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Airway simulation simulator

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https://www.readbyqxmd.com/read/29349776/effect-of-palpable-vs-impalpable-cricothyroid-membranes-in-a-simulated-emergency-front-of-neck-access-scenario
#1
C F Pairaudeau, C Mendonca, C Hillermann, I Qazi, P A Baker, R E Hodgson, S Radhakrishna
The Difficult Airway Society 2015 guidelines recommend and describe in detail a surgical cricothyroidotomy technique for the can't intubate, can't oxygenate (CICO) scenario, but this can be technically challenging for anaesthetists with no surgical training. Following a structured training session, 104 anaesthetists took part individually in a simulated can't intubate, can't oxygenate event using simulation and airway models to evaluate how well they could perform these front-of-neck access techniques. Main outcomes measures were: ability to correctly perform the technical steps; procedural time; and success rate...
January 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29347980/semiprone-position-is-superior-to-supine-position-for-paediatric-endotracheal-intubation-during-massive-regurgitation-a-randomized-crossover-simulation-trial
#2
Espen Fevang, Karin Haaland, Jo Røislien, Conrad Arnfinn Bjørshol
BACKGROUND: Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotracheal intubation would be easier and quicker to perform when the patient is turned over to a semiprone position, as compared to the supine position. METHODS: In a randomized crossover simulation trial, a child manikin with on-going regurgitation was intubated both in the supine and semiprone positions...
January 18, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29345194/transient-stretch-induces-cytoskeletal-fluidization-through-the-severing-action-of-cofilin
#3
Bo Lan, Ramaswamy Krishnan, Chan Y Park, Rodrigo Watanabe, Ronald Panganiban, James P Butler, Quan Lu, William C Cole, Jeffrey J Fredberg
With every deep inspiration (DI) or sigh the airway wall stretches, as do the airway smooth muscle cells that it contains. In response, the airway smooth muscle (ASM) cell undergoes rapid stretch-induced cytoskeletal fluidization. As a molecular mechanism underlying that ASM fluidization response, here we demonstrate a key role for the actin-severing protein, cofilin. Using primary human ASM cells, we simulated a DI by imposing a transient stretch of physiologic magnitude and duration. We measured the resulting changes in contractile forces using traction microscopy...
January 18, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29334925/implementing-blended-learning-in-emergency-airway-management-training-a-randomized-controlled-trial
#4
Madeleine Huei Tze Kho, Keng Sheng Chew, Muhaimin Noor Azhar, Mohd Lotfi Hamzah, Kee Man Chuah, Aida Bustam, Hiang Chuan Chan
BACKGROUND: While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training...
January 15, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#5
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29317326/study-of-the-upper-airway-of-obstructive-sleep-apnea-patient-using-fluid-structure-interaction
#6
Yang Liu, Jennifer Mitchell, Yitung Chen, Woosoon Yim, Wenxiao Chu, Robert C Wang
Up to 14% of the U.S. population is estimated to have obstructive sleep apnea (OSA), while the outcomes of the treatments have variable results. In the current study, a three-dimensional fluid-structure interaction modeling was applied to simulate the upper airway to identify the precise location, severity, and characteristic of airway collapse. This was accomplished using Simpleware® and ANSYS® software applied to a 3-D rendering of the airway in a real patient with severe OSA. During this simulation, areas which are prone to collapse and precipitate apneic episodes were identified at the tip of the soft palate and the base of the tongue, with intrathoracic pressure as low as -1370 Pa...
January 6, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29314751/emergency-airway-and-ventilator-procedures-for-community-based-home-care-staff-validation-of-an-educational-program
#7
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29297393/substance-deposition-assessment-in-obstructed-pulmonary-system-through-numerical-characterization-of-airflow-and-inhaled-particles-attributes
#8
Antonios Lalas, Stavros Nousias, Dimitrios Kikidis, Aris Lalos, Gerasimos Arvanitis, Christos Sougles, Konstantinos Moustakas, Konstantinos Votis, Sylvia Verbanck, Omar Usmani, Dimitrios Tzovaras
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma are considered as the two most widespread obstructive lung diseases, whereas they affect more than 500 million people worldwide. Unfortunately, the requirement for detailed geometric models of the lungs in combination with the increased computational resources needed for the simulation of the breathing did not allow great progress to be made in the past for the better understanding of inflammatory diseases of the airways through detailed modelling approaches...
