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pediatric airway management

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https://www.readbyqxmd.com/read/27923646/role-of-the-allergist-immunologist-and-upper-airway-allergy-in-sleep-disordered-breathing
#1
Dennis Shusterman, Fuad M Baroody, Timothy Craig, Samuel Friedlander, Talal Nsouli, Bernard Silverman
BACKGROUND: Sleep-disordered breathing in general and obstructive sleep apnea in particular are commonly encountered conditions in allergy practice. Physiologically, nasal (or nasopharyngeal) obstruction from rhinitis, nasal polyposis, or adenotonsillar hypertrophy are credible contributors to snoring and nocturnal respiratory obstructive events. Nevertheless, existing practice parameters largely relegate the role of the allergist to adjunctive treatment in cases of continuous positive airway pressure intolerance...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27894559/helicopter-transport-in-regionalized-burn-care-one-program-s-perspective
#2
Benjamin Nicholson, Harinder Dhindsa
BACKGROUND: The decision to use helicopter EMS (HEMS) for the transport of burn patients is a complex decision. This analysis sought to evaluate burn patients flown to burn centers who met predetermined criteria for patients who likely benefit from HEMS care. METHODS: A retrospective transport chart review of all burn transports covering the preceding nine and a half years was conducted to evaluate for HEMS appropriate criteria defined as patients requiring advanced airway management, ventilator support, facial burns, inhalation injury, circumferential burns, electrical or chemical burn, or major burns...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894434/pediatric-airway-and-esophageal-foreign-bodies
#3
REVIEW
Elizabeth A Berdan, Thomas T Sato
Foreign bodies aspirated into the airway or ingested with retention in the esophagus are common in infants and children. Both can cause life-threatening complications and must be approached with expeditious diagnosis and definitive treatment. Pediatric surgeons should be familiar with diagnosis, treatment, operative management, complications, and outcomes of aerodigestive tract foreign bodies.
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27870272/the-airway-device-preference-may-affect-the-overlapping-of-the-common-carotid-artery-by-the-internal-jugular-vein
#4
Menekse Ozcelik, Cigdem Guclu, Basak Meco, Derya Oztuna, Ahmet Kucuk, Saban Yalcin, Zekeriyya Alanoglu, Neslihan Alkis
BACKGROUND: Anatomical variation in the internal jugular vein (IJV), as well as its small size, tendency to collapse, and proximity to the common carotid artery (CCA) makes central venous cannulation via the IJV a technically challenging procedure, especially in pediatric patients. AIM: We evaluated the effects of laryngeal mask airway insertion and endotracheal intubation (ETT) on the anatomical relationship between the IJV and the CCA in neutral and 40° head away positions...
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27863641/the-influence-of-pediatric-tracheostomy-on-the-body-weight-percentile-of-children
#5
Shereen Yankasari, Yoon Se Lee, Won Kyung Chang, Hyun Moon, Jiwon Kim, Jong-Lyel Roh, Seung-Ho Choi, Sang Yoon Kim, Soon Yuhl Nam
OBJECTIVES: The purpose of this study was to evaluate the changes in body weight following tracheostomy in pediatric patients. METHODS: Ninety-eight patients who underwent tracheostomy at the age of 0-6 years were enrolled. The body weight and growth percentile were measured before tracheostomy and at 1, 6, and 12 months after surgery. The body weight and growth percentile were plotted against time, which was compared with Korean growth chart curve. A Retrospective observational cohort study was performed...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27863622/objective-characterization-of-airway-dimensions-using-image-processing
#6
Victoria K Pepper, Christian Francom, Cameron A Best, Ekene Onwuka, Nakesha King, Eric Heuer, Nathan Mahler, Jonathan Grischkan, Christopher K Breuer, Tendy Chiang
OBJECTIVES: With the evolution of medical and surgical management for pediatric airway disorders, the development of easily translated techniques of measuring airway dimensions can improve the quantification of outcomes of these interventions. We have developed a technique that improves the ability to characterize endoscopic airway dimensions using common bronchoscopic equipment and an open-source image-processing platform. METHODS: We validated our technique of Endoscopic Airway Measurement (EAM) using optical instruments in simulation tracheas...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27824001/pneumomediastinum-secondary-to-foreign-body-aspiration-clinical-features-and-treatment-explorement-in-39-pediatric-patients
#7
Xiao-Jian Yang, Jie Zhang, Ping Chu, Yong-Li Guo, Jun Tai, Ya-Mei Zhang, Li-Xing Tang, Xin Ni
