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https://www.readbyqxmd.com/read/29429553/intubation-in-two-patients-with-difficult-airway-management-and-tracheal-stenosis-after-tracheostomy-in-thoracic-surgery
#1
M Granell Gil, P Solís Albamonte, C Córdova Hernández, I Cobo, R Guijarro, J A de Andrés Ibañez
Lung isolation in thoracic surgery is a challenge, this is even more complex in the presence of unknown tracheal stenosis (TS). We report two cases of unknown TS and its airway management. TS appears most frequently after long term intubation close to the endotracheal tube cuff or in the stoma of tracheostomy that appears as a consequence of the granulation tissue after the surgical opening of the trachea. Clinical history, physical examination, difficult intubating predictors and imaging tests (CT scans) are crucial, however most of tracheal stenosis may be unnoticed and symptoms depend on the degree of obstruction...
February 8, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29390285/use-of-univent-tube-for-intermittent-lung-isolation-during-thoracoscopic-mediastinal-tracheal-resection-and-reconstruction-a-case-report
#2
Yabing Zhang, Juan Xin, Ye Ma, Qian Li, Bin Liu
RATIONALE: Primary tracheal adenoid cystic carcinoma of the trachea primary is a rare neoplasm and commonly misdiagnosed. Lung isolation during surgery and ventilation pose a tremendous challenge to anesthesiologists. PATIENT CONCERNS: The authors describe a novel technique of lung isolation and ventilation with a Univent tube during thoracoscopic mediastinal tracheal resection and reconstruction in a female patient. DIAGNOSES: Primary tracheal adenoid cystic carcinoma, nonsmall cell carcinoma...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29351111/novel-bronchoscopic-management-of-airway-bleeding-with-absorbable-gelatin-and-thrombin-slurry
#3
A Rolando Peralta, Mohit Chawla, Robert P Lee
BACKGROUND: Airway bleeding, either spontaneous or as a result of bronchoscopy, is associated with significant morbidity and mortality. Multiple bronchoscopic techniques are available to achieve complete hemostasis or as a bridge to definitive therapies. METHODS: We report our experience on the feasibility of endobronchial instillation of an absorbable gelatin and thrombin slurry (GTS) for the treatment of spontaneous hemoptysis and procedure-related bleeding. RESULTS: We identified 13 cases in which GTS was used for endobronchial hemostasis when standard bronchoscopic measures like cold saline, epinephrine, and in some cases balloon occlusion were not successful...
January 18, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29343044/bronchial-blocker-positioning-learning-curve-and-confidence-in-its-use
#4
Marco Rispoli, Gianluca Zani, Federico Bizzarri, Moana R Nespoli, Dario M Mattiacci, Vanni Agnoletti, Alfonso Fiorelli, Antonio Corcione, Salvatore Buono
BACKGROUND: Despite simple and safe to use and cheap, EZ Blocker remains underused probably because it requires particular skills in recognizing airway and in using fiber- bronchoscopy to check the exact position of their cuffs. Thus, we planned an education training program on the use of EZB for novices in anaesthesia and evaluated the number of procedures required for the acquisition of the skills of this technique. METHODS: The educational training program included three different phases as follows...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#5
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29312732/bronchial-suction-does-not-facilitate-lung-collapse-when-using-a-double-lumen-tube-during-video-assisted-thoracoscopic-surgery-a-randomized-controlled-trial
#6
Xiang Quan, Jie Yi, Yuguang Huang, Xiuhua Zhang, Le Shen, Shanqing Li
Background: Bronchial suction through the lumen of a bronchial blocker has been reported to accelerate lung collapse. The aim of the current study was to examine whether bronchial suction could also facilitate lung collapse when using a double-lumen tube (DLT). Methods: Eighty patients scheduled for elective video-assisted thoracoscopic surgery for lung cancer using a DLT for one-lung ventilation (OLV) were randomised into an arm that received bronchial suction and an arm that underwent spontaneous collapse (n=40 per arm)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29249583/bronchial-blocker-versus-left-double-lumen-endotracheal-tube-for-one-lung-ventilation-in-right-video-assisted-thoracoscopic-surgery
#7
Yao Lu, Wei Dai, Zhijun Zong, Yimin Xiao, Di Wu, Xuesheng Liu, Gordon Tin Chun Wong
OBJECTIVE: The aim of this study was to compare the quality of lung deflation of a left-sided double-lumen endotracheal tube (DLT) with a bronchial blocker (BB) for one-lung ventilation in video-assisted thoracic surgery (VATS). DESIGN: A prospective, randomized, clinical study. SETTING: A university-affiliated teaching hospital. PARTICIPANTS: Forty-five adult patients undergoing esophageal tumor surgery using VATS with right lung deflation...
