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Bronchoscopic intubation

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https://www.readbyqxmd.com/read/27891428/fiberoptic-guided-retrograde-intubation-in-an-anticipated-difficult-airway-revival-of-an-antiquated-technique
#1
Samarjit Dey, Marie Ninu, Md Yunus, Newstar Syiemiong
Retrograde intubation is an invaluable technique which can be helpful in anticipated difficult airway situation. In this advanced era where fiberoptic intubation and video laryngoscopes are in abundant use, retrograde intubation is a forgotten technique. However, it may be useful in various difficult airway situations in this advanced era. In our case the patient had a bitter experience with previous fiberoptic intubation. Owing to that we had planned and performed a fiber optic guided retrograde intubation, where we had kept the fiberoptic bronchoscope in the pharynx keeping larynx and vocal cords in the focus to facilitate the emergence of guide wire through one of the nostrils as well as direct visual confirmation of intubation...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27875775/bronchoscopic-intubation-is-an-effective-airway-strategy-in-critically-ill-patients
#2
Kevin C Ma, Augustine Chung, Kerri I Aronson, Jamuna K Krishnan, Igor Z Barjaktarevic, David A Berlin, Edward J Schenck
PURPOSE: American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients. METHODS: We performed a retrospective cohort study of patients who underwent endotracheal intubation in the medical intensive care unit of a tertiary urban referral center over 1 academic year...
November 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27871545/fiberoptic-guided-intubation-after-insertion-of-the-i-gel-airway-device-in-spontaneously-breathing-patients-with-difficult-airway-predicted-a-prospective-observational-study
#3
Julian Arévalo-Ludeña, Jose Juan Arcas-Bellas, Rafael Alvarez-Rementería, Luis Enrique Muñoz Alameda
STUDY OBJECTIVE: To assess the viability of performing fiberoptic-guided orotracheal intubation through the i-gel airway device previously inserted in spontaneously breathing patients with predicted difficult airway to achieve a patent airway. DESIGN: Prospective observational study. SETTING: Operating room in a tertiary care hospital. PATIENTS: Eighty-five adult patients with at least 3 difficult airway predictors or difficult airway management history were included...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27868188/patency-of-paediatric-endotracheal-tubes-for-airway-instrumentation
#4
J Elfgen, P K Buehler, J Thomas, M Kemper, S Imach, M Weiss
BACKGROUND: Airway exchange catheters (AEC) and fiberoptic bronchoscopes (FOB) for tracheal intubation are selected so that there is only a minimal gap between their outer and inner diameter of endotracheal tube (ETT) to minimize the risk of impingement during airway instrumentation. This study aimed to test the ease of passage of FOBs and AECs through paediatric ETT of different sizes and from different manufacturers when using current recommendations for dimensional equipment compatibility taken from text books and manufacturers information...
November 20, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27853078/recurred-post-intubation-tracheal-stenosis-treated-with-bronchoscopic-cryotherapy
#5
Ye-Ryung Jung, Joon Taek Jeong, Myoung Kyu Lee, Sang-Ha Kim, Suk Joong Yong, Seok Jeong Lee, Won-Yeon Lee
Post-intubation tracheal stenosis accounts for the greatest proportion of whole-cause tracheal stenosis. Treatment of post-intubation tracheal stenosis requires a multidisciplinary approach. Surgery or an endoscopic procedure can be used, depending on the type of stenosis. However, the efficacy of cryotherapy in post-intubation tracheal stenosis has not been validated. Here, we report a case of recurring post-intubation tracheal stenosis successfully treated with bronchoscopic cryotherapy that had previously been treated with surgery...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27852079/propofol-and-remifentanil-sedation-for-bronchial-thermoplasty-a-prospective-cohort-trial
#6
Julia N S d'Hooghe, Susanne Eberl, Jouke T Annema, Peter I Bonta
BACKGROUND: Bronchial thermoplasty (BT) is a rapidly emerging bronchoscopic treatment for patients with moderate-to-severe asthma. Different sedation strategies are currently used, ranging from mild midazolam sedation to general anesthesia requiring tracheal intubation. OBJECTIVES: The aim of this study was to assess the feasibility, safety, and both patients' and bronchoscopists' satisfaction with propofol and remifentanil sedation administered by specialized sedation anesthesiology nurses during BT in severe asthma patients...
