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https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#1
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148213/dynamic-expiratory-ct-an-effective-non-invasive-diagnostic-exam-for-fragile-children-with-suspected-tracheo-bronchomalacia
#2
Nicola Ullmann, Aurelio Secinaro, Laura Menchini, Serena Caggiano, Elisabetta Verrillo, Teresa Pia Santangelo, Renato Cutrera, Paolo Tomà
BACKGROUND: Tracheobronchomalacia, defined as variable collapse of the airways, has been recognized as an important cause of respiratory morbidity but still widely underdiagnosed. Bronchoscopy is still considered as the gold standard, but numerous limitations are known, especially for fragile sick children. Moreover, information on parenchymal lung disease cannot be described. There is a real need for a reliable, non-invasive test to help detection of airway and parenchymal malformations in children, specifically when bronchoscopy cannot be performed...
November 17, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29146601/airway-microbiota-across-age-and-disease-spectrum-in-cystic-fibrosis
#3
Edith T Zemanick, Brandie D Wagner, Charles E Robertson, Richard C Ahrens, James F Chmiel, John P Clancy, Ronald L Gibson, William T Harris, Geoffrey Kurland, Theresa A Laguna, Susanna A McColley, Karen McCoy, George Retsch-Bogart, Kurtis T Sobush, Pamela L Zeitlin, Mark J Stevens, Frank J Accurso, Scott D Sagel, J Kirk Harris
Our objectives were to characterise the microbiota in cystic fibrosis (CF) bronchoalveolar lavage fluid (BALF), and determine its relationship to inflammation and disease status.BALF from paediatric and adult CF patients and paediatric disease controls undergoing clinically indicated bronchoscopy was analysed for total bacterial load and for microbiota by 16S rDNA sequencing.We examined 191 BALF samples (146 CF and 45 disease controls) from 13 CF centres. In CF patients aged <2 years, nontraditional taxa (e...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29106861/laryngotracheal-reconstruction-and-swallowing-a-review
#4
REVIEW
Jennifer F Ha, Lynn Driver, David A Zopf
OBJECTIVES: Significant advances in laryngotracheal reconstruction over the last few decades have revolutionised the management of paediatric patients with complex congenital or acquired airway stenosis. The primary aim of laryngotracheal reconstruction has focused primarily on airway and surgery specific outcomes, often at the expense of voice, as well as swallowing function, which are all intricately related. There is currently a paucity of data on swallowing outcome. The goal of this paper is to review and discuss the existing research on the impact of laryngotracheal on swallowing...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29046100/analysis-of-intensive-care-admissions-among-paediatric-obstructive-sleep-apnoea-referrals
#5
S D Sharma, S Gupta, M Wyatt, D Albert, B Hartley
Introduction The aim of this study was to identify the proportion of children referred to a paediatric tertiary referral centre who required admission to the paediatric intensive care unit (PICU) following surgery for obstructive sleep apnoea (OSA) and to establish risk factors for these admissions. Methods Retrospective review of case notes and the operative database was performed for all children undergoing adenotonsillectomy for sleep disordered breathing and OSA symptoms in Great Ormond Street Hospital over a 10-year period...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29028928/effectiveness-of-tip-rotation-in-fibreoptic-bronchoscopy-under-different-experimental-conditions-an-in-vitro-crossover-study
#6
T Piegeler, N G Clausen, M Weiss
Background: Proper manipulation of fibreoptic bronchoscopes is essential for successful tracheal intubation or diagnostic bronchoscopy. Failure of proper navigation and rotation of the fibrescope may lead to difficulties in advancing the fibrescope and might also be responsible for (unnecessary) difficulties and delays in fibreoptic tracheal intubation, with subsequent hypoxaemia. The present study, therefore, aimed to assess the effectiveness of tip rotation in flexible bronchoscopes in different experimental conditions...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28993356/life-threatening-parapharyngeal-and-retropharyngeal-abscess-in-an-infant
#7
Anusha Balasubramanian, J Redzwan Shah, Norzi Gazali, Philip Rajan
Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5.3×8 cm collection involving the left parapharyngeal and retropharyngeal space, causing significant airway narrowing. 40 mL of frank pus was drained via intraoral incision and drainage with the aid of endoscope, and undesirable complications from an external approach were averted...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28981579/comparison-of-the-paediatric-blade-of-the-pentax-aws-and-ovassapian-airway-in-fibreoptic-tracheal-intubation-in-patients-with-limited-mouth-opening-and-cervical-spine-immobilization-by-a-semi-rigid-neck-collar-a-randomized-controlled-trial
#8
D H Kim, J Y Yoo, S Y Ha, Y J Chae