July 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29231594/-regulation-of-acupuncture-on-expression-of-akt-protein-in-lung-tissues-of-asthma-rats
#8
Jinhua Yang, Ye Zhao, Shuang Li, Junping Han, Yueyue Yu, Zhizhong Fan, Huijuan Liu, Jianmei Cui
OBJECTIVE: To explore the effects of acupuncture on the expression of protein kinase B (PKB/AKT) in lung tissues of asthma rats. METHODS: Forty SPF male SD rats were randomly divided into a blank group, a model group, an acupuncture group and a blocker group, 10 rats in each one. The rat model of asthma was established by egg albumin stimulation in the model group, acupuncture group and blocker group. Since the establishment of rat model, the rats in the acupuncture group were treated with acupuncture at "Dazhui" (GV 14), "Feishu" (BL 13) and "Fengmen" (BL 12) before atomization; the rats in the blocker group were treated with intervention of blocker LY294002, once every two days, for 7 times...
April 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29175450/crosstalk-between-machrm3-and-%C3%AE-2ar-via-acetylcholine-pi3-pkc-pbep1-raf-1-mek1-2-erk1-2-pathway-activation-in-human-bronchial-epithelial-cells-after-long-term-cigarette-smoke-exposure
#9
Giusy Daniela Albano, Anna Bonanno, Monica Moscato, Giulia Anzalone, Caterina Di Sano, Loredana Riccobono, Sally E Wenzel, Mirella Profita
BACKGROUND: Cigarette smoke extract (CSE) affects the expression of non-neuronal components of cholinergic system in bronchial epithelial cells and, as PEBP1/Raf-mediated MAPK1/2 and ERK1/2 pathway, promotes inflammation and oxidative stress. AIMS: We studied whether Acetylcholine (ACh) is involved in the mechanism of crosstalk between mAChRM3 and β2Adrenergic receptors (β2AR) promoting, via PI3/PKC/PBEP1/Raf/MEK1/2/ERK1/2 activation, β2AR desensitization, inflammation and, oxidative stress in a bronchial epithelial cell line (16HBE) after long-term exposure to cigarette smoke extract (LECSE)...
November 22, 2017: Life Sciences
https://www.readbyqxmd.com/read/29078668/anaesthesiology-for-uniportal-vats-double-lumen-single-lumen-and-tubeless
#10
REVIEW
Ze-Rui Zhao, Rainbow W H Lau, Calvin S H Ng
The advent of one-lung ventilation (OLV) technique provides immobilized surgical field which is fundamental in minimally invasive thoracic surgery. Mainstem methods of achieving lung separation are either via a double-lumen endotracheal tube or placing a bronchial blocker (BB) through a single-lumen endotracheal tube. More recently, the use of non-intubated thoracic surgery (NITS) has been investigated intensively, attempting to minimise the complications that follow general anaesthesia. The aim of this review is to describe the mechanism of these techniques briefly and outlines the advantages and drawbacks of them with the comparison...
2017: Journal of visualized surgery
https://www.readbyqxmd.com/read/28987399/review-of-difficult-airway-management-in-thoracic-surgery
#11
M Granell, M J Parra, M J Jiménez, L Gallart, A Villalonga, O Valencia, M C Unzueta, A Planas, J M Calvo
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers...