December 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29287862/using-simulators-to-teach-pediatric-airway-procedures-in-an-international-setting
#9
Marissa A Schwartz, Katherine R Kavanagh, Steven J Frampton, Iain A Bruce, Tulio A Valdez
INTRODUCTION: There has been a growing shift towards endoscopic management of laryngeal procedures in pediatric otolaryngology. There still appears to be a shortage of pediatric otolaryngology programs and children's hospitals worldwide where physicians can learn and practice these skills. Laryngeal simulation models have the potential to be part of the educational training of physicians who lack exposure to relatively uncommon pediatric otolaryngologic pathology. OBJECTIVES: The objective of this study was to assess the utility of pediatric laryngeal models to teach laryngeal pathology to physicians at an international meeting...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29283921/a-simulation-study-to-evaluate-improvements-in-anesthesia-work-environment-contamination-after-implementation-of-an-infection-prevention-bundle
#10
Grete H Porteous, Helen A Bean, Crystal M Woodward, Ryan P Beecher, Jennifer R Bernstein, Sarah Wilkerson, Ian Porteous, Robert L Hsiung
BACKGROUND: Microbiological contamination of the anesthesia work environment (AWE) is a potential source of health care-associated infections. Medication syringes, stopcocks, and many other areas are routinely contaminated during anesthetic care, and adherence to hand hygiene recommendations is poor. Using a simulation model, we investigated whether AWE contamination could be reduced by implementing an intervention bundle focused on infection prevention. METHODS: Twenty-five anesthesia providers were enrolled in this nonrandomized simulation scenario crossover design study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29261769/optimal-endobronchial-tool-sizes-for-targeting-lung-lesions-based-on-3d-modeling
#11
Torre M Bydlon, Gerrit C Langhout, Ferry Lalezari, Koen J Hartemink, Jasper Nijkamp, Susan G Brouwer de Koning, Sjaak Burgers, Benno H W Hendriks, Theodoor J M Ruers
BACKGROUND: For patients with suspicious lung lesions found on chest x-ray or CT, endo/trans- bronchial biopsy of the lung is the preferred method for obtaining a diagnosis. With the addition of new screening programs, a higher number of patients will require diagnostic biopsy which will prove even more challenging due to the small size of lesions found with screening. There are many endobronchial tools available on the market today and a wide range of new tools under investigation to improve diagnostic yield...
2017: PloS One
https://www.readbyqxmd.com/read/29242911/comparison-of-airflow-between-spreader-grafts-and-butterfly-grafts-using-computational-flow-dynamics-in-a-cadaveric-model
#12
Bryan M Brandon, Grace K Austin, Gita Fleischman, Saikat Basu, Julia S Kimbell, William W Shockley, J Madison Clark
Importance: Nasal valve compromise is a major cause of nasal obstruction, and multiple methods have been developed to address it. Objective: To compare nasal airflow resistance, airflow partitioning, and mucosal cooling (heat flux) before and after 2 surgical interventions, butterfly and spreader graft placement, used to treat nasal valve compromise. Design, Setting, and Participants: In this cadaveric tissue study, 4 fresh cadaveric heads underwent both spreader graft and butterfly graft surgical procedures in alternating sequence in March 2016...
December 14, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29224971/biomechanical-effects-of-a-mandibular-advancement-device-on-the-temporomandibular-joint
#13
David S P Heidsieck, Jan Harm Koolstra, Maurits H T de Ruiter, Aarnoud Hoekema, Jan de Lange
PURPOSE: Mandibular advancement devices are commonly used in the treatment of patients with mild to moderate obstructive sleep apnea (OSA). Designed to maintain the mandible in forced protrusion while being worn, mandibular advancement devices (MADs) are intended to increase the upper airway during sleep, thereby reducing OSA symptoms. Depending on the extent of mandibular protrusion, side effects including temporomandibular joint dysfunction are frequently reported. These are likely to reduce overall treatment success by affecting therapeutic adherence...
November 22, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29217332/revisiting-high-frequency-oscillatory-ventilation-in-vitro-and-in-silico-in-neonatal-conductive-airways
#14
REVIEW
Katrin Bauer, Eliram Nof, Josué Sznitman
BACKGROUND: High frequency oscillatory ventilation is often used for lung support in premature neonates suffering from respiratory distress syndrome. Despite its broad use in neonatal intensive care units, there are to date no accepted protocols for the choice of appropriate ventilation parameter settings. In this context, the underlying mass transport mechanisms are still not fully understood. METHODS: We revisit the question of flow phenomena under conventional mechanical ventilation and high frequency oscillatory ventilation in an anatomically-inspired model of neonatal conductive airways spanning the first few airway generations...