Background: We compared the performances of the paediatric blade of a Pentax Airway Scope and an Ovassapian airway in fibreoptic tracheal intubation in patients whose necks were stabilized by semi-rigid neck collars. Methods: Ninety patients were enrolled in this prospective, open-label, randomized controlled trial. Patients were randomly allocated to one of two groups (Group OVA-FOB and Group AWS-FOB). The time to tracheal intubation, success rate of tracheal intubation, number of optimization manoeuvres (jaw thrust), and difficulty of manipulation of the fibreoptic bronchoscope were compared between the groups...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28974069/premedication-with-salbutamol-prior-to-surgery-does-not-decrease-the-risk-of-perioperative-respiratory-adverse-events-in-school-aged-children
#9
A Ramgolam, G L Hall, D Sommerfield, L Slevin, T F E Drake-Brockman, G Zhang, B S von Ungern-Sternberg
Background: Perioperative respiratory adverse events (PRAE) remain the leading cause of morbidity and mortality in the paediatric population. This double-blinded randomized control trial investigated whether inhaled salbutamol premedication decreased the occurrence of PRAE in children identified as being at high risk of PRAE. Methods: Children with at least two parentally reported risk factors for PRAE undergoing elective surgery were eligible for recruitment. They were randomized to receive either salbutamol (200 µg) or placebo prior to their surgery and PRAE (bronchospasm, laryngospasm, airway obstruction, desaturation, coughing and stridor) were recorded...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28972652/shared-decision-making-for-people-with-asthma
#10
REVIEW
Kayleigh M Kew, Poonam Malik, Krishnan Aniruddhan, Rebecca Normansell
BACKGROUND: Asthma is a chronic inflammatory disease that affects the airways and is common in both adults and children. It is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. People with asthma may be helped to manage their condition through shared decision-making (SDM). SDM involves at least two participants (the medical practitioner and the patient) and mutual sharing of information, including the patient's values and preferences, to build consensus about favoured treatment that culminates in an agreed action...
October 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28971804/a-randomised-trial-to-compare-truview-pcd-%C3%A2-c-mac-%C3%A2-and-macintosh-laryngoscopes-in-paediatric-airway-management
#11
Ranju Singh, Nishant Kumar, Aruna Jain
AIM: To evaluate and compare the Truview PCD and C-MAC laryngoscopes to the standard Macintosh laryngoscope in paediatric patients. METHODS: One hundred and fifty ASA I-II patients in the age group of 1-6 years (10-20 kg) scheduled for elective surgery were randomised into three equal groups for laryngoscopy and intubation with either Truview PCD (Group T), C-MAC (Group C) or Macintosh (Group M) laryngoscopes under general anaesthesia. Percentage of glottic opening (POGO) score, application of external laryngeal manoeuvre, time to intubation, number of attempts at intubation, failed intubations, episodes of desaturation and trauma caused were recorded and statistically analysed...
June 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28965646/haemodynamic-response-and-effectiveness-of-tracheal-intubation-with-airtraq%C3%A2-versus-macintosh-laryngoscope-in-paediatric-patient-undergoing-elective-surgery-prospective-randomised-and-blind-clinical-trial
#12
J A Orozco, J L Rojas, A J Medina-Vera
OBJECTIVE: To compare the haemodynamic response and effectiveness of tracheal intubation with Airtraq® device and Macintosh laryngoscope, for airway management of patients between 2 and 8 years undergoing elective surgery. METHODS: A prospective, comparative, randomised and blind clinical trial where the effectiveness of tracheal intubation in 80 paediatric patients undergoing elective surgery was determined. Patients were divided into 2 groups of 40 subjects each: group A, intubated with Airtraq® optical laryngoscope; and group M, intubated with Macintosh laryngoscope...
September 28, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28964302/the-implications-of-pneumomediastinum-and-subcutaneous-emphysema-for-the-paediatric-otolaryngologist
#13
Chloe Swords, Neil Cheng-Wen Tan, Nico Jonas
Three patients presented within a 6-month period with pneumomediastinum. The underlying cause in each was distinct. One case occurred due to blunt laryngeal trauma and required urgent surgical intervention due to a decompensating airway. The second case was related to tracheal perforation secondary to a myofibroblastic tracheal tumour and the final case was related to adenovirus upper respiratory tract infection. Pneumomediastinum may be spontaneous or secondary to an underlying cause. Children should be managed using a multidisciplinary approach...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28960660/conservative-post-natal-management-of-antenatally-diagnosed-congenital-pulmonary-airway-malformations
#14
Allya V Makhijani, Flora Y Wong
AIM: Management of congenital pulmonary airway malformations (CPAM) is controversial, especially for asymptomatic patients. We aim to describe the clinical manifestations and management of CPAM at a tertiary paediatric hospital using a retrospective audit. METHODS: Infants with CPAM were identified on the Fetal Diagnostic Unit database from 2007 to 2014. Information on antenatal and post-natal management was collected from medical record. RESULTS: Thirty-five infants with antenatally diagnosed CPAM were included...
