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Bronchoscopic intubation

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
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...
February 6, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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
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.
February 26, 2018: Paediatric Anaesthesia
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
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
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
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
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
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
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
Fu-Shan Xue, Gui-Zhen Yang, Chao Wen
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
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
J M Huo, K Bai, Y Q Fu, C J Liu, F Xu
Objective: To investigate the effect of fiberoptic bronchoscope-guided one-lung ventilation (OLV) on treatment of intractable atelectasis in children. Method: This retrospective cohort study was conducted in Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University from December 2014 to May 2017. Six patients with intractable atelectasis of left lung were included. Three cases were male and three female with the age from 1.5 to 11.0 years. The endotracheal tube was intubated to the left main bronchus for OLV by the guidance of fiberoptic bronchoscopy...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Yuichi Okata, Tomomi Hasegawa, Yuko Bitoh, Kosaku Maeda
BACKGROUND: Tracheomalacia and bronchomalacia (TM/BM) are one of the serious causes of airway obstruction in infants and children. This study reviewed our bronchoscopic assessments and clinical outcomes in pediatric patients with TM/BM, and investigated risk factors of surgical intervention for TM/BM. METHODS: Fifty-seven consecutive patients who were diagnosed as TM/BM by bronchoscopy between 2009 and 2013 were reviewed retrospectively. They were divided into two groups according to the presence (group E, n = 26) or absence (group N, n = 31) of acute life-threatening events and extubation failure (ALTE/EF)...
January 2018: Pediatric Surgery International
Shinya Onishi, Akinori Osuka, Yuichi Kuroki, Masashi Ueyama
Aim: For patients with inhalation injury, the indications for early intubation are diverse. The purpose of this study was to identify the most reliable symptoms, physical findings, and medical examinations with which to determine the indications for early intubation in patients with inhalation injury. Methods: We retrospectively collected patient data from medical records. Collected data included age, sex, burn size, symptoms, physical findings, carboxyhemoglobin levels (COHb), and bronchial wall thickness (BWT) determined from chest computed tomography images...
July 2017: Acute Medicine & Surgery
Keita Iyama, Tomohiro Ueki, Shuhei Yamano, Goro Tajima, Takamitsu Inokuma, Tomohito Hirao, Kazunori Yamashita, Atsuko Nagatani, Osamu Tasaki
Case: A 61-year-old man who was hospitalized with schizophrenia in a psychiatric hospital drank hot water estimated to be 90°C. Eight hours after injury, laryngopharynx edema gradually progressed, and his breathing deteriorated. Upon arrival at our emergency room, we secured his respiratory tract by nasal intubation under a bronchoscope. Outcome: The edema gradually improved after peaking at hospital day 2, and he was extubated on hospital day 18. There were no apparent respiratory or esophageal problems, and he was discharged back to the psychiatric hospital on day 28...
April 2017: Acute Medicine & Surgery
Jagtar Singh Heir, Shu-Lin Guo, Ronaldo Purugganan, Tim A Jackson, Anupamjeet Kaur Sekhon, Kazim Mirza, Javier Lasala, Lei Feng, Juan P Cata
OBJECTIVE: To compare the incidence of fiberoptic bronchoscope (FOB) use (1) during verification of initial placement and (2) for reconfirmation of correct placement following repositioning, when either a double-lumen tube (DLT) or video double-lumen tube (VDLT) was used for lung isolation during thoracic surgery. DESIGN: A randomized controlled study. SETTING: Single-center university teaching hospital. PARTICIPANTS: The study comprised 80 patients who were 18 years or older requiring lung isolation for surgery...
May 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
T Piegeler, N G Clausen, M Weiss, Takashi Asai
Background: Proper manipulation of fibreoptic bronchoscopes is essential for successful tracheal intubation or diagnostic bronchoscopy. Failure of proper navigation and rotation of the fibrescope may lead to difficulties in advancing the fibrescope and might also be responsible for (unnecessary) difficulties and delays in fibreoptic tracheal intubation, with subsequent hypoxaemia. The present study, therefore, aimed to assess the effectiveness of tip rotation in flexible bronchoscopes in different experimental conditions...
December 1, 2017: British Journal of Anaesthesia
Abdul Haseeb, Noman Lateef, Muhammad Bilal, Kumar Gaurav, Jason Prudom, Ali Musani
Bravo® capsule (BC) (Medtronic, Minneapolis, MN) endoscopy is a reliable, viable, and well-tolerated diagnostic modality for resistant gastroesophageal reflux disease (GERD). Common complications of the procedure include early dislodgment, poor transmission, and premature removal due to intractable pain, while aspiration of the capsule is exceedingly rare. This paper reports a case of BC aspiration in a 52-year-old female who presented after being ventilated when her oxygen saturation dropped. The initial chest radiograph revealed that the BC was in the right main bronchus; the site was further elaborated by flexible endoscopy and the capsule was found to be in the right lower lobe bronchus distal to the bronchus intermedius...
August 9, 2017: Curēus
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