November 28, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29204444/the-finite-element-simulation-of-the-upper-airway-of-patients-with-moderate-and-severe-obstructive-sleep-apnea-hypopnea-syndrome
#15
Huiping Luo, Austin Scholp, Jack J Jiang
Objectives: To investigate the snoring modes of patients with Obstructive Sleep Apnea Hypopnea Syndrome and to discover the main sources of snoring in soft tissue vibrations. Methods: A three-dimensional finite element model was developed with SolidEdge to simulate the human upper airway. The inherent modal simulation was conducted to obtain the frequencies and the corresponding shapes of the soft tissue vibrations. The respiration process was simulated with the fluid-solid interaction method through ANSYS...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29202698/safety-and-applicability-of-a-pre-stage-public-access-ventilator-for-trained-laypersons-a-proof-of-principle-study
#16
Patricia Fuchs, Juliane Obermeier, Svend Kamysek, Martin Degner, Hannes Nierath, Henning Jürß, Hartmut Ewald, Jens Schwarz, Martin Becker, Jochen K Schubert
BACKGROUND: Contemporary resuscitation guidelines for basic life support recommend an immediate onset of cardiac compressions in case of cardiac arrest followed by rescue breaths. Effective ventilation is often omitted due to fear of doing harm and fear of infectious diseases. In order to improve ventilation a pre-stage of an automatic respirator was developed for use by laypersons. METHODS: Fifty-two healthy volunteers were ventilated by means of a prototype respirator via a full-face mask in a pilot study...
December 4, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29199444/steering-sheath-for-2-nostril-transnasal-office-laryngoscopy
#17
Henry T Hoffman, Helen Stegall, Troy Wingler, Andrew Blitzer
OBJECTIVE: The aim was to study the feasibility of performing office-based laryngeal procedures employing a flexible hollow steerable sheath placed contralateral to the nostril through which a standard flexible video endoscope is placed. METHODS: The study design included simulation of transnasal endoscopic laryngeal procedures evaluating the use of a flexible steering sheath in laboratory and clinic settings. Transnasal laryngeal procedures were performed in an otolaryngology office setting employing an airway-management-trainer mannequin and then repeated in a human cadaver lab with standard transnasal flexible video laryngoscopy...
December 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29180527/azithromycin-pharmacodynamics-against-persistent-haemophilus-influenza-in-chronic-obstructive-pulmonary-disease
#18
Brian T Tsuji, James Fisher, Raheal Boadi-Yeboah, Patricia N Holden, Sanjay Sethi, Melinda M Pettigrew, Timothy F Murphy
The pharmacodynamic profile of azithromycin against persistent strains of non-typeable H. influenzae (NTHi) from COPD patients was characterized. Azithromycin displayed differential concentration-dependent activity (R2 >0.98): pharmacodynamic response was attenuated comparing the 'first' vs. 'last' strain of NTHi which persisted in the airway of the same patient for 819 days (EC50 increased >50 times: 0.0821 mg/L vs. 4.23). In the Hollow Fiber Infection Model NTHi viability was maintained throughout simulated Zithromax Z-pak regimens over 10 days...
November 27, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29177931/evaluating-the-interaction-of-a-tracheobronchial-stent-in-an-ovine-in-vivo-model
#19
Donnacha J McGrath, Anja Lena Thiebes, Christian G Cornelissen, Barry O'Brien, Stefan Jockenhoevel, Mark Bruzzi, Peter E McHugh
Tracheobronchial stents are used to restore patency to stenosed airways. However, these devices are associated with many complications such as stent migration, granulation tissue formation, mucous plugging and stent strut fracture. Of these, granulation tissue formation is the complication that most frequently requires costly secondary interventions. In this study a biomechanical lung modelling framework recently developed by the authors to capture the lung in-vivo stress state under physiological loading is employed in conjunction with ovine pre-clinical stenting results and device experimental data to evaluate the effect of stent interaction on granulation tissue formation...
November 24, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29175100/computational-modeling-of-drug-transport-across-the-in-vitro-cornea
#20
Joseph Pak, Z J Chen, Kay Sun, Andrzej Przekwas, Ross Walenga, Jianghong Fan
A novel quasi-3D (Q3D) modeling approach was developed to model networks of one dimensional structures like tubes and vessels common in human anatomy such as vascular and lymphatic systems, neural networks, and respiratory airways. Instead of a branching network of the same tissue type, this approach was extended to model an interconnected stack of different corneal tissue layers with membrane junction conditions assigned between the tissues. The multi-laminate structure of the cornea presents a unique barrier design and opportunity for investigation using Q3D modeling...
November 23, 2017: Computers in Biology and Medicine
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