November 17, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27828867/a-simple-blind-placement-of-the-left-sided-double-lumen-tubes
#7
Zhi Jun Zong, Qi Ying Shen, Yao Lu, Yuan Hai Li
One-lung ventilation (OLV) has been commonly provided by using a double-lumen tube (DLT). Previous reports have indicated the high incidence of inappropriate DLT positioning in conventional maneuvers.After obtaining approval from the medical ethics committee of First Affiliated Hospital of Anhui Medical University and written consent from patients, 88 adult patients belonging to American society of anesthesiologists (ASA) physical status grade I or II, and undergoing elective thoracic surgery requiring a left-side DLT for OLV were enrolled in this prospective, single-blind, randomized controlled study...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27808401/continuous-ventilation-during-intubation-through-a-supraglottic-airway-device-guided-by-fiberoptic-bronchoscopy-a-observational-assessment
#8
H E Landsdalen, M Berge, F Kristensen, A B Guttormsen, E Søfteland
INTRODUCTION: supraglottic airway devices remain, despite advances in video laryngoscopy, important tools in the management of unexpected difficult airways. Intubation through a functioning supraglottic airway device with the aid of a fiberoptic bronchoscope is a well-known technique usually performed in apnoea. With a simple modification, the patient can be ventilated during this procedure. METHODS: In this observational study, Tracheal intubation Assisted by Bronchoscopy And Sad during Continuous Oxygenation (TABASCO) was performed as part of department training routine in 26 elective, fasted patients...
November 3, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27752604/comparison-of-intubation-times-using-a-manikin-with-an-immobilized-cervical-spine-macintosh-laryngoscope-vs-glidescope-vs-fiberoptic-bronchoscope
#9
Jung-In Ko, Sang Ook Ha, Min Seok Koo, Miyoung Kwon, Jieun Kim, Jin Jeon, So Hee Park, Sangwoo Shim, Youjin Chang, Taejin Park
OBJECTIVE: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared. METHODS: Nine physician experts in airway management participated in this study...
December 2015: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27703636/bronchoscopic-concerns-in-proteus-syndrome-a-case-report
#10
Jung-Min Hong, Hyeon Jeong Lee, Eun Soo Kim, Hae-Kyu Kim, Soeun Jeon, Hyae-Jin Kim
Proteus syndrome (PS) is a rare congenital hamartomatous disorder with multisystem involvement. PS shows highly clinical variability due to overgrowth of the affected areas, and several features can make anesthetic management challenging. Little is known about the airway problem associated with anesthesia in PS patients. An 11-year-old girl with PS was scheduled for ear surgery under general anesthesia. She had features complicating intubation including facial asymmetry and disproportion, abnormal teeth, limitation of neck movement due to torticollis, and thoracolumbar scoliosis...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27687400/transorbital-endotracheal-intubation-a-nonstandard-approach-to-a-difficult-airway
#11
Nathan H Waldron, Bryant W Stolp, Michael P Ogilvie, David B Powers, Michael R Shaughnessy
We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. Given his limited mouth opening, the surgeon requested a nasal endotracheal tube...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27652080/anesthetic-management-of-a-patient-with-localised-scleroderma
#12
Fangfan Ye, Gaoyin Kong, Jia Huang
INTRODUCTION: Scleroderma is a progressive fibrotic disorder of connective tissue which can present multiple anesthetic challenges to anesthetists, especially airway management. Awake intubation with fiberoptic bronchoscope is widely accepted and implemented for progressive systematic scleroderma patients. With the development and improvement of intubation devices these years, there is no report addressing other intubation methods for sclerotic patients. CASE DESCRIPTION: A 47 year-old, 42-kg man with 1-year history of localized scleroderma was scheduled for the operation of inner fixation after 6 days of his acetabular fracture...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27637970/supraglottic-jet-oxygenation-and-ventilation-assisted-fibre-optic-bronchoscope-intubation-in-patients-with-difficult-airways
#13
Caineng Wu, Jianqi Wei, Qingyun Cen, Xuefan Sha, Qingxiang Cai, Wuhua Ma, Ying Cao
A difficult airway may lead to hypoxia and brain damage. The WEI Nasal Jet Tube (WNJ) is a new nasal pharyngeal tube that applies supraglottic jet oxygenation and ventilation (SJOV) for patients during tracheal intubation without the need for mask ventilation. We evaluated the effectiveness and safety of SJOV-assisted fibre-optic bronchoscopy (FOB) using the WNJ in the management of difficult tracheal intubations. A total of 50 adult patients with Cormack-Lehane grade ≥3 and general anesthesia with tracheal intubation were randomly assigned to either the laryngeal mask airway (LMA) or WNJ groups...
