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Simulated airway

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https://www.readbyqxmd.com/read/28095918/anti-staphylococcal-activity-resulting-from-epithelial-lining-fluid-elf-concentrations-of-amikacin-inhale-administered-via-the-pulmonary-drug-delivery-system
#1
Islam M Ghazi, Mordechai Grupper, David P Nicolau
BACKGROUND: Amikacin inhale (BAY41-6551), a unique drug-device combination of a specially formulated drug solution and a pulmonary drug delivery system device (AMK-I) is currently under phase III study as an adjunctive therapy to IV antibiotics for the treatment of Gram-negative pneumonia in mechanically ventilated patients. While the epidemiology of nosocomial pneumonia is predominated by Gram-negative pathogens such as Pseudomonas aeruginosa and the Enterobacteriaceae, Staphylococcus aureus is increasingly recognized as a pathogen of concern for these pulmonary based infections...
January 17, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28089607/estimates-of-nasal-airflow-at-the-nasal-cycle-mid-point-improve-the-correlation-between-objective-and-subjective-measures-of-nasal-patency
#2
Courtney Gaberino, John S Rhee, Guilherme J M Garcia
INTRODUCTION: The nasal cycle represents a significant challenge when comparing pre- and post-surgery objective measures of nasal airflow. METHODS: Computational fluid dynamics (CFD) simulations of nasal airflow were conducted in 12 nasal airway obstruction patients showing significant nasal cycling between pre- and post-surgery computed tomography scans. To correct for the nasal cycle, mid-cycle models were created virtually. Subjective scores of nasal patency were obtained via the Nasal Obstruction Symptom Evaluation (NOSE) and unilateral visual analog scale (VAS)...
January 9, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28081306/tracheal-intubation-in-patients-immobilized-by-a-rigid-collar-a-comparison-of-glidescope-and-an-intubating-laryngeal-mask-airway
#3
Semih Özdil, Zehra İpek Arslan Aydın, Zehra Nur Baykara, Kamil Toker, Zeynep Mine Solak
BACKGROUND/AIM: Intubation must be rapidly performed with the utmost care in cervical trauma patients. We present the first comparison of GlideScope and an intubating laryngeal mask airway (ILMA) regarding insertion and intubation times, intubation success rates, mucosal damage, need for optimization maneuvers, effects on hemodynamic changes, and postoperative minor complications in a simulated cervical injury with a Philadelphia cervical collar. MATERIALS AND METHODS: Ethics committee approval and patient consent were obtained and 94 American Society of Anesthesiology physical status I or II patients were enrolled in this study...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28072732/comparison-of-the-i-gel-and-other-supraglottic-airways-in-adult-manikin-studies-systematic-review-and-meta-analysis
#4
Jiwon An, Sang Beom Nam, Jong Seok Lee, Jinae Lee, Hanna Yoo, Hye Mi Lee, Min-Soo Kim
BACKGROUND: The i-gel has a gel-like cuff composed of thermoplastic elastomer that does not require cuff inflation. As the elimination of cuff inflation may shorten insertion time, the i-gel might be a useful tool in emergency situations requiring prompt airway care. This systematic review and meta-analysis of previous adult manikin studies for inexperienced personnel was performed to compare the i-gel with other supraglottic airways. METHODS: We searched PubMed, the Cochrane Library, and EMBASE for eligible randomized controlled trials (RCTs) published before June 2015, including with a crossover design, using the following search terms: "i-gel," "igel," "simulation," "manikin," "manikins," "mannequin," and "mannequins...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068958/effects-of-ventilator-settings-nebulizer-and-exhalation-port-position-on-albuterol-delivery-during-non-invasive-ventilation-an-in-vitro-study
#5
Yuda Sutherasan, Lorenzo Ball, Pasquale Raimondo, Valentina Caratto, Elisa Sanguineti, Federico Costantino, Maurizio Ferretti, Robert M Kacmarek, Paolo Pelosi
BACKGROUND: Few studies have investigated the factors affecting aerosol delivery during non-invasive ventilation (NIV). Our aim was to investigate, using a bench-top model, the effect of different ventilator settings and positions of the exhalation port and nebulizer on the amount of albuterol delivered to a lung simulator. METHODS: A lung model simulating spontaneous breathing was connected to a single-limb NIV ventilator, set in bi-level positive airway pressure (BIPAP) with inspiratory/expiratory pressures of 10/5, 15/10, 15/5, and 20/10 cmH2O, or continuous positive airway pressure (CPAP) of 5 and 10 cmH2O...
