Intraoperative Ventilatory Compromise Following Intubation in an Infant: A Diagnostic Challenge

Document Type

Conference Proceeding

Publication Date

10-17-2026

Abstract

A healthy 11-month-old male underwent right orchiopexy, inguinal hernia, and hydrocele repair under general anesthesia. Intubation was uneventful; however, immediately after, markedly elevated peak airway pressures and difficulty with manual ventilation were noted. Oxygen saturation remained >95%, but rising end-tidal CO₂ and diminished breath sounds raised concern for bronchospasm. Albuterol and low-dose epinephrine were administered without improvement. Ventilation via a Mapleson circuit improved compliance, suggesting equipment malfunction. Replacement of the anesthesia circuit normalized ventilation. This case underscores the importance of systematically evaluating intraoperative ventilatory difficulty with a broad differential while applying the pediatric difficult airway algorithm to guide timely management.

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