Continuous Muscle Relaxant Administration for the Management of Severe Tracheomalacia
Management of children with severe tracheomalacia is very difficult. Most cases require mechanical ventilation; the mortality rate from severe tracheomalacia is as high as 80%. Crying is often triggered, the respiratory condition gets worse, and eventually, it leads to death. For severe cases, surgical treatment should be considered immediately. Meanwhile, the prevention of fatal attacks by medical treatment is indispensable while waiting for surgery. In this report, a method to manage the patients with severe tracheomalacia using muscle relaxant was discussed. Based on clinical experience, continuous administration of 7 μg/kg/min of rocuronium was required to prevent life-threatening cyanotic attacks. However, the infusion requirements of rocuronium would show patient-to-patient variability. Further, case reports and evaluation of the effectiveness of muscle relaxants for the treatment of severe tracheomalacia were required.