January 10, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28062484/heterogeneity-of-airway-dimensions-in-humans-a-critical-determinant-of-lung-function-in-asthmatics-and-non-asthmatics
#6
Christopher D Pascoe, Chun Y Seow, Tillie-Louise Hackett, Peter D Paré, Graham M Donovan
Airway remodeling, a key feature of asthma, alters every layer of the airway wall but most strikingly the airway smooth muscle (ASM) layer. Airway remodeling in asthmatics contributes to fixed airflow obstruction and can amplify airway narrowing caused by ASM activation. Previous modeling studies have shown that the increase in ASM mass has the largest effect on increasing maximal airway narrowing. Simulated heterogeneity in the dimensions and properties of the airway wall can further amplify airway narrowing...
January 6, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28062122/airflow-behavior-changes-in-upper-airway-caused-by-different-head-and-neck-positions-comparison-by-computational-fluid-dynamics
#7
Wei Wei, Shi-Wei Huang, Lian-Hua Chen, Yang Qi, Yi-Min Qiu, Shi-Tong Li
The feasibility of computational fluid dynamics (CFD) to evaluate airflow characteristics in different head and neck positions has not been established. This study compared the changes in volume and airflow behavior of the upper airway by CFD simulation to predict the influence of anatomical and physiological airway changes due to different head-neck positions on mechanical ventilation. One awake volunteer with no risk of difficult airway underwent computed tomography in neutral position, extension position (both head and neck extended), and sniffing position (head extended and neck flexed)...
December 29, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28060323/a-model-to-simulate-clinically-relevant-hypoxia-in-humans
#8
Lars Eichhorn, Florian Kessler, Volker Böhnert, Felix Erdfelder, Anja Reckendorf, Rainer Meyer, Richard K Ellerkmann
In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to hypoxia sensitive organs such as the brain, compensatory circulatory mechanisms help to maintain an adequate oxygen supply. This is mainly achieved by increased cerebral blood flow. Intermittent hypoxia is a commonly seen phenomenon in patients with obstructive sleep apnea. Acute airway obstruction can also result in hypoxia and hypercapnia. Until now, no adequate model has been established to simulate these dynamics in humans...
December 22, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28050896/cost-analysis-of-single-use-ambu-%C3%A2-ascope%C3%A2-and-reusable-bronchoscopes-in-the-icu
#9
S Perbet, M Blanquet, C Mourgues, J Delmas, S Bertran, B Longère, V Boïko-Alaux, P Chennell, J-E Bazin, J-M Constantin
BACKGROUND: Flexible optical bronchoscopes are essential for management of airways in ICU, but the conventional reusable flexible scopes have three major drawbacks: high cost of repairs, need for decontamination, and possible transmission of infectious agents. The main objective of this study was to measure the cost of bronchoalveolar lavage (BAL) and percutaneous tracheostomy (PT) using reusable bronchoscopes and single-use bronchoscopes in an ICU of an university hospital. The secondary objective was to compare the satisfaction of healthcare professionals with reusable and single-use bronchoscopes...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28048834/th-ef-bra-03-assessment-of-data-driven-respiratory-motion-compensation-methods-for-4d-cbct-image-registration-and-reconstruction-using-clinical-datasets
#10
M J Riblett, E Weiss, G E Christensen, G D Hugo
PURPOSE: To evaluate the performance of a 4D-CBCT registration and reconstruction method that corrects for respiratory motion and enhances image quality under clinically relevant conditions. METHODS: Building on previous work, which tested feasibility of a motion-compensation workflow using image datasets superior to clinical acquisitions, this study assesses workflow performance under clinical conditions in terms of image quality improvement. Evaluated workflows utilized a combination of groupwise deformable image registration (DIR) and image reconstruction...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048277/mo-fg-bra-06-electromagnetic-beacon-insertion-in-lung-cancer-patients-and-resultant-surrogacy-errors-for-dynamic-mlc-tumour-tracking
#11
N Hardcastle, J Booth, V Caillet, R O'Brien, C Haddad, C Crasta, K Szymura, P Keall
