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paediatric airway

M Boyle, J E Moore, J L Whitehouse, D Bilton, D G Downey
Aspergillus fumigatus is commonly found in the airways of patients with cystic fibrosis (CF), and allergic bronchopulmonary aspergillosis (ABPA) is the most recognized associated clinical condition. However, accurate diagnosis remains challenging, and there is a paucity of clinical trials to guide clinical management of fungal disease. The aim of this survey was to assess the variability in current practice across the UK in diagnosis and management of fungal lung disease in CF patients. A 21 question anonymous online survey was sent to 94 paediatric and adult CF consultants in the UK...
March 15, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Bernar Tan Wen Sheng, Patrick Wong, Constance Teo Ee Hoon
INTRODUCTION: Recurrent respiratory papillomatosis results in hoarseness, stridor and airway obstruction. Management is surgical, with most surgeons using microdebrider or laser. Transoral robotic surgery (TORS) has been successfully utilised for the excision of oropharyngeal malignancies and paediatric airway surgery. This is the first case report of TORS being used for the excision of laryngeal papillomas. CASE REPORT: A 36 year old Chinese female was diagnosed with juvenile onset recurrent respiratory papillomatosis...
March 3, 2018: American Journal of Otolaryngology
Ben McNaughten, Caroline Hart, Stephen Gallagher, Carol Junk, Patricia Coulter, Andrew Thompson, Thomas Bourke
AIM: Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency. METHODS: Clinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions...
March 7, 2018: Archives of Disease in Childhood
Lafi Olayan, Abdulaleem Alatassi, Jaimin Patel, Sherran Milton
Background: Airway management is a core clinical skill in anaesthesia. Pre-oxygenation prior to induction of anaesthesia is a standard practice to prevent desaturation. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. The effectiveness of apnoeic oxygenation in the adult is well documented; however, evidence in the paediatric is lacking. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in children...
2018: Perioperative Medicine
Reut Gruber, Evelyn Constantin, Jean Yves Frappier, Robert T Brouillette, Merrill S Wise
Background: Sleep disorders are prevalent in children and are associated with significant comorbidity. Objective: To assess the training, knowledge, attitudes and practices of Canadian health care providers (HCPs) regarding sleep disorders in children. Method: A 42-item survey, designed to collect information on frequency of paediatric sleep disorders-related screening and diagnosis, implementation of evidence-based interventions and related knowledge base, was completed by HCPs...
September 2017: Paediatrics & Child Health
Abdullah AlShammari, Aman Inayah, Nasir Ali Afsar, Akram Nurhussen, Amna Siddiqui, Muhammad Lucman Anwer, Sadek Obeidat, Mohammed Khaled Bakro, Tawfik Samer Abu Assale, Eyad Almidani, Abdullah Alsonbul, Sami Alhaider, Ibrahim Bin Hussain, Emad Khadawardi, Muhammad Zafar
OBJECTIVE: To explore the effects of simulation training on paediatric residents' confidence and skills in managing advanced skills in critical care. METHODS: The study was conducted at Alfaisal University, Riyadh, Saudi Arabia, from March to June 2016, and comprised junior residents in paediatrics. All paediatric residents (years 1 and 2) were recruited into two workshops, held one week apart. The first workshop covered lumbar puncture/ cerebrospinal fluid interpretation, oral intubation, bone marrow aspiration, and critical airway management...
February 2018: JPMA. the Journal of the Pakistan Medical Association
Antonella Concerto, Marco Cavallaro, Carmela Visalli, Anna Maria Bagnato, Ugo Barbaro, Ignazio Salamone
A laryngeal foreign body (FB) is a significant, life-threatening event in the paediatric population. Incomplete airways obstruction by a thin, laminar, radiolucent FB lodged in the glottis or supraglottis is a rare occurrence that may present with non-specific symptoms, absence of chest findings, and normal radiographic investigations, resulting in misdiagnosis, delay in diagnosis, or prolonged recovery. We report two cases of 10-month-old male infants, each with a thin radiolucent FB lodged between the vocal folds that was detected with low-dose multidetector computed tomography (MDCT) and thin-slice reconstruction...
April 2018: Respirology Case Reports
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
Lai Peng Tham, Win Wah, Rachel Phillips, Nur Shahidah, Yih Yng Ng, Sang Do Shin, Tatsuya Nishiuchi, Kwanhathai Darin Wong, Patrick Chow-In Ko, Nalinas Khunklai, Ghulam Yasin Naroo, Marcus Eng Hock Ong
BACKGROUND: The Pan Asian Resuscitation Outcomes Study (PAROS) is a retrospective study of out- of-hospital cardiac arrest(OHCA), collaborating with EMS agencies and academic centers in Japan, South Korea, Malaysia, Singapore, Taiwan, Thailand and UAE-Dubai. The objectives of this study is to describe the characteristics and outcomes, and to find factors associated with survival after paediatric OHCA. METHODS: We studied all children less than 17 years of age with OHCA conveyed by EMS and non-EMS transports from January 2009 to December 2012...
February 5, 2018: Resuscitation
Jessica A Schults, Marie Cooke, Debbie A Long, Andreas Schibler, Robert S Ware, Marion L Mitchell
INTRODUCTION: Endotracheal suction (ETS) is a frequent and necessary airway intervention for the intubated child. The aim of ETS is to clear the endotracheal tube and airways of respiratory secretions; however, the methods of performing ETS are varied. Internationally a number of ETS treatments are in use. Many have not been rigorously evaluated in a randomised controlled trial setting, and it is uncertain whether any are associated with better outcomes for the critically ill child. With approximately 50% of paediatric intensive care admissions requiring intubation, ETS interventions that maximise the efficacy and minimise the complications of ETS could translate to improved health for substantial numbers of critically ill children, and significant cost savings...
January 31, 2018: BMJ Open
K Hutchinson, C P Kerley, J Faul, P Greally, D Coghlan, M Louw, B Elnazir, Y Rochev
Background. Asthma is a common childhood respiratory disease, affecting around 20% of Irish children. In other populations, vitamin D receptor (VDR) polymorphisms have been associated with asthma risk. We aimed to investigate the association between 2 VDR polymorphisms and uncontrolled paediatric asthma. Methods. 44 asthmatic children and 57 healthy volunteers were studied. The VDR TaqI gene variant in exon 9 (T/C) (rs731236) and ApaI (rs7975232) in intron 8 (C/T) were determined, using TaqMan® Assays. The lung function, serum 25-hydroxyvitamin D (25OHD) levels and other biomarkers of allergy, immunity, airway and systemic inflammation were as-sessed...
November 28, 2017: European Annals of Allergy and Clinical Immunology
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
Asbjørn Børch Hasselager, Torsten Lauritsen, Tim Kristensen, Cathrine Bohnstedt, Claus Sønderskov, Doris Østergaard, Martin Grønnebæk Tolsgaard
BACKGROUND: Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. METHODS: A Delphi consensus survey was conducted...
January 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
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
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
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
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
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
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
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