Nathan Tighe

42 statements · 2 topics

Aerodigestive / ENT · guest expert

Featured statements

Unrepaired single ventricle kids are really sensitive to changes in their ventilation.
quote · Aerodigestive / ENT
Three dimensions are important for lung isolation: tracheal diameter (particularly AP diameter), bronchial diameters, and the length of the right main stem bronchus between carina and right upper lobe takeoff.
clinical · Aerodigestive / ENT
Regular endotracheal tube is the most common device for lung isolation in neonates because it is relatively straightforward to mainstem into the left bronchus, which has a good landing zone for the balloon.
clinical · Esophageal Atresia
Unrepaired single ventricle patients are sensitive to changes in ventilation because they can have swings in circulation direction based on pulmonary vascular resistance.
clinical · Esophageal Atresia

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Nathan's statements about Aerodigestive / ENT 21 statements

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QUAD #7 Anesthesia for Thoracoscopic Techniques with Dr. Nathaniel Tighe

Statement Birth history and patient size are important preoperative considerations for esophageal atresia repair. Open
Quotation Birth history is really important and how big the child is. Open
Statement Physiologic status from ventilation and cardiac standpoints is particularly important in preoperative assessment. Open
Quotation We can help make better decisions ahead of time and probably spend less time in the operating room with a child under anesthesia if we have a good look at what that child's airway looks like before we start. Open
Statement Preoperative visualization of the child's airway allows better decision-making and potentially less time under anesthesia. Open
Quotation Akinesis or keeping the kids still can be very challenging in these small children, especially when intraoperative neuromonitoring is involved. Open
Statement Akinesis (keeping children still) can be very challenging in small children, especially when intraoperative neuromonitoring is involved. Open
Statement Intraoperative neuromonitoring precludes the use of neuromuscular blocking drugs like rocuronium and vecuronium. Open
Quotation As far as the anesthetic goes, it precludes our use of neuromuscular blocking drugs like urouronium, Becuronium, and others. Open
Statement Patients with compliance abnormalities often require higher peak inspiratory or mean airway pressures, resulting in the need for very high insufflation pressures. Open
Statement Lung isolation utility is restricted by patient size and airway anatomy and requires expertise and specialized equipment. Open
Quotation There's 3 dimensions that are really important. Open
Statement Three dimensions are important for lung isolation: tracheal diameter (particularly AP diameter), bronchial diameters, and the length of the right main stem bronchus between carina and right upper lobe takeoff. Open
Statement Regular endotracheal tube is the most common device for lung isolation in neonates because it is relatively straightforward to mainstem into the left bronchus, which has a good landing zone for the balloon. Open
Quotation Regular old endotracheal tube is probably the most common in neonates because it's relatively straightforward to mainstem. Open
Statement Bronchial blockers or Fogarty catheters require enough space between the carina and right upper lobe takeoff for balloon placement. Open
Statement In kids with a pig bronchus, bronchial blocker placement becomes very difficult and may require selective lobar blockade. Open
Statement Bronchial blockers can be helpful in kids with abnormal parenchyma when higher ventilatory pressures are needed but higher insufflation pressures should be avoided. Open
Statement Unrepaired single ventricle patients are sensitive to changes in ventilation because they can have swings in circulation direction based on pulmonary vascular resistance. Open
Quotation Unrepaired single ventricle kids are really sensitive to changes in their ventilation. Open
Statement Insufflation causes changes in preload, and patients with passive pulmonary circulations are particularly sensitive to this insufflation. Open
Nathan's statements about Esophageal Atresia 21 statements

Open the Esophageal Atresia collection →

QUAD #7 Anesthesia for Thoracoscopic Techniques with Dr. Nathaniel Tighe

Quotation Birth history is really important and how big the child is. Open
Statement Birth history and patient size are important preoperative considerations for esophageal atresia repair. Open
Statement Physiologic status from ventilation and cardiac standpoints is particularly important in preoperative assessment. Open
Quotation We can help make better decisions ahead of time and probably spend less time in the operating room with a child under anesthesia if we have a good look at what that child's airway looks like before we start. Open
Statement Preoperative visualization of the child's airway allows better decision-making and potentially less time under anesthesia. Open
Statement Akinesis (keeping children still) can be very challenging in small children, especially when intraoperative neuromonitoring is involved. Open
Quotation Akinesis or keeping the kids still can be very challenging in these small children, especially when intraoperative neuromonitoring is involved. Open
Quotation As far as the anesthetic goes, it precludes our use of neuromuscular blocking drugs like urouronium, Becuronium, and others. Open
Statement Intraoperative neuromonitoring precludes the use of neuromuscular blocking drugs like rocuronium and vecuronium. Open
Statement Patients with compliance abnormalities often require higher peak inspiratory or mean airway pressures, resulting in the need for very high insufflation pressures. Open
Statement Lung isolation utility is restricted by patient size and airway anatomy and requires expertise and specialized equipment. Open
Quotation There's 3 dimensions that are really important. Open
Statement Three dimensions are important for lung isolation: tracheal diameter (particularly AP diameter), bronchial diameters, and the length of the right main stem bronchus between carina and right upper lobe takeoff. Open
Statement Regular endotracheal tube is the most common device for lung isolation in neonates because it is relatively straightforward to mainstem into the left bronchus, which has a good landing zone for the balloon. Open
Quotation Regular old endotracheal tube is probably the most common in neonates because it's relatively straightforward to mainstem. Open
Statement Bronchial blockers or Fogarty catheters require enough space between the carina and right upper lobe takeoff for balloon placement. Open
Statement In kids with a pig bronchus, bronchial blocker placement becomes very difficult and may require selective lobar blockade. Open
Statement Bronchial blockers can be helpful in kids with abnormal parenchyma when higher ventilatory pressures are needed but higher insufflation pressures should be avoided. Open
Quotation Unrepaired single ventricle kids are really sensitive to changes in their ventilation. Open
Statement Unrepaired single ventricle patients are sensitive to changes in ventilation because they can have swings in circulation direction based on pulmonary vascular resistance. Open
Statement Insufflation causes changes in preload, and patients with passive pulmonary circulations are particularly sensitive to this insufflation. Open