PURPOSE: To assess endo-bronchial electromagnetic beacon insertion and to quantify the geometric accuracy of using beacons as a surrogate for tumour motion in real-time multileaf collimator (MLC) tracking of lung tumours. METHODS: The LIGHT SABR trial is a world-first clinical trial in which the MLC leaves move with lung tumours in real time on a standard linear accelerator. Tracking is performed based on implanted electromagnetic beacons (CalypsoTM, Varian Medical Systems, USA) as a surrogate for tumour motion...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048230/su-g-206-15-effects-of-dose-reduction-on-emphysema-score
#12
P Lo, S Young, J Hoffman, M Wahi-Anwar, H Kim, M McNitt-Gray
PURPOSE: The purpose of this study was to investigate the effects of reducing radiation dose levels on emphysema scores from lung cancer screening CT exams. METHODS: 52 cases were selected from the National Lung Screening Trial (NLST) patients for which we had both the image series and the raw CT data. All scans were acquired with fixed effective mAs (25 for standard-sized patients, 40 for large patients) on a 64-slice scanner (Sensation 64, Siemens Healthcare) using 120kV, 64×0...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045709/cricoid-pressure-controversies-narrative-review
#13
M Ramez Salem, Arjang Khorasani, Ahed Zeidan, George J Crystal
Since cricoid pressure was introduced into clinical practice, controversial issues have arisen, including necessity, effectiveness in preventing aspiration, quantifying the cricoid force, and its reliability in certain clinical entities and in the presence of gastric tubes. Cricoid pressure-associated complications have also been alleged, such as airway obstruction leading to interference with manual ventilation, laryngeal visualization, tracheal intubation, placement of supraglottic devices, and relaxation of the lower esophageal sphincter...
January 3, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28043780/influence-of-mouth-opening-on-oropharyngeal-humidification-and-temperature-in-a-bench-model-of-neonatal-continuous-positive-airway-pressure
#14
Hendrik S Fischer, Tim L Ullrich, Christoph Bührer, Christoph Czernik, Gerd Schmalisch
Clinical studies show that non-invasive respiratory support by continuous positive airway pressure (CPAP) affects gas conditioning in the upper airways, especially in the presence of mouth leaks. Using a new bench model of neonatal CPAP, we investigated the influence of mouth opening on oropharyngeal temperature and humidity. The model features the insertion of a heated humidifier between an active model lung and an oropharyngeal head model to simulate the recurrent expiration of heated, humidified air. During unsupported breathing, physiological temperature and humidity were attained inside the model oropharynx, and mouth opening had no significant effect on oropharyngeal temperature and humidity...
December 30, 2016: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28041757/comparison-of-the-macintosh-laryngoscope-and-blind-intubation-via-the-igel-for-intubation-with-cervical-spine-immobilization-a-randomized-crossover-manikin-trial
#15
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Lukasz Szarpak, Michael Frass, Oliver Robak
INTRODUCTION: Endotracheal intubation (ETI) using a Macintosh laryngoscope (MAC) requires the head to be positioned in a modified Jackson position, slightly reclined and elevated. Intubation of trauma patients with an injured neck or spine is therefore difficult, since the neck usually cannot be turned or is already immobilized in order to prevent further injury. The iGEL supraglottic airway seems optimal for such conditions due to its blind insertion without the need of a modified Jackson position...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040237/-comparison-of-effectiveness-of-intubation-by-way-of-gum-elastic-bougie-and-intubating-laryngeal-mask-airway-in-endotracheal-intubation-of-patients-with-simulated-cervical-trauma
#16
Esra Yildiz Sut, Solmaz Gunal, Mehmet Akif Yazar, Bayazit Dikmen
PURPOSE: In this study, we evaluated the effectiveness of intubations by way of Gum Elastic Bougie and Intubating Laryngeal Mask Airway in endotracheal intubation of patients with simulated cervical trauma. METHOD: One hundred and thirty four patients were included in the study. All patients were placed cervical collar for a simulated cervical trauma. Patients were allocated randomly into three groups: Group NI (n=45) intubation with Macintosh laryngoscopy, Group GEB (n=45) intubation with Gum Elastic Bougie, and Group ILMA (n=44) intubation with Intubating Laryngeal Mask Airway...
