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https://www.readbyqxmd.com/read/29112511/an-anesthesiologist-s-perspective-on-the-history-of-basic-airway-management-the-progressive-era-1904-to-1960
#1
Adrian A Matioc
This third installment of the history of basic airway management discusses the transitional-"progressive"-years of anesthesia from 1904 to 1960. During these 56 yr, airway management was provided primarily by basic techniques with or without the use of a face mask. Airway maneuvers were inherited from the artisanal era: head extension and mandibular advancement. The most common maneuver was head extension, also used in bronchoscopy and laryngoscopy. Basic airway management success was essential for traditional inhalation anesthesia (ether, chloroform) and for the use of the new anesthetic agents (cyclopropane, halothane) and intravenous drugs (thiopental, curare, succinylcholine)...
November 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29106868/the-use-of-ct-scan-in-foreign-body-aspiration-in-children-a-6-years-experience
#2
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/29101958/interventional-pulmonology
#3
REVIEW
David M DiBardino, Andrew R Haas, Richard C Month
Bronchoscopy presents a unique challenge and need for collaboration between anesthesia providers and bronchoscopists. The approach to topical anesthesia, analgesia, and sedation must be customized based on complexity, duration, and setting. The bronchoscopy team must work together in each phase of the procedure to ensure patient safety and allow completion of a quality bronchoscopy. Airway access may change depending on the type of procedure planned and must be discussed before each case. Intraprocedural difficulties with ventilation, airway pressure, and sedation may arise that must be addressed together...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29077665/biphasic-cuirass-ventilation-during-anesthesia-for-tracheobronchial-stent-insertion-or-removal-by-a-rigid-bronchoscope-a-case-report
#4
Hideaki Mori, Atsuko Shono, Ritsuko Hirade, Tetsuro Nikai, Yoji Saito
Airway management and ventilation during a tracheobronchial stenting procedure are challenging given that mandatory positive pressure ventilation cannot be fully achieved while using a rigid bronchoscope due to leakage from the scope tip. Biphasic cuirass ventilation is a negative pressure ventilation method using an external cuirass fitted to the anterior chest, which could assist in spontaneous breathing and ventilation support. We report 3 successful anesthesia cases in which we could maintain adequate ventilation and oxygenation, supported by biphasic cuirass ventilation, in patients undergoing tracheobronchial stent placement or removal procedures using rigid bronchoscopy...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29052061/comparison-of-two-new-techniques-for-the-management-of-malignant-central-airway-obstruction-argon-plasma-coagulation-with-mechanical-tumor-resection-versus-cryorecanalization
#5
Derya Kızılgöz, Zafer Aktaş, Aydın Yılmaz, Ayperi Öztürk, Fatih Seğmen
BACKGROUND: The development of central airway obstruction during malignant diseases is an important cause of morbidity and mortality. Endobronchial therapies can decrease the patient's symptoms and improve quality of life. Here, we compare airway recanalization methods: argon plasma coagulation with mechanical tumor resection (APC + MTR) and cryorecanalization (CR efficiency, complications, restenosis rate, and time to restenosis) in patients with malignant exophytic endobronchial airway obstruction...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29047403/successful-treatment-of-a-recurrent-granulation-polyp-in-the-airways-with-high-dose-rate-brachytherapy-a-case-report
#6
M Polke, J Oelmann-Avendano, A Warth, C P Heussel, F J F Herth, R Eberhardt
BACKGROUND: Benign central airway tumors are very rare diseases. Their unspecific symptoms are responsible for late diagnosis. Endoscopic interventions with different techniques and tools are widely used for their treatment. However, in certain cases interventional endoscopy might be unsuccessful and therefore other methods such as high-dose-rate brachytherapy could be a therapeutic option. CASE PRESENTATION: A 76-year-old white German woman was referred to our clinic for an endoscopic treatment of a recurrent granulation polyp in her left main bronchus...
