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https://www.readbyqxmd.com/read/29331616/paediatric-video-laryngoscopy-and-airway-management-what-s-the-clinical-evidence
#1
Xue Fu-Shan, Liu Ya-Yang, Li Hui-Xian, Yang Gui-Zhen
The major complications of paediatric airway management are uncommon, but the outcomes are often severe. Over the last decade, additions and advancements in the devices and technology have significantly improved our ability to manage difficult paediatric airways safely. Videolaryngoscopy involves the use of video and optical technology to facilitate indirect visualisation of the larynx during intubation and has been seen as an evolutionary step in intubation technology. Over the past few years, video laryngoscopes have been receiving plenty of attention as new airway devices for use in paediatric patients...
January 10, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29327733/orthopaedic-treatment-effects-of-functional-therapy-on-the-sagittal-pharyngeal-dimensions-in-subjects-with-sleep-disordered-breathing-and-class-ii-malocclusion
#2
C Pavoni, E Cretella Lombardo, R Lione, P Bollero, F Ottaviani, P Cozza
The purpose of this cephalometric study was to evaluate the craniofacial changes induced by functional treatment of mandibular advancement with special regard to pharyngeal sagittal airway dimensions, tongue and hyoid bone position in subjects with sleep-disordered breathing (SDB) and dentoskeletal Class II malocclusions compared with an untreated Class II control group. 51 subjects (24 female, 27 male; mean age 9.9 ± 1.3 years) with Class II malocclusion and SDB consecutively treated with a functional appliance (Modify Monobloc, MM) were compared with a control group of 31 subjects (15 males, 16 females; mean age 10...
December 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29301676/severe-macroglossia-after-posterior-fossa-and-craniofacial-surgery-in-children
#3
J Bouaoud, A Joly, A Picard, B Thierry, E Arnaud, S James, I Hennessy, B McGarvey, P Cairet, A Vecchione, E Vergnaud, C Duracher, R H Khonsari
Massive swelling of the tongue can occur after posterior fossa and craniofacial surgery. Several hypotheses have been proposed to explain the occurrence of such severe postoperative macroglossia, but this phenomenon is still poorly understood. Severe postoperative macroglossia can be a life-threatening condition due to upper airway obstruction. Three cases of severe postoperative macroglossia that occurred after cervical spine, craniofacial, and posterior fossa surgical procedures are reported here. These cases required specialized maxillofacial management and a prolonged stay in the intensive care unit...
January 1, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#4
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29279262/inkt-cells-are-increased-in-children-with-severe-therapy-resistant-asthma
#5
L Antunes, A P Duarte de Souza, P D de Araújo, L A Pinto, M H Jones, R T Stein, P M Pitrez
BACKGROUND: Invariant natural killer T (iNKT) cells play complex functions in the immune system, releasing both Th1 and Th2 cytokines. The role of iNKT cells in human asthma is still controversial and never described in severe therapy-resistant asthma in children. The objective of this work was to analyse iNKT frequency in peripheral blood of children with severe therapy-resistant asthma (STRA), compared to children with milder asthma and healthy controls. METHODS: Children with asthma (n=136) (non-severe and STRA) from a referral centre and healthy controls (n=40) were recruited...
December 23, 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29242258/ers-statement-interventional-bronchoscopy-in-children
#6
Ernst Eber, Juan L Antón-Pacheco, Jacques de Blic, Iolo Doull, Al Faro, Raffaella Nenna, Thomas Nicolai, Petr Pohunek, Kostas N Priftis, Paola Serio, Courtney Coleman, Sarah Masefield, Thomy Tonia, Fabio Midulla
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29238672/rigid-bronchoscopy-in-pediatric-patients
#7
Vikas Sinha, Samanth Talagauara Umesh, Sushil G Jha
Aspiration of foreign-bodies remains a major life-threatening situation in children and have always been a source of interest and confusion to otolaryngologists due to their varied presentations. These conditions if not promptly diagnosed and managed can prove to be fatal, but the current mortality is only one percent compared to pre bronchoscopy era (Rothman and Boeckman in Ann Otol Rhinol Laryngol 89:434-436, 1980). Peak incidence of this condition is in early childhood due to child's habit of putting small objects in mouth to determine their taste and texture and chew while teething...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29233755/postoperative-fasting-after-general-anaesthesia-a-survey-of-french-anaesthesiology-practices
#8
Sylvain Le Pape, Matthieu Boisson, Thibault Loupec, FabienVigneau, Bertrand Debaene, Denis Frasca
BACKGROUND: Preoperative fasting is well-codified worldwide. In contrast, the literature on the postoperative fasting (POF) is scarce leading to potentially wide discrepancies among anaesthesiology practices. This survey assessed French POF practices. METHODS: From March 2013 to January 2014, a survey was conducted among anaesthesiologists, members of the French Society of Anaesthesiology and Critical Care. The POF durations of either fluid or solid food intake was assessed according to airway management procedures (endotracheal intubation [EI] or laryngeal mask [LMA]) and age of the patients (adult or paediatric)...
December 9, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29217866/airway-management-of-a-paediatric-patient-with-temporomandibular-joint-ankylosis-with-extra-hepatic-portal-vein-obstruction-splenomegaly-hypersplenism-and-obstructive-sleep-apnoea-for-shunt-surgery-a-unique-challenge
#9
Shiv Akshat, Shikha Jain, Puneet Khanna, Ravinder Kumar Batra
No abstract text is available yet for this article.