BACKGROUND: Pneumomediastinum (PM) secondary to foreign body aspiration (FBA) is rare in children. Although it is mainly benign, some cases may be fatal. Due to the rare nature of this clinical entity, proper assessment and management have been poorly studied so far. Here, we characterized the presentation and management of this clinical entity and provided an evaluation system for the management. METHODS: We retrospectively reviewed children with PM secondary to FBA, who were treated in Beijing Children's Hospital from January 2010 to December 2015...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27811586/verbal-communication-during-airway-management-and-emergent-endotracheal-intubation-observations-of-team-behavior-among-multi-institutional-pediatric-intensive-care-unit-in-situ-simulations
#8
Ranna A Rozenfeld, Anna P Nannicelli, Alexandra R Brown, Walter J Eppich, Donna M Woods, Steven O Lestrud, Zehava L Noah, Jane L Holl
OBJECTIVE: To assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. METHODS: We conducted video-recorded, risk-informed in situ simulations at 5 hospitals with pediatric intensive care units in the Chicago, Illinois, area. Clinicians participated in their clinical roles (eg, attending physician, bedside nurse) and had access to hospital operational systems (eg, electronic health record, medical imaging, laboratory services)...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27810015/pediatric-obstructive-sleep-apnea
#9
REVIEW
Zarmina Ehsan, Stacey L Ishman
Screening for obstructive sleep apnea (OSA) with in-laboratory polysomnography is recommended for children with sleep disordered breathing. Adenotonsillectomy is the first-line therapy for pediatric OSA, although intranasal steroids and montelukast can be considered for those with mild OSA and continuous positive airway pressure for those with moderate to severe OSA awaiting surgery, poor surgical candidates or persistent OSA. Bony or soft tissue upper airway surgery is reasonable for children failing medical management or those with persistent OSA following adenotonsillectomy...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27763701/alternative-methods-of-lung-isolation-in-cases-of-pediatric-bilateral-thoracoscopic-surgery
#10
Mark Wigginton, Laura Lehrian
We compare airway management and lung isolation methods in two pediatric cases of congenital central hypoventilation syndrome undergoing bilateral throacoscopic phrenic-nerve-stimulator surgery. One child received lung isolation using a 7Fr bronchial blocker in conjunction with a 6.0 cuffed endotracheal tube; and the second received a technique of endobronchial intubation using a 3.5 microcuffed tube via the tracheostomy stoma in conjunction with 5.0 cuffed endotracheal intubation; a technique previously undescribed in pediatric patients...
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27756487/advanced-airway-management-strategies-for-severe-osas-and-craniofacial-anomalies
#11
Anil Gungor
Pediatric OSAS and craniofacial malformations present challenges that require innovative approaches and comprehensive treatment strategies. Synchronous airway lesions, craniofacial malformations, obstructive anomalies of the tongue base, nasal vault and choanae are commonly addressed by subspecialists from various clinical and surgical academic traditions who practice variable levels of required communication. This is not a mere social requirement but an important requisite for intelligent and effective airway management...
January 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27752382/airway-management-in-a-patient-with-wolf-hirschhorn-syndrome
#12
John F Gamble, Dinesh J Kurian, Andrea G Udani, Nathaniel H Greene
We present a case of a 3-month-old female with Wolf-Hirschhorn syndrome (WHS) undergoing general anesthesia for laparoscopic gastrostomy tube placement with a focus on airway management. WHS is a rare 4p microdeletion syndrome resulting in multiple congenital abnormalities, including craniofacial deformities. Microcephaly, micrognathia, and glossoptosis are common features in WHS patients and risk factors for a pediatric airway that is potentially difficult to intubate. We discuss anesthesia strategies for airway preparation and management in a WHS patient requiring general anesthesia with endotracheal intubation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27749629/bottle-tongue-entrapment-increasingly-popular-soda-becomes-airway-emergency
#13
Michael T Long, Matthew P Murray
Tongue entrapments within bottles are very rare childhood mishaps. The most immediate hazard in a tongue entrapment is airway obstruction. Tongue entrapment is an airway emergency; contingency planning to maintain airway patency, oxygenation, and ventilation is critical. Here, we report the case of a 5-year-old girl presenting to a pediatric emergency department with an increasingly popular novelty soda bottle, featuring a unique and dangerous design, entrapped on her tongue. Operative removal was anticipated...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27700196/pediatric-blunt-neck-trauma-causing-esophageal-and-complete-tracheal-transection