September 14, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27614374/utilization-of-a-gum-elastic-bougie-to-facilitate-single-lung-intubation
#14
Michael Gottlieb, Vibhu Sharma, John Field, Michael Rozum, John Bailitz
INTRODUCTION: Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotracheal tube to maximum depth does not ensure that the proper (nonhemorrhagic) lung is ventilated...
August 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27602904/bronchoscopic-management-of-iatrogenic-tracheal-laceration-using-polyurethane-covered-nitinol-tracheal-stents
#15
Ehab Hussein, Vikas Pathak, Ray Wesley Shepherd, Samira Shojaee
Iatrogenic tracheal laceration is a known complication of emergent endotracheal intubation. Patients with tracheal laceration present a therapeutic challenge. There is no established standard treatment approach in this patient population. Interventions reported include conservative management, stent placement, or surgery. We present our experience of tracheal tears in patients with respiratory failure successfully managed with polyurethane-covered nitinol stent, including three cases of postintubation and one case of postsurgical tracheostomy tracheal injury...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27599401/emergency-endotracheal-intubation-under-fluoroscopy-guidance-for-patients-with-acute-dyspnea-or-asphyxia
#16
Dechao Jiao, Na Xie, Xinwei Han, Gang Wu
OBJECTIVE: To evaluate the feasibility and effectiveness of emergency endotracheal intubation (EEI) under fluoroscopy guidance for patients with acute dyspnea or asphyxia. METHODS: From October 2011 to October 2014, of 1521 patients with acute dyspnea or asphyxia who required EEI in 6 departments, 43 patients who experienced intubation difficulty or failure were entered into this study. Data on technical success, procedure time, complications, and clinical outcome were collected...
August 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27569229/evaluation-of-endotracheal-intubation-with-a-flexible-fiberoptic-bronchoscope-in-lateral-patient-positioning-a-prospective-randomized-controlled-trial
#17
Hui Li, Wu Wang, Ya-Ping Lu, Yan Wang, Li-Hua Chen, Li-Pei Lei, Xiang-Ming Fang
BACKGROUND: There is an unmet need for a reliable method of airway management for patients in the lateral position. This prospective randomized controlled two-center study was designed to evaluate the feasibility of intubation using a flexible fiberoptic bronchoscope in the lateral position during surgery. METHODS: Seventy-two patients scheduled for elective nonobstetric surgery in the lateral decubitus position requiring tracheal intubation under general anesthesia at Lishui Central Hospital of Zhejiang Province and Jiaxing First Hospital of Zhejiang Province from April 1, 2015, to September 30, 2015, were enrolled in this study...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27555698/tombs-of-aspergillus-a-missed-cause-of-recurrent-respiratory-infections-in-allergic-bronchopulmonary-aspergillosis
#18
Onkar Kumar Jha, Arjun Khanna, Charul Dabral, Deepak Talwar
Broncholithiasis is an often overlooked condition and has been associated with symptoms such as cough, hemoptysis, and recurrent respiratory infections. The most common mechanism of a broncholith formation is the enlargement and subsequent erosion of a lymph node into an adjacent airway. Here, we describe this entity in a patient with advanced allergic bronchopulmonary aspergillosis, with chronic hypercapnic respiratory failure, and with frequent infective exacerbations. These frequent exacerbations were initially attributed to the poor lung function of the patient and the inability to cough out the secretions...
July 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27555208/vivasight-a-new-era-in-the-evolution-of-tracheal-tubes
#19
REVIEW
Ayten Saracoglu, Kemal T Saracoglu
STUDY OBJECTIVE: To evaluate the available data describing the use of single and double lumen VivaSight tubes. DESIGN: Systematic review. SETTING: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications. PATIENTS: Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27555201/ultrasound-guided-airway-blocks-using-a-curvilinear-probe
#20
Martin Krause, Bahareh Khatibi, Jacklynn F Sztain, Pariza Rahman, Anna B Shapiro, NavParkash S Sandhu
We describe a novel technique of real-time ultrasound-guided superior laryngeal nerve and translaryngeal blocks in 4 patients with anticipated difficult airways. All patients had altered neck anatomy, and 1 had a prior unsuccessful awake fiberoptic bronchoscopic intubation. For block performance, an 11-mm broadband curved array transducer with a scanning frequency between 8 and 5 MHz (Sonosite, Bothell, WA) was used for anatomical structure identification, needle guidance toward each superior laryngeal nerve and through the cricothyroid membrane, and deposition of local anesthetic in the appropriate location...
September 2016: Journal of Clinical Anesthesia
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