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29215159/sleep-disorders-in-obese-children-are-not-limited-to-obstructive-sleep-apnoea-syndrome
#10
C Carriere, O Coste, M C Meiffred-Drouet, P Barat, H Thibault
AIM: This study was to characterised respiratory and non-respiratory sleep disorders in obese children and evaluated the diagnostic and therapeutic impact of a specific sleep consultation. METHODS: A descriptive study was conducted in obese French children who received multidisciplinary care management from the hospital centre for paediatric obesity in Bordeaux. This followed a specific sleep consultation between 2007 and 2015, because their paediatrician had identified symptoms suggestive of sleep disorders...
December 7, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29210179/cross-sectional-follow-up-of-voice-outcomes-in-children-who-have-a-history-of-airway-reconstruction-surgery
#11
Wendy Cohen, David M Wynne, Susan Lloyd, Richard B Townsley
OBJECTIVES: This study reports vocal function in a cross-section of children with subglottic stenosis. Each child had a history of laryngotracheal reconstruction and/or cricotracheal resection surgery. Vocal function was measured using laryngoscopy, acoustic analysis, perceptual evaluation and impact of voice on quality of life. DESIGN: All patients aged >5 years with history of laryngotracheal reconstruction and/or cricotracheal resection surgery at the Scottish National Complex Airways service were invited to participate...
December 6, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29202565/the-efficacy-of-topical-hyaluronan-in-rhinosinusitis-a-systematic-review
#12
M Casale, P Vella, A Moffa, V Grimaldi, L Sabatino, V Rinaldi, M A Lopez, P Baptista, F Salvinelli
Rhinosinusitis is one of the most common inflammatory conditions of the nasal cavity and paranasal sinuses and is one of the most common causes of absence from work and for visits to the family doctor. The treatment strategy in both acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) is to reduce the severity of the symptoms, minimize the duration of the disease and prevent complications. Topical therapy has become an important tool in otolaryngologists’ armamentarium for rhinosinusitis treatment. Recently, topical hyaluronic acid (HA), the major component of many extracellular matrices that promotes tissue healing, including activation and moderation of the inflammatory responses, cell proliferation, migration and angiogenesis, has been proposed for ARS and CRS adjuvant tool...
December 4, 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29201634/innovative-chest-physiotherapy-techniques-the-metaneb%C3%A2-system-in-the-intubated-child-with-extensive-burns
#13
Alexandra Ferguson, Sarah Wright
Introduction: The Metaneb® is a new generation Intrapulmonary Percussive Ventilation device utilised by the physiotherapist to assist airway clearance by providing calibrated oscillations during inspiration up to 3.8Hz. Predominantly used in the adult chronic respiratory patient, with anecdotal evidence in intubated patients, it was also proven to be safe in a paediatric lung model lab study. This case report outlines the first use of the Metaneb® with an intubated child in Australia...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29187760/the-exit-ex-utero-intrapartum-treatment-procedure-from-the-paediatric-ent-perspective
#14
B Pucher, J Szydlowski, K Jonczyk-Potoczna, J Sroczynski
The main principle of the EXIT procedure is to maintain uteroplacental circulation with neonatal anaesthesia by controlled uterine hypotonia. This enables securing the foetal airways and decompress or resect large neck and mediastinal foetal masses. The authors present their experience with use of the EXIT procedure in 7 foetuses in whom evaluation and management of the airways were performed. In 4 patients, the neck mass was surgically removed in the neonatal period, in 1 the propranolol treatment was introduced...
November 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29182799/inhaled-magnesium-sulfate-in-the-treatment-of-acute-asthma
#15
REVIEW
Rachel Knightly, Stephen J Milan, Rodney Hughes, Jennifer A Knopp-Sihota, Brian H Rowe, Rebecca Normansell, Colin Powell
BACKGROUND: Asthma exacerbations can be frequent and range in severity from mild to life-threatening. The use of magnesium sulfate (MgSO₄) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO₄ has been demonstrated, the role of inhaled MgSO₄ is less clear. OBJECTIVES: To determine the efficacy and safety of inhaled MgSO₄ administered in acute asthma. SPECIFIC AIMS: to quantify the effects of inhaled MgSO₄ I) in addition to combination treatment with inhaled β₂-agonist and ipratropium bromide; ii) in addition to inhaled β₂-agonist; and iii) in comparison to inhaled β₂-agonist...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29174374/tracheobronchial-stenting-for-airway-malacia
#16
REVIEW
Colin Wallis, Clare A McLaren
Tracheobronchomalacia is a rare but clinically troublesome condition in paediatrics. The softening of the major airways - which can include some or all of the tracheobronchial tree can lead to symptoms ranging from the minor (harsh barking cough, recurrent chest infections) to severe respiratory difficulties including prolonged ventilator support and 'near death attacks'. The causes are broadly divided into intrinsic softening of the airway wall which is considered a primary defect (e.g. syndromes; post tracheo-oesophageal fistula repair; extreme prematurity) or secondary malacia due to external compression from vascular structures or cardiac components...
October 13, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/29170348/51%C3%A2-paediatric-emergency-clinicians-are-rarely-exposed-to-non-airway-critical-procedures-a-predict-pern-study
#17
Juan P Garrahan, Mark Lyttle, Ed Oakley, Stuart Dalziel, Lucia Nguyen, Arjun Rao, Santiago Mintegi, Franz Babl
BACKGROUND: Recent studies suggest that approximately one per thousand paediatric ED attendances may require some sort of critical procedure, with intubation being by far the most common. It is unknown how often critical non-airway procedures such as chest decompression, CPR, ED thoracotomy, defibrillation, pacing, and advanced vascular access techniques are performed by paediatric emergency clinicians. OBJECTIVE: To determine the recent performance or supervision, and confidence for various paediatric critical non-airway procedures by senior paediatric emergency clinicians...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#18
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
#19
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
#20
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
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