October 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29033734/microlaryngeal-endotracheal-tube-for-lung-isolation-in-pediatric-patient-with-significant-tracheal-narrowing
#7
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/28915133/complications-and-unplanned-admissions-in-nonoperating-room-procedures
#8
Kate Leslie, Benjamin Kave
PURPOSE OF REVIEW: The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. RECENT FINDINGS: The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28910517/pediatric-flexible-and-rigid-bronchoscopy-in-european-centers-availability-and-current-practice
#9
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/28904706/-when-the-denture-becomes-dangerous
#10
Nouzha Sadak, Laila Herrak, Leila Achachi, Mustapha El Ftouh
Although rare in adults, foreign body aspiration (FBA) is a serious accident which can be potentially life threatening or lead to significant sequelae. We report the case of a 50 year old patient without previous pathological history, presenting to the emergency department with chest pain, intermittent cough and exertional dyspnea occurring six days after the accidental aspiration of his plastic dental prosthesis during a meal. Clinical examination was unremarkable. Chest X-ray as well as abdominal x-ray requiring no prior preparation showed no abnormalities...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28834918/endobronchial-melanoma-metastasis-40-years-after-the-excision-of-the-primary-cutaneous-tumor-a-case-report
#11
Georgia Karpathiou, Marios Froudarakis, Vanessa Da Cruz, Fabien Forest, Maxime Sauvage, Jean Michel Vergnon, Michel Peoc'h
RATIONALE: Endobronchial melanoma metastases are rare, comprising 4.5% of all endobronchial metastases. They are diagnosed at a median time of 48 months from primary tumor presentation, and survival of these patients is poorer when accompanied by other metastatic sites or malignant pleural effusion. We present a case of endobronchial melanoma metastasis happening 40 years after the initial diagnosis. The need of adjuvant techniques in the diagnosis of this tumor is highlighted and a short review on this rare phenomenon is provided...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28757767/anesthesia-for-a-patient-with-unexpected-giant-tracheobronchomegaly
#12
Chien-Ching Lee, Bor-Shyh Lin, Jen-Yin Chen, Chia-Chun Chuang
Tracheobronchomegaly (also called Mounier-Kuhn syndrome) is a rare disease characterized by flaccid and markedly dilated trachea and main bronchi on inspiration with narrowing or collapse on expiration or cough. It is associated with recurrent lower respiratory tract infection. A 75-year-old man with unexpected giant tracheomegaly had a significant peritubal air leak which impeded an operation. Lumbar epidural anesthesia was performed for a subsequent operation without any sequela. Careful evaluation with chest radiography is basic to exclude a large airway...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#13
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28687379/moderate-sedation-changes-for-bronchoscopy-in-2017
#14
REVIEW
Michael E Nelson
The reimbursement for procedures using moderate (conscious) sedation has changed significantly as of January 1, 2017. Due to the increasing use of anesthesia services to provide moderate sedation during endoscopy, the Centers for Medicare & Medicaid Services made the decision to remove work relative value units from many of the services requiring moderate sedation, including the bronchoscopy codes. If a bronchoscopist provides moderate sedation to a patient without using anesthesia services or another qualified provider, that work (and revenue) can be reclaimed by using the relevant codes...
October 2017: Chest
https://www.readbyqxmd.com/read/28590065/safety-and-efficacy-of-laryngeal-mask-airway-ventilation-in-obese-patients-with-airway-stenosis
#15
D Cole Pourciau, D Peter Hotard, Schuylor Hayley, Kasey Hayley, Collin Sutton, Andrew J McWhorter, Daniel S Fink
OBJECTIVE: To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis. STUDY DESIGN: A retrospective chart review was conducted in an academic practice in a tertiary care center. METHODS: We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O2 saturation and maximum-end tidal carbon dioxide (CO2 ) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded...
November 2017: Laryngoscope
https://www.readbyqxmd.com/read/28542051/critical-airway-stenosis-in-an-adolescent-male-with-pompe-disease-and-thoracic-lordosis-a-case-report
#16
B Randall Brenn, Mary T Theroux, Suken A Shah, William G Mackenzie, Robert Heinle, Mena T Scavina
An adolescent male with late-onset Pompe disease (glycogen storage disease type II) presented with a history of restrictive airway disease and a near-cardiorespiratory arrest during anesthesia for a liver biopsy initially thought to be due to bronchospasm. During a subsequent posterior spinal fusion procedure, he suffered cardiorespiratory arrest resulting in the procedure being aborted. Bronchoscopy performed shortly after resuscitation revealed an undiagnosed narrowing of the distal trachea and bronchi. This is the first description of a patient with late-onset Pompe disease with undiagnosed critical tracheal stenosis due to the progression of thoracic lordosis, which was ultimately relieved by posterior spinal fusion...
October 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28542046/elective-venovenous-extracorporeal-membrane-oxygenation-for-resection-of-endotracheal-tumor-a-case-report
#17
W Jonathan Dunkman, Alina Nicoara, Jacob Schroder, Momen M Wahidi, Aimen El Manafi, Desiree Bonadonna, Coral X Giovacchini, Frederick W Lombard
We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room and underwent bifemoral cannulation for VV-ECMO under light sedation while maintaining spontaneous ventilation. After VV-ECMO was initiated, general anesthesia was induced, and the tumor was resected via rigid bronchoscopy. After resection, the patient was intubated, weaned from ECMO, decannulated, awoken, extubated, and taken to the postanesthesia care unit for recovery...
August 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28538020/incidence-and-risk-factors-of-hypoxemia-during-interventional-rigid-bronchoscopy-under-spontaneous-assisted-ventilation
#18
Saowapark Chumpathong, Jamsak Tscheikuna, Thanatporn Boonsombat, Saipin Muangman, Choopong Luansritisakul
BACKGROUND: Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined. METHODS: Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed...
October 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28527967/feasibility-and-safety-of-the-transbronchial-access-tool-for-peripheral-pulmonary-nodule-and-mass
#19
Mark R Bowling, Craig Brown, Carlos J Anciano
BACKGROUND: Navigational bronchoscopy and other imaging modalities have improved the ability to evaluate pulmonary nodules/mass. Many of these lesions are located outside the bronchial airway and are difficult to access even with these devices. The Transbronchial Access Tool (Medtronic, Minneapolis, MN) allows the bronchoscopist to create a pathway from the bronchial airway, across the lung parenchyma, and into the target lesion. We are reporting the feasibility and safety of this new device...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28499653/customized-hinged-covered-metallic-stents%C3%A2-for-the-treatment-of-benign-main-bronchial-stenosis
#20
Xinwei Han, Quazi Al-Tariq, Yanle Zhao, Lei Li, Zhe Cheng, Huaqi Wang, Chao Liu, Dechao Jiao, Gang Wu
BACKGROUND: To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications. METHODS: This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance. RESULTS: Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87...
August 2017: Annals of Thoracic Surgery
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