December 28, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28029374/selection-bias-examining-the-feasibility-utility-and-participant-receptivity-to-incorporating-simulation-into-the-general-surgery-residency-selection-process
#17
Aimee K Gardner, Christopher P Steffes, Dmitry Nepomnayshy, Cate Nicholas, Warren D Widmann, Shimae C Fitzgibbons, Brian J Dunkin, Daniel B Jones, John T Paige
BACKGROUND: Opportunities exist to revise the current residency selection process to capture desirable candidate competencies. We examined the extent to which components of the American College of Surgeons/Association for Surgical Education simulation-based medical student curriculum combined with a teamwork activity could be used as potential screening method. METHODS: Students participated in a workshop consisting of training/evaluation of knot tying, suturing, airway management, gowning/gloving, and teamwork...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28003555/redesign-of-an-open-system-oxygen-face-mask-with-mainstream-capnometer-for-children
#18
Natalie Napolitano, Akira Nishisaki, Hayley S Buffman, Jessica Leffelman, Matthew R Maltese, Vinay M Nadkarni
BACKGROUND: Partial pressure of end-tidal carbon dioxide (PETCO2 ) monitoring in children is important to detect apnea or hypopnea early to intervene before hypoxemia develops. Monitoring PETCO2 in children without a tracheal tube is challenging. To improve PETCO2 measurement accuracy in a commercially available mask with a mainstream CO2 detector, we implemented design changes with deform-and-hold shaping technology and anterior-posterior adjustment of the expiratory gas flow cup. METHODS: Two sizes of redesigned face masks (small for 7-20 kg, medium for 10-40 kg) were evaluated...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27999601/reservoir-cannulas-for-pediatric-oxygen-therapy-a-proof-of-concept-study
#19
Grace Wu, Alec Wollen, Robert M DiBlasi, Stephen Himley, Eugene Saxon, Glenn Austin, Jaclyn Delarosa, Rasa Izadnegahdar, Amy Sarah Ginsburg, Darin Zehrung
Hypoxemia is a complication of pneumonia-the leading infectious cause of death in children worldwide. Treatment generally requires oxygen-enriched air, but access in low-resource settings is expensive and unreliable. We explored use of reservoir cannulas (RCs), which yield oxygen savings in adults but have not been examined in children. Toddler, small child, and adolescent breathing profiles were simulated with artificial lung and airway models. An oxygen concentrator provided flow rates of 0 to 5 L/min via a standard nasal cannula (NC) or RC, and delivered oxygen fraction (FdO2) was measured...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27991580/anatomically-correct-visualization-of-the-human-upper-airway-using-a-high-speed-long-range-optical-coherence-tomography-system-with-an-integrated-positioning-sensor
#20
Joseph C Jing, Lidek Chou, Erica Su, Brian J F Wong, Zhongping Chen
The upper airway is a complex tissue structure that is prone to collapse. Current methods for studying airway obstruction are inadequate in safety, cost, or availability, such as CT or MRI, or only provide localized qualitative information such as flexible endoscopy. Long range optical coherence tomography (OCT) has been used to visualize the human airway in vivo, however the limited imaging range has prevented full delineation of the various shapes and sizes of the lumen. We present a new long range OCT system that integrates high speed imaging with a real-time position tracker to allow for the acquisition of an accurate 3D anatomical structure in vivo...
December 19, 2016: Scientific Reports
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