September 28, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28941298/symptom-management-and-psychological-support-for-families-are-the-cornerstones-of-end-of-life-care-for-children-with-spinal-muscular-atrophy-type-1
#15
Chiara Di Pede, Caterina Agosto, Valentina De Tommasi, Alessandra De Gregorio, Franca Benini
AIM: This study described end-of-life care for children affected by spinal muscular atrophy type 1 (SMA1), which is characterised by progressive muscle weakness and develops in the first six months of life. METHODS: We retrospectively analysed 17 children (13 boys) who attended the University of Padua's paediatric palliative care centre in Italy from March 2000 to March 2015. All the children received supportive care without proactive respiratory intervention to prolong survival...
September 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28921537/nasotracheal-intubation-over-a-bougie-vs-non-bougie-intubation-a-prospective-randomised-controlled-trial-in-older-children-and-adults-using-videolaryngoscopy
#16
R O Abrons, M B Zimmerman, Y M S El-Hattab
Conventionally, nasotracheal intubation has consisted of blind nasal passage and external manipulation of the tube through the glottis ('conventional technique'), a technique associated with a high incidence of nasal trauma. We evaluated a novel technique for routine asleep (i.e. post-induction) nasotracheal intubation using a bougie ('bougie technique'), which uses a nasopharyngeal airway to guide a paediatric bougie nasotracheally for use as a Seldinger tracheal intubation guide. Two hundred and fifty-seven older children (> 8 years) and adults were randomly assigned to videolaryngoscopy-assisted nasotracheal intubation using either the conventional or the bougie technique...
September 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28913912/streptococcus-pneumoniae-colonization-of-the-nasopharynx-is-associated-with-increased-severity-during-respiratory-syncytial-virus-infection-in-young-children
#17
Jaelle C Brealey, Keith J Chappell, Sally Galbraith, Emmanuelle Fantino, Jane Gaydon, Sarah Tozer, Paul R Young, Patrick G Holt, Peter D Sly
BACKGROUND AND OBJECTIVE: Respiratory syncytial virus (RSV) is the most significant cause of acute respiratory infection (ARI) in early life. RSV and other respiratory viruses are known to stimulate substantial outgrowth of potentially pathogenic bacteria in the upper airways of young children. However, the clinical significance of interactions between viruses and bacteria is currently unclear. The present study aimed to clarify the effect of viral and bacterial co-detections on disease severity during paediatric ARI...
September 15, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28905374/heat-and-moisture-exchangers-versus-heated-humidifiers-for-mechanically-ventilated-adults-and-children
#18
REVIEW
Donna Gillies, David A Todd, Jann P Foster, Bisanth T Batuwitage
BACKGROUND: Invasive ventilation is used to assist or replace breathing when a person is unable to breathe adequately on their own. Because the upper airway is bypassed during mechanical ventilation, the respiratory system is no longer able to warm and moisten inhaled gases, potentially causing additional breathing problems in people who already require assisted breathing. To prevent these problems, gases are artificially warmed and humidified. There are two main forms of humidification, heat and moisture exchangers (HME) or heated humidifiers (HH)...
September 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28883927/listening-panel-agreement-and-characteristics-of-lung-sounds-digitally-recorded-from-children-aged-1-59-months-enrolled-in-the-pneumonia-etiology-research-for-child-health-perch-case-control-study
#19
Eric D McCollum, Daniel E Park, Nora L Watson, W Chris Buck, Charatdao Bunthi, Akash Devendra, Bernard E Ebruke, Mounya Elhilali, Dimitra Emmanouilidou, Anthony J Garcia-Prats, Leah Githinji, Lokman Hossain, Shabir A Madhi, David P Moore, Justin Mulindwa, Dan Olson, Juliet O Awori, Warunee P Vandepitte, Charl Verwey, James E West, Maria D Knoll, Katherine L O'Brien, Daniel R Feikin, Laura L Hammit
INTRODUCTION: Paediatric lung sound recordings can be systematically assessed, but methodological feasibility and validity is unknown, especially from developing countries. We examined the performance of acoustically interpreting recorded paediatric lung sounds and compared sound characteristics between cases and controls. METHODS: Pneumonia Etiology Research for Child Health staff in six African and Asian sites recorded lung sounds with a digital stethoscope in cases and controls...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28871575/inert-gas-washout-background-and-application-in-various-lung-diseases
#20
Jakob Usemann, Sophie Yammine, Florian Singer, Philipp Latzin
Multiple breath inert gas washout (MBW) is a lung function technique to measure ventilation inhomogeneity. The technique was developed more than 60 years ago, but not much used for many decades. Technical improvements, easy protocols and higher sensitivity compared with standard lung function tests in some disease groups have led to a recent renaissance of MBW. The lung clearance index (LCI) is a common measure derived from MBW tests, and offers information on lung pathology complementary to that from conventional lung function tests such as spirometry...
September 5, 2017: Swiss Medical Weekly
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