There are few things more distressing to a parent than watching a child struggle to breathe. Wheezing in the middle of the night, a cough that doesn’t seem to settle, or repeated chest infections that keep bringing a child back to the hospital – these are experiences many families across India know all too well.
There has also been an increase in children with chronic respiratory conditions such as asthma, bronchiectasis, recurrent airway infections, and complex structural airway problems diagnosed over the last ten years. However, advances in paediatric respiratory medicine are helping experts to identify and treat these conditions earlier and more effectively than before.
Now, paediatric airway management in India has improved a lot with more safety and accuracy. Today, modern imaging techniques, better bronchoscopy equipment and a better understanding of childhood lung diseases allow doctors to spot problems that sometimes went unnoticed in the past. Whether it’s a narrowing in the airway, hidden inflammation or mucus plugging within the lungs, technology is helping us see clearly and act early.
Paediatric video laryngoscopes and flexible fibre-optic scopes have emerged as the major advances in airway management in children. They allow doctors to see much more clearly into a child’s airway during procedures, increasing the odds that the airway will be secured on the first attempt. This can make a real difference for infants and small children where even seconds count.
Another major development is the increasing use of second-generation supraglottic airway devices. These are essentially specially designed breathing support devices that can be used both in emergencies and planned procedures. They offer better safety, better sealing and often fewer complications.
Even endotracheal tubes used for assisted breathing in children have been altered. Current cuffed tubes, including micro-cuff designs, are now considered safe even in very young children and neonates. They reduce the need for repeated tube changes, thus less trauma and more stability in critical care.
Additionally, advanced techniques such as humidified oxygen therapy during airway procedures have significantly improved safety by helping maintain oxygen levels during critical cases. Point-of-care ultrasound is also becoming an important part of airway management, allowing clinicians to assess airway anatomy with greater accuracy, especially in complex or unexpected situations.
Paediatric airway management is not just confined to emergency, it also includes long-term support for children with chronic breathing conditions, with personalised respiratory interventions such as bronchoscopy-guided interventions, airway clearance therapies, inhaler-based treatment plans and regular monitoring that is integrated into school, family and city life.
Artificial intelligence is being investigated to aid in predicting and directing treatment planning for challenging airways. Simulation-based training is boosting the confidence and skills of doctors who treat complex cases. More hospitals are establishing dedicated paediatric bronchoscopy units and tele-consultation models are beginning to alleviate the burden of repeated hospital visits on families.
Paediatric airway care is essentially about giving a child what every parent secretly wishes for: an untroubled breath, an undisturbed sleep and the freedom to just run, play and grow.
(The author is a lead consultant, paediatric interventional pulmonology, Manipal Hospital, Yelahanka)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
