐Q, but supraglottic airway devices may be a consideration for their other practical advantages.     

A randomised comparison of the LMA SupremeTM and LMAProSealTM in children

We conducted a randomised trial comparing the size‐2 LMA Supreme? with the LMA ProSeal? in 60 children undergoing surgery. The outcomes measured were airway leak pressure, ease and time for insertion, fibreoptic examination, incidence of gastric insufflation, ease of gastric tube placement, quality of the airway during anaesthetic maintenance and complications. There were no statistically significant differences between the LMA Supreme and LMA ProSeal in median (IQR [range]) insertion time (12 (10–15 [7–18]) s vs 12 (10–13 [8–25]) s; p = 0.90), airway leak pressures (19 (16–21 [12–30]) cmH₂O vs 18 (16–24 [10–34]) cmH₂O; p = 0.55), fibreoptic position of the airway or drain tube, ease of gastric access and complications. Both devices provided effective ventilation requiring minimal airway manipulation. The LMA Supreme can be a useful alternative to the LMA ProSeal when single‐use supraglottic devices with gastric access capabilities are required.