A Case of CHARGE Syndrome and Hypoxemia

The following book chapter is entitled “A Case of CHARGE Syndrome and Hypoxemia.” This chapter describes a challenging clinical case and offers several educational lessons related to CHARGE patients as well as pediatric anesthesiology. The perioperative care of pediatric patients often requires knowledge of syndromes, which have several anesthetic implications. Patients with CHARGE syndrome may present numerous challenges to the anesthesiologist. Airways can be difficult to manage as these patients may have micrognathia, choanal atresia, laryngeal clefts, laryngeal webs, laryngomalacia, or subglottic stenosis. In this case, the airway was managed with a nasotracheal intubation, and this technique of securing the airway along with its associated complications and contraindications is discussed. In addition to reviewing background information on CHARGE syndrome and the airway management involved in the case, this chapter reviews information related to perioperative adverse respiratory events such as laryngospasm, bronchospasm, and breath holding. Decision-making in the patient presenting with an upper respiratory tract infection is also described. Finally, aspects of pediatric advanced life support measures are reviewed. Overall, the chapter format engages the reader and serves as a unique way of teaching “lessons learned.”