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https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#1
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28528369/effect-of-physical-stress-on-drug-induced-sleep-endoscopy-for-obstructive-sleep-apnea
#2
Sang Min Park, Dong-Kyu Kim