January 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28800989/a-prospective-comparison-of-intraluminal-and-extraluminal-placement-of-the-9-french-arndt-bronchial-blocker-in-adult-thoracic-surgery-patients
#12
T Wesley Templeton, Benjamin N Morris, Eduardo J Goenaga-Diaz, Daniel J Forest, Rhett Hadley, Blake A Moore, Yvon F Bryan, Roger L Royster
OBJECTIVE: To compare the standard intraluminal approach with the placement of the 9-French Arndt endobronchial blocker with an extraluminal approach by measuring the time to positioning and other relevant intraoperative and postoperative parameters. DESIGN: A prospective, randomized, controlled trial. SETTING: University hospital. PARTICIPANTS: The study comprised 41 patients (20 intraluminal, 21 extraluminal) undergoing thoracic surgery...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28757838/anesthetic-management-for-lobectomy-of-a-2-month-old-infant-with-bronchogenic-cyst-case-report-along-with-review-of-literature
#13
T Bansal, S Kiran, K Kamal, N Bangarwa
Bronchogenic cyst, a benign congenital cystic lesion of the lung, is a rare cause of respiratory distress in children comprising 7.5% of all mediastinal masses. A thorough preoperative evaluation is crucial to plan for definitive intra- and post-operative management. All patients should be thoroughly evaluated for the presence of compression, deviation or distortion of airways and great veins. The easiest means of providing one lung ventilation in pediatrics is to intubate the main stem bronchus of the nonoperated lung...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28607884/rigid-bronchoscopic-placement-of-fogarty-catheter-as-a-bronchial-blocker-for-one-lung-isolation-and-ventilation-in-infants-and-children-undergoing-thoracic-surgery-a-single-institution-experience-of-27-cases
#14
Sunil Kant Kamra, Ashwin Ashok Jaiswal, Amrish Kumar Garg, Manoj Kumar Mohanty
One-lung ventilation (OLV) is a challenging task in infants and children as few techniques are possible because of narrow anatomy. The aim of this study is to evaluate and experience lung isolation with Fogarty catheters as a bronchial blocker placed by rigid bronchoscope for OLV in infants and children with lung pathologies requiring surgical management in an industrial hospital. This study is a prospective study carried out in J.L.N. Hospital and Research Centre, Bhilai (CG), from January 2011 to December 2014...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28603907/a-randomised-controlled-trial-evaluating-a-low-cost-3d-printed-bronchoscopy-simulator
#15
T H Pedersen, J Gysin, A Wegmann, M Osswald, S R Ott, L Theiler, R Greif
Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering complex procedural skills. We developed a cost-effective bronchial tree simulator based on a human thorax computed tomography scan using rapid-prototyping (3D-print) technology. This randomised, single-blind study evaluated how realistic our 3D-printed simulator would mimic human anatomy compared with commercially available bronchial tree simulators (Laerdal(®) Airway Management Trainer with Bronchial Tree and AirSim Advance Bronchi, Stavanger, Norway)...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28550957/feasibility-of-a-supraglottic-airway-device-for-transbronchial-lung-cryobiopsy-a-retrospective-analysis
#16
Axel Schmutz, Thorsten Dürk, Marco Idzko, Thomas Koehler, Johannes Kalbhenn, Torsten Loop
OBJECTIVES: To determine the feasibility of a supraglottic airway device for transbronchial cryobiopsy in adults. DESIGN: Retrospective analysis of anesthetic and pulmonary records between March 2015 and August 2016. SETTING: Single university medical center. PARTICIPANTS: One hundred thirty-two patients who underwent transbronchial cryobiopsy procedures performed under general anesthesia. INTERVENTIONS: Not applicable...
February 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28526465/-selective-lobar-blockade-with-a-coopdech-blocker-combined-with-a-double-lumen-endotracheal-tube-for-lung-metastases-resection-by-laser
#17
Patricia Cruz, Hugo David Orozco, Ignacio Garutti Martinez, Gloria Hernández Fernández
In recent years, laser resection of lung metastases has been established as the standard procedure worldwide. To avoid airway fire, it is necessary to collapse the surgical lung. The selective lobar bronchial blockade is a technique that allows one-lung ventilation while the operated lobe is collapsed in patients with previous pulmonary resection requiring subsequent resection or with limited pulmonary reserve. We report a clinical case about our experience of a selective lobar bronchial blockade technique with a bronchial blocker (Coopdech endobronchial blocker) that was employed successfully with a double-lumen endotracheal tube in a patient with previous contralateral pulmonary resection who was scheduled for atypical resections of pulmonary metastases by laser...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#18
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28502060/comparison-of-univent-tube-and-ez-blocker-in-one-lung-ventilation-airway-pressures-and-gas-exchange
#19
Tülay Hoşten, Can Aksu, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Mine Solak
Univent tube (UT) and EZ-blocker were used for one-lung ventilation (OLV). UT is a single lumen tube with a small separate lumen containing a bronchial blocker. EZ-blocker differs with its unique y-shaped double-cuffed distal end. We aimed to compare these two airway devices effects on airway pressures, oxygenation, ventilation and haemodynamics during OLV. Patients undergoing elective thoracotomy for the first time were included in this prospective randomized study. Patients were divided into two groups as UT and EZ...
May 13, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28476448/a-ballooning-crisis-three-cases-of-bronchial-blocker-malfunction-and-a-review
#20
Rafael Honikman, Cesar A Rodriguez-Diaz, Edmond Cohen
No abstract text is available yet for this article.
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
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