#14
Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27692146/primary-ciliary-dyskinesia-in-israel-prevalence-clinical-features-current-diagnosis-and-management-practices
#15
Revital Abitbul, Israel Amirav, Hannah Blau, Soliman Alkrinawi, Micha Aviram, David Shoseyov, Lea Bentur, Avraham Avital, Chaim Springer, Moran Lavie, Dario Prais, Husein Dabbah, Nael Elias, Arnon Elizur, Shmuel Goldberg, Avigdor Hevroni, Eitan Kerem, Anthony Luder, Yehudah Roth, Malena Cohen-Cymberknoh, Marta Ben Ami, Avigdor Mandelberg, Galit Livnat, Elie Picard, Joseph Rivlin, Moshe Rotschild, Ruth Soferman, Niki T Loges, Heike Olbrich, Claudius Werner, Alexander Wolter, Martina Herting, Julia Wallmeier, Johanna Raidt, Heymut Omran, Huda Mussaffi
BACKGROUND: Primary Ciliary Dyskinesia (PCD) is rare and its features in Israel have not been described. AIMS: to assess prevalence utilizing state-of-the-art diagnostic techniques, and describe clinical features, diagnostic and management practices in Israel. METHODS: A national multicenter study from 2012 to 2013 recruited patients diagnosed or suspected of having PCD. Diagnosis was verified using: nasal Nitric Oxide (nNO); High-speed Video Microscope Analysis (HVMA); Transmission Electron Microscopy (TEM) of cilia; Immuno-fluorescence staining (IF) for ciliary proteins, and genetic analysis...
October 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27669029/anesthetic-management-for-pediatric-awake-tracheostomy
#16
Ian Yuan, Benjamin B Bruins, Eleanor P Kiell, Luv R Javia, Jorge A Galvez
Awake tracheostomy is indicated for acute upper airway obstruction, when other methods of securing the airway, such as intubation and cricothyrotomy, have failed or are inappropriate. This option is rarely considered in pediatrics because of the concerns of patient cooperation and safety and has not been described in the literature. We describe the anesthetic management of an awake tracheostomy performed on a 7-year-old girl, with a large supraglottic mass obstructing the laryngeal introitus.
December 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27642743/-endotracheal-intubation-in-pediatric-patients
#17
Alexander Humberg, Wolfgang Göpel
Procedure of intubation of children is different to intubation in adults and requires specific considerations. Before intubation management of difficult airway problems should be anticipated. Risk of developing hypoxia is common in children usually due to a reduced apnea tolerance and demands skill of the medical team. Due to soft tissues of the upper airways and the V-shaped epiglottis several laryngoscopes are available. Attention should be kept on a physiological subglottic stenosis, which determines the size of the endotracheal tube...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27636982/beyond-dilation-current-concepts-in-endoscopic-airway-stenting-and-reconstruction
#18
Sharon H Gnagi, David R White
PURPOSE OF REVIEW: To discuss current modalities of endoscopic airway management beyond balloon dilation therapy. RECENT FINDINGS: Advances continue to be made through technology and bioengineering with exciting potential in the pediatric airway. Smaller robots and instrumentation allow increased endoscopic surgical success. Biodegradable stents and bioengineered grafts are on the horizon for use in airway surgery. Dysphonia following airway reconstruction is of increasing recognition with new endoscopic treatments being performed...
December 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27635273/reversible-severe-pulmonary-hypertension-after-adenotonsillectomy-a-case-report-of-a-child-treated-at-bugando-medical-centre-northwestern-tanzania
#19
Rogatus Kabyemera, Neema Chami, Neema Kayange, Respicius Bakalemwa, Antke Zuechner, Tumaini Mhada, Gustave Buname, Adolfine Hokororo, Johannes Kataraihya
Upper airway obstruction (UAO) due to adenotonsillar hypertrophy represents one of the rare causes of pulmonary hypertension in children. We report a case of adenotonsillar hypertrophy, managed at pediatric and otorhinolaryngology departments in Bugando Medical Centre (BMC), northwestern Tanzania, with complete remission of symptoms of pulmonary hypertension following adenotonsillectomy. A 17-month-old boy presented with difficulty breathing, dry cough, and noisy breathing since 1 year. He had facial and lower limb oedema with a pan systolic murmur at the tricuspid area, fine crepitations, and tender hepatomegaly...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27600126/pediatric-burn-resuscitation
#20
REVIEW
Tina L Palmieri
Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management.
October 2016: Critical Care Clinics
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