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Bronchoscopic intubation

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https://www.readbyqxmd.com/read/29708920/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#1
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29684995/successful-airway-management-with-combined-use-of-mcgrath%C3%A2-mac-video-laryngoscope-and-fiberoptic-bronchoscope-in-a-severe-obese-patient-with-huge-goiter-a-case-report
#2
Mee Young Chung, Byunghoon Park, Jaeho Seo, Chang Jae Kim
Huge goitor can lead to tracheal compression and hence difficulty in intubation. This is compounded by severe obesity. Failed tracheal intubation in difficult intubation is a serious event that may lead to increased patient morbidity and mortality. Current intubation rescue techniques and combination of different rescue techniques may increase the success rate of difficult intubation. In a 47-year-old female patient, with severe obesity and a huge goiter, our attempts at intubation using direct laryngoscope, video laryngoscope, and awake fiberoptic bronchoscope had failed...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29674397/massive-haemoptysis-secondary-to-mycotic-pulmonary-artery-aneurysm-in-subacute-invasive-aspergillosis
#3
Shahbaz Piracha, Asad Mahmood, Noman Qayyum, Muhammad Badar Ganaie
A 68-year-old man, presented with 3 week history of infective symptoms and mild haemoptysis. Past medical history included severe emphysema and a chronic right upper lobe (RUL) cavity. He was discharged from follow-up a year ago in view of clinical and radiological stability; previous bronchoscopic examinations yielded no specific diagnosis. CT scan on admission confirmed complex cavitary consolidation of RUL. He developed massive haemoptysis requiring intubation and ventilation. CT pulmonary angiogram (CTPA) revealed 16 mm RUL pulmonary artery (PA) aneurysm which was successfully embolized...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#4
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29657064/-selective-left-mainstem-bronchial-intubation-in-the-neonatal-intensive-care-unit
#5
Anthony M H Ho, Michael P Flavin, Melinda L Fleming, Glenio Bitencourt Mizubuti
BACKGROUND: Selective neonatal left mainstem bronchial intubation to treat right lung disease is typically achieved with elaborate maneuvers, instrumentation and devices. This is often attributed to bronchial geometry which favors right mainstem entry of an endotracheal tube deliberately advanced beyond the carina. CASE SUMMARY: A neonate with severe bullous emphysema affecting the right lung required urgent non-ventilation of that lung. We achieved left mainstem bronchial intubation by turning the endotracheal tube 180° such that the Murphy's eye faced the left instead of the right, and simulated a left-handed intubation by slightly orientating the endotracheal tube such that its concavity faced the left instead of the right as in a conventional right-handed intubation...
April 12, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29627056/airway-management-following-tracheal-surgery
#6
REVIEW
Thomas R J Todd
The ability to remove longer segments of airway and to extend resections into the larynx proper has managed to create novel situations that will require attention to postoperative management. This article deals with prophylactic measures to prevent the requirement of assisted ventilation. It, however, also emphasizes various bronchoscopic and intubation techniques, which if required, will help to avoid trauma to the airway anastomosis. In addition, a variety of ventilator modalities are discussed that were developed by the author over many years at the Toronto General Hospital...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29621098/comparison-of-the-efficacy-and-efficiency-of-the-use-of-virtual-reality-simulation-with-high-fidelity-mannequins-for-simulation-based-training-of-fiberoptic-bronchoscope-manipulation
#7
Bailin Jiang, Hui Ju, Ying Zhao, Lan Yao, Yi Feng
INTRODUCTION: This study compared the efficacy and efficiency of virtual reality simulation (VRS) with high-fidelity mannequin in the simulation-based training of fiberoptic bronchoscope manipulation in novices. METHODS: Forty-six anesthesia residents with no experience in fiberoptic intubation were divided into two groups: VRS (group VRS) and mannequin (group M). After a standard didactic teaching session, group VRS trained 25 times on VRS, whereas group M performed the same process on a mannequin...
April 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29556460/retrograde-intubation-through-nasal-route-in-patients-with-limited-mouth-opening-undergoing-oral-and-maxillofacial-surgery
#8
Ashwant Kumar Vadepally, Ramen Sinha, A V S S Subramanya Kumar
Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening...
January 2018: Journal of Oral Biology and Craniofacial Research
https://www.readbyqxmd.com/read/29524199/self-pressurized-air-q-%C3%A2-intubating-laryngeal-airway-versus-the-lma-%C3%A2-classic%C3%A2-a-randomized-clinical-trial
#9
Sang Hee Ha, Min-Soo Kim, Jiwoo Suh, Jong Seok Lee
PURPOSE: The self-pressurized air-Q® (air-Q SP) intubating laryngeal airway is a relatively new supraglottic airway (SGA) device. The intracuff pressure of air-Q dynamically equilibrates with the airway pressure and adjusts to the patient's pharyngeal and periglottic anatomy, potentially providing improved airway fit and seal. The aim of this prospective randomized study was to compare the clinical performance of air-Q to the LMA® Classic™ SGA. METHODS: Adult patients requiring general anesthesia for elective surgery were prospectively enrolled and randomly assigned to either air-Q SP or the LMA Classic SGA...
May 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29501292/volume-relationships-between-cricoid-and-main-stem-bronchi-in-children-using-three-dimensional-computed-tomography-imaging
#10
Tariq M Wani, Ayman Mohammad AlAhdal, Mohammed Hakim, Tanveer Hussein, Abdul Basit Mir, Ravees Jan, Dmitry Tumin, Joseph D Tobias
BACKGROUND: There are limited data to guide the selection of the appropriate sized endobronchial tube for main stem intubation to provide one-lung ventilation in children. The relationship between the cricoid and the main bronchi (right and left) has been previously evaluated using two-dimensional computed tomography (CT) imaging and video-bronchoscopic images. The present study defines the three-dimensional, CT-derived volume-based relationships between the right main-stem bronchus (RMB), left main-stem bronchus (LMB), and the cricoid ring...
April 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29484765/intentional-tracheoesophageal-fistula-cannulation-for-gastric-decompression-in-type-c-esophageal-atresia
#11
Paola Papoff, Roberto Cicchetti, Francesco Montecchia, Fabio Midulla, Silvia Ceccanti, Denis Cozzi
We describe a nonsurgical technique for managing gastric distention in infants with type C esophageal atresia, involving intubating the trachea with an umbilical catheter and entering the stomach through the fistula as soon as a flexible bronchoscope found its wide-open orifice. This technique might have a special role when gastric distention precedes other commonly used preventive measures.
April 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29477268/diagnostic-utilities-of-tracheal-ultrasound-and-usb-endoscope-for-the-confirmation-of-endotracheal-tube-placement-a-cadaver-study
#12
Erkman Sanri, Ebru Unal Akoglu, Sinan Karacabey, Ural Verimli, Haldun Akoglu, Umit Sehirli, Arzu Denizbasi
OBJECTIVES: Confirmation of the endotracheal tube placement (CoETP) has the utmost importance in the management of an airway. Visualization of tracheal rings or carina with a fiber-optical bronchoscope (FOB) has considered to be a reliable method for the CoETP. However, FOB is expensive, time-consuming, and not always practical. Inexpensive endoscopic USB-cameras were shown to aid intubation successfully and reliably. On the other hand, there have been no studies investigating their use for the CoETP...
February 17, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29465052/nasotracheal-intubation-in-children-for-outpatient-dental-surgery-is-fiberoptic-bronchoscopy-useful
#13
A S Ozkan, S Akbas
Background: The aim of our study was to compare the hemodynamic responses and adverse events associated with nasotracheal intubation (NTI) using a fiberoptic bronchoscope (FOB) and a direct laryngoscope (DLS) in children undergoing general anesthesia for outpatient dental surgery. Methods: Eighty children (aged 5-15 years) were scheduled to undergo outpatient dental surgery under general anesthesia and of these children those who required NTI were included. Results: NTI was significantly longer in the FOB group (P = 0...
February 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29387523/undiagnosed-chicken-meat-aspiration-as-a-cause-of-difficult-to-ventilate-in-a-boy-with-traumatic-brain-injury
#14
Nazhan Afeef Mohd Ariff, Mohd Zulfakar Mazlan, Mohd Erham Mat Hassan, Praveena A/P Seevaunnamtum, Wan Fadzlina Wan Muhd Shukeri, Nik Abdullah Nik Mohamad, Shamsul Kamalrujan Hassan, Kamaruddin Jaalam, Mohamad Hasyizan Hassan, Sanihah Che Omar, Chandran Nadarajan, Irfan Mohamad
Introduction: Bronchoscopy is a commonly used procedure in the context of aspiration in the Intensive Care Unit setting. Despite its ability to remove mucus plug and undigested gastric contents, aspiration of gastric content into the trachea is one of the most feared complications among anesthesiologist. Discussion: The scenario is made worst if the aspiration causes acute hypoxemic respiratory failure immediately post intubation. However, in the event of desaturation, the quick decision to proceed with bronchoscopy is a challenging task to the anesthesiologist without knowing the causes...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29221981/chest-computed-tomography-image-for-accurately-predicting-the-optimal-insertion-depth-of-left-sided-double-lumen-tube
#15
Zhuo Liu, Li Zhao, Qianqian Jia, Xiaochun Yang, Shu Juan Liang, Wensheng He
OBJECTIVE: The main objective of this study was to assess the feasibility and accuracy of measuring the distance between the vocal cord and carina using chest computer tomography (CT) as a guide for the intubation of a left-sided double-lumen tube (LDLT). DESIGN: Single-center, prospective, randomized study. SETTING: Local hospital in China. PARTICIPANTS: Sixty adult patients undergoing elective thoracic surgery requiring an LDLT for one lung ventilation were enrolled in this study...
September 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221291/airway-stenting-in-patients-requiring-intubation-due-to-malignant-airway-stenosis-a-10-year-experience
#16
Masahide Oki, Hideo Saka, Kazumi Hori
Background: Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. Methods: Patients with malignant airway stenosis who underwent emergency intubation prior to airway stent placement from September 2005 to September 2015 in a single center were retrospectively reviewed...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29210725/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#17
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29209509/realtime-ultrasound-guided-percutaneous-tracheostomy-in-emergency-setting-the-glass-ceiling-has-been-broken
#18
Parli Raghavan Ravi, M N Vijai, Sachin Shouche
Background: In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature...
2017: Disaster and Military Medicine
https://www.readbyqxmd.com/read/29149007/awake-bronchoscopic-intubation-with-a-noninvasive-positive-pressure-support-in-critically-ill-patients
#19
Fu-Shan Xue, Gui-Zhen Yang, Chao Wen
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29148179/clinical-implications-of-de-barsy-syndrome
#20
Lindsay L Warner, David A Olsen, Hugh M Smith
BACKGROUND: De Barsy syndrome is a rare, autosomal recessive syndrome characterized by cutis laxa, progeroid appearance, ophthalmic opacification, skeletal malformations, growth delays, and intellectual disability. AIMS: The aim of this case series is to identify the anesthetic considerations in the clinical management of patients with de Barsy syndrome. METHODS: A retrospective case review from 1968 to 2016 was performed at a single tertiary medical center to identify patients with de Barsy syndrome who underwent anesthesia for diagnostic and surgical procedures...
January 2018: Paediatric Anaesthesia
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