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https://www.readbyqxmd.com/read/29657064/-selective-left-mainstem-bronchial-intubation-in-the-neonatal-intensive-care-unit
#1
Anthony M H Ho, Michael P Flavin, Melinda L Fleming, Glenio Bitencourt Mizubuti
BACKGROUND: Selective neonatal left mainstem bronchial intubation to treat right lung disease is typically achieved with elaborate maneuvers, instrumentation and devices. This is often attributed to bronchial geometry which favors right mainstem entry of an endotracheal tube deliberately advanced beyond the carina. CASE SUMMARY: A neonate with severe bullous emphysema affecting the right lung required urgent non-ventilation of that lung. We achieved left mainstem bronchial intubation by turning the endotracheal tube 180° such that the Murphy's eye faced the left instead of the right, and simulated a left-handed intubation by slightly orientating the endotracheal tube such that its concavity faced the left instead of the right as in a conventional right-handed intubation...
April 12, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29608006/-evaluation-of-the-association-between-topical-prostaglandin-f2%C3%AE-analogs-and-asthma-using-the-jader-database-comparison-with-%C3%AE-blockers
#2
Katsuhiro Ohyama, Munetoshi Sugiura
 Prostaglandin F2α (PGF2α) analog formulations are the most commonly used drugs for glaucoma treatment. They are known to be superior to β-blockers for reducing intraocular pressure and can be effective all through the day. Because of the action, topical β-blockers are contraindicated for patients with bronchial asthma. PGF2α is also known to act as a constrictor of the respiratory tract. The present study aims to analyze the relationship between PGF2α analogs and asthma. In addition, we utilized β-blockers and combined formulations of both contents to evaluate for comparison with PGF2α analogs...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29576225/single-lung-ventilation-with-bronchofibroscopy-during-lung-resection-surgery
#3
B Cimadevilla Calvo, C López Sánchez, J M Rabanal LLevot, L Sánchez Moreno
Lung isolation using one-lung ventilation is common during thoracic surgery procedures, as it allows proper visualisation and manipulation of the lung to be operated on. Selective lobar blockade has been described in patients that do not tolerate one-lung ventilation, and is usually achieved using endobronchial blockers. However, it depends on endobronchial blocker availability, its complexity regarding proper positioning, and the need for constant monitoring to ensure the correct placement of the bronchial seal...
March 22, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29572436/pulmonary-artery-rupture-management-with-a-single-lumen-endotracheal-tube-old-tricks-that-should-be-revisited
#4
Thanuja Neerukonda, William J Gibson, Travis Abicht, Andrew Sauer, Brigid C Flynn
BACKGROUND Pulmonary artery rupture can be a lethal complication of a pulmonary artery catheter (PAC). Different techniques have been used to manage PAC-induced pulmonary artery rupture, including double lumen endotracheal tube (DLT), bronchial blockers, pulmonary artery embolization, thoracotomy with hematoma evacuation, and extracorporeal life support for ventilation (ECLS). Single lumen endotracheal tube (ETT) is not frequently reported in the literature despite its advantages. CASE REPORT The authors present a case of PAC-induced pulmonary artery rupture successfully managed with a single lumen ETT...
March 24, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29554712/-use-of-bronchial-blockers-for-lung-isolation
#5
Tom Kreft, Thomas Hachenberg
Traditionally the double-lumen-tube (DLT) is considered the gold standard for lung separation. Despite being equally feasible for standard situations, there are special populations and circumstances requiring the use of a bronchial blocker (BB) to establish one-lung ventilation. Children under 8 years of age and patients without a patent orotracheal airway necessitate the use of a bronchial blocker in most cases, as well as those requiring selective lobar blockade or a rapid sequence induction. Surgery with predicted postoperative mechanical ventilation or in tracheotomized patients at least favors their use by avoiding the complications of a tube exchange...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29554710/-airway-management-in-thoracic-anesthesia-with-double-lumen-tube
#6
Torsten Loop, Johannes Spaeth
Lung separation and isolation with accomplished one-lung ventilation plays a key role in the airway management for thoracic surgery. Spectrum of indication contains thoracic surgery, procedure- and patient-dependent factors. Usually lung isolation is achieved with a double-lumen tube or a bronchial blocker. Knowledge in tracheobronchial anatomy is routinely requested for anesthesiologists just as the standard use of flexible fibreoptic bronchoscope. This review would give an overview and discussion about the airway management in patients during thoracic anesthesia with double-lumen tubes and recommendations for the clinical routine...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29429553/intubation-in-two-patients-with-difficult-airway-management-and-tracheal-stenosis-after-tracheostomy-in-thoracic-surgery
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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...
February 2018: 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
#14
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
#15
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)...
January 1, 2018: Life Sciences
https://www.readbyqxmd.com/read/29078668/anaesthesiology-for-uniportal-vats-double-lumen-single-lumen-and-tubeless
#16
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
#17
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
#18
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
#19
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
#20
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
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