• Down's syndrome
    • Trisomy 21 (95%), chromosomal translocation (4%) or mosaic trisomy (1%)
    • Choose smaller tube size as they are short for age as large tubes cause oedema and swelling with post op stridor.
    • Clinical features
      • General
        • LBW, obesity in childhood, short stature, brachycephaly, flat nasal bridge, simian crease, micrognathia, oropharyngeal hypotonia
      • Neurological
        • Hypotonia, impaired IQ, post-op agitating, Alzheimer's, epilepsy, squint, cataracts
      • Spinal disease
        • Atlanta-axial instability (10-20%, suggested by a >4mm gap between peg and atlas arch), cervical spondylitis
      • Respiratory
        • OSAS, Subglottic stenosis, LRTI
      • CV
        • CHD, PAH, Valvular heart disease, ASD, VSD, TOF,
      • GI
        • GORD, GI atresias, Hirschprung's disease
      • Endocrine
        • Hypothyroidism
      • Immunological
        • Prone to sepsis due to immune dysfunction
    • CEACCP
      Link:ceaccp.oxfordjournals.org/content/3/3/83.full.pdf