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pediatric bronchoscopy anesthesia

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https://www.readbyqxmd.com/read/29106868/the-use-of-ct-scan-in-foreign-body-aspiration-in-children-a-6-years-experience
#1
Vincent Pitiot, Margaux Grall, Dominique Ploin, Eric Truy, Sonia Ayari Khalfallah
INTRODUCTION: A foreign body aspiration is a risky situation, common in pediatric emergency. The "gold standard" to rule out a foreign body or proceed to its extraction, is rigid bronchoscopy (RB) under general anesthesia. However, RB is an intrusive exam with possible complications. Depending on authors, RB in emergency is a procedure at risk of complications in 4-17% of cases. Advances in radiology allow CT-scanners of fast acquisition and high definition, which could be used as an alternative to RB...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29033734/microlaryngeal-endotracheal-tube-for-lung-isolation-in-pediatric-patient-with-significant-tracheal-narrowing
#2
Renu Sinha, Anjan Trikha, Rajkumar Subramanian
A 15-year-old boy, weighing 45 kg, 160 cm height with large anterior mediastinal mass and significant tracheal narrowing was scheduled for thoracotomy and excision of the mass. He had a history of progressive dyspnea, inability to lie supine, and a right upper hemithorax mass 13 cm × 13 cm × 11 cm as evident on a computerized tomography with significant compression of the trachea and right main stem bronchus. Inhalational induction was carried out using sevoflurane with 100% oxygen. After achieving adequate depth of anesthesia with the maintenance of spontaneous respiration with oxygen and sevoflurane (minimum alveolar concentration 1...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28910517/pediatric-flexible-and-rigid-bronchoscopy-in-european-centers-availability-and-current-practice
#3
Dirk Schramm, Yin Yu, Anna Wiemers, Christina Vossen, Deborah Snijders, Uros Krivec, Kostas Priftis, Ernst Eber, Petr Pohunek
AIM: Eighteen years have passed since the last European survey concerning practices in pediatric bronchoscopy was conducted. Therefore, members of the European Respiratory Society (ERS) Pediatric Bronchology Group 7.7, initiated the "European Pediatric Bronchoscopy Survey 2015," which aimed to assess the current state of this evolving diagnostic and therapeutic procedure in the field of pediatric respiratory medicine. METHOD: A questionnaire was sent to national representatives of 44 European countries with the request to distribute it to all centers performing pediatric bronchoscopies...
November 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28476033/dexmedetomidine-plus-sufentanil-for-pediatric-flexible-bronchoscopy-a-retrospective-clinical-trial
#4
Xiujing Dang, Weidong Hu, Zhendong Yang, Shiyu Su
Several studies have reported the use of dexmedetomidine (DEX) plus opioids for flexible bronchoscopy in both adults and children. To determine whether DEX plus sufentanil (SF) is safe for children, 142 children undergoing flexible bronchoscopy were assigned to one of three groups, each of which received the same SF loading dose and similar DEX and SF maintenance doses, but different loading doses of DEX: DS1 (DEX 0.5 μg·kg-1), DS2 (DEX 1.0 μg·kg-1), and DS3 (DEX 1.5 μg·kg-1). The Ramsay sedation scale was maintained at 3 in all groups...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28393433/nasal-high-flow-oxygen-delivery-in-children-with-abnormal-airways
#5
Susan Humphreys, Derek Rosen, Tessa Housden, Julia Taylor, Andreas Schibler
BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange has been shown to safely prolong the safe apnea time in well children post induction of anesthesia and is rapidly becoming a new standard for apneic oxygenation in adults. The same oxygenation technique is described as nasal high flow and can be used in infants and children at risk of apnea during anesthesia. AIM: We investigated the use of nasal high flow oxygen delivery during anesthesia in children with abnormal airways requiring tubeless airway assessment or surgery...
June 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28296782/the-safety-and-efficacy-of-dexmedetomidine-remifentanil-in-children-undergoing-flexible-bronchoscopy-a-retrospective-dose-finding-trial
#6
Xia Li, Xue Wang, Shuguang Jin, Dongsheng Zhang, Yanuo Li
Flexible bronchoscopy is more and more used for diagnosis and management of various pulmonary diseases in pediatrics. As poor coordination of children, the procedure is usually performed under general anesthesia with spontaneous or controlled ventilation to increase children and bronchoscopists' safety and comfort. Previous studies have reported that dexmedetomidine (DEX) could be safely and effectively used for flexible bronchoscopy in both adulate and children. However, there is no trial to evaluate the dose-finding of safety and efficacy of dexmedetomidine-remifentanil (DEX-RF) in children undergoing flexible bronchoscopy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072737/the-efficacy-of-dexmedetomidine-remifentanil-versus-dexmedetomidine-propofol-in-children-undergoing-flexible-bronchoscopy-a-retrospective-trial
#7
Hongquan Zhang, Baojun Fang, Wenjing Zhou
Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy.We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27555184/reversal-of-profound-neuromuscular-blockade-with-sugammadex-in-an-infant-after-bronchial-foreign-body-removal
#8
Mustafa Azizoglu, Handan Birbicer, Suleyman Memis, Hakan Taşkınlar
Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. In the emergency department, the patient's condition deteriorated, and he went into respiratory arrest...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27358613/flexible-bronchoscopy-contribution-in-the-approach-of-diagnosis-and-treatment-of-children-s-respiratory-diseases-the-experience-of-a-unique-pediatric-unit-in-tunisia
#9
Samia Hamouda, Amal Oueslati, Imen Belhadj, Fatma Khalsi, Faten Tinsa, Khadija Boussetta
OBJECTIVE: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children's respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. METHODS: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. RESULTS: We performed 365 FB in 333 patients aged 46 months on average (1 month - 15 years), often under conscious anesthesia (81...
March 2016: African Health Sciences
https://www.readbyqxmd.com/read/27228464/tracheal-cartilaginous-sleeves-in-children-with-syndromic-craniosynostosis
#10
Tara L Wenger, John Dahl, Elizabeth J Bhoj, Anna Rosen, Donna McDonald-McGinn, Elaine Zackai, Ian Jacobs, Carrie L Heike, Anne Hing, Avni Santani, Andrew F Inglis, Kathleen C Y Sie, Michael Cunningham, Jonathan Perkins
PURPOSE: Because a tracheal cartilaginous sleeve (TCS) confers a significant mortality risk that can be mitigated with appropriate intervention, we sought to describe the prevalence and associated genotypes in a large cohort of children with syndromic craniosynostosis. METHODS: Chart review of patients with syndromic craniosynostosis across two institutions. RESULTS: In a cohort of 86 patients with syndromic craniosynostosis, 31 required airway evaluation under anesthesia...
May 26, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/27145336/sedation-and-general-anesthesia-for-patients-with-cornelia-de-lange-syndrome-a-case-series
#11
Alessandra Moretto, Vittorio Scaravilli, Valentina Ciceri, Mariagrazia Bosatra, Federica Giannatelli, Bianca Ateniese, Milena Mariani, Anna Cereda, Simone Sosio, Alberto Zanella, Antonio Pesenti, Angelo Selicorni
Cornelia De Lange syndrome (CdLS) is a rare congenital disease characterized by typical facial dysmorphism, developmental disability, and limb deficiency defects. Various congenital malformations and medical complications have been described with gastroesophageal reflux as the major one. CdLS patients often require multiple high-risk anesthetic procedures. At San Gerardo Hospital (Monza, Italy) the management of CdLS patients is routinely organized through a standard protocol and a dedicated pediatric anesthesia team has been implemented...
June 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/26939917/usefulness-of-upper-airway-endoscopy-in-the-evaluation-of-pediatric-pulmonary-aspiration
#12
Eelam Adil, Ozgul Gergin, Kosuke Kawai, Reza Rahbar, Karen Watters
IMPORTANCE: There is no consensus on the evaluation of pediatric patients with aspiration. OBJECTIVES: To determine the yield of direct laryngoscopy and bronchoscopy (DLB) using general anesthesia in pediatric patients who aspirate and to identify clinical predictors of aspiration-related airway lesions. DESIGN, SETTING, AND PARTICIPANTS: Retrospective review at a tertiary referral children's hospital. A medical record review was performed on all patients with a documented diagnosis of pulmonary aspiration who underwent DLB using general anesthesia during a 5-year period (January 2010 to December 2014)...
April 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/26501239/evaluation-and-management-of-chronic-aspiration-in-children-with-normal-upper-airway-anatomy
#13
Eelam Adil, Hasan Al Shemari, Amy Kacprowicz, Jennifer Perez, Kara Larson, Kayla Hernandez, Kosuke Kawai, Julia Cowenhoven, David Urion, Reza Rahbar
IMPORTANCE: Chronic airway aspiration is a challenging problem for physicians and caregivers and can cause significant pulmonary morbidity in pediatric patients. Our knowledge regarding the causes and optimal management of these patients is in its infancy. OBJECTIVE: To review our experience with the evaluation and management of pediatric patients with documented aspiration and normal upper airway anatomy. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective medical record review, we studied pediatric patients for airway disorders at a pediatric tertiary referral center who were diagnosed as having aspiration on modified barium swallow study during a 10-year period (June 1, 2002, through September 31, 2012)...
November 2015: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/26422815/flow-dynamics-in-pediatric-rigid-bronchoscopes-using-computer-aided-design-modeling-software
#14
Mitchell D Barneck, J Taylor Webb, Ryan E Robinson, J Fredrik Grimmer
OBJECTIVES/HYPOTHESIS: Observed complications during rigid bronchoscopy, including hypercarbia and hypoxemia, prompted us to assess how well rigid bronchoscopes serve as an airway device. We performed computer-aided design flow analysis of pediatric rigid bronchoscopes to gain insight into flow dynamics. STUDY DESIGN: We made accurate three-dimensional computer models of pediatric rigid bronchoscopes and endotracheal tubes. SOLIDWORKS (Dassault Systemes, Vélizy-Villacoublay, France) flow analysis software was used to analyze fluid dynamics during pressure-controlled and volume-controlled ventilation...
August 2016: Laryngoscope
https://www.readbyqxmd.com/read/26230306/smartphones-in-the-operating-room-distraction-or-diagnostic-aid-a-case-of-newly-diagnosed-wolff-parkinson-white-in-a-pediatric-patient-having-bronchoscopy-under-general-anesthesia
#15
Brandon Esenther, Riva Ko
A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded...
August 1, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/26194048/is-inpatient-admission-necessary-following-removal-of-airway-foreign-bodies
#16
Steven M Andreoli, Emma Kofmehl, Steven E Sobol
OBJECTIVE: To determine the need for postoperative admission following airway foreign body retrieval by examining the preoperative presentation, operative details, and postoperative recovery. INTRODUCTION: Inpatient admission following foreign body removal is common, however little evidence supports this practice. In the era of cost containment and prudent utilization of hospital resources, careful examination of the postoperative course following airway foreign body removal is required...
September 2015: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/26139499/chemocauterization-with-trichloroacetic-acid-in-congenital-and-recurrent-tracheoesophageal-fistula-a-minimally-invasive-treatment
#17
Yann Lelonge, François Varlet, Patricio Varela, Francisco Saitúa, Laurent Fourcade, Rocio Gutierrez, Sophie Vermesch, Jean-Michel Prades, Manuel Lopez
OBJECTIVE: Recurrent tracheoesophageal fistula (RTEF) is a serious complication after primary repair of esophageal atresia and tracheoesophageal fistula (EA/TEF). Treatment of RTEF involved an open surgery by thoracotomy. Technically it is a challenge with a high morbidity and mortality. Congenital tracheoesophageal fistula (CTEF) traditionally involved an open surgery by thoracotomy or cervicotomy. Many endoscopic techniques have been developed since the past decades: thoracoscopic or bronchoscopic approach for the treatment of RTEF and CTEF; nevertheless, optimal treatment is not still determined because of few numbers of patients, short-term follow-up, and different procedures...
April 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/26011218/treatment-of-tracheal-mucoepidermoid-carcinoma-by-argon-plasma-coagulation-during-pregnancy
#18
Assaad Kesrouani, Georges Dabar, Samir Rahal, Claude Ghorra
Mucoepidermoid carcinoma of the tracheobronchial tree is a rare airway tumor (<1% of all lung tumors). In adults, the majority of primary tracheal tumors are malignant. Management during pregnancy is complex and requires weighing maternal and fetal prognosis. Reported cases describe surgical resection following cesarean section. We report the first case to be treated by Argon-Plasma Coagulation (APC) in pregnancy. A 35-year-old Caucasian woman G1P0, at 27 weeks of gestation was admitted to the emergency department because of hemoptysis and severe dyspnea...
May 2015: International Surgery
https://www.readbyqxmd.com/read/25746697/tracheobronchomalacia-in-pediatric-patients-with-esophageal-atresia-comparison-of-diagnostic-laryngoscopy-bronchoscopy-and-dynamic-airway-multidetector-computed-tomography
#19
Monawat Ngerncham, Edward Y Lee, David Zurakowski, Donald A Tracy, Russell Jennings
PURPOSE: Diagnostic laryngoscopy and bronchoscopy (DLB) has been the traditional preoperative diagnostic modality for evaluating presence and severity of tracheobronchomalacia (TBM), and requires anesthesia. Alternatively, multidetector computed tomography (MDCT) is potentially a noninvasive modality that provides high-resolution, 3-dimensional (3D) imaging of the thorax providing preoperative guidance for pediatric surgeons. This study compares MDCT with intraoperative DLB in the assessment of TBM in symptomatic pediatric patients with esophageal atresia (EA)...
March 2015: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/25370783/the-can-t-intubate-can-t-oxygenate-scenario-in-pediatric-anesthesia-a-comparison-of-the-melker-cricothyroidotomy-kit-with-a-scalpel-bougie-technique
#20
COMPARATIVE STUDY
Sarah L Prunty, Alberto Aranda-Palacios, Andy M Heard, Gordon Chapman, Anoop Ramgolam, Mary Hegarty, Shyan Vijayasekaran, Britta S von Ungern-Sternberg
BACKGROUND: While the majority of pediatric intubations are uncomplicated, the 'Can't intubate, Can't Oxygenate' scenario (CICO) does occur. With limited management guidelines available, CICO is still a challenge even to experienced pediatric anesthetists. OBJECTIVES: To compare the COOK Melker cricothyroidotomy kit (CM) with a scalpel bougie (SB) technique for success rate and complication rate in a tracheotomy on a cadaveric 'infant airway' animal model. METHODS: Two experienced proceduralists repeatedly attempted tracheotomy in eight rabbits, alternately using CM and SB (4 fr) technique...
April 2015: Paediatric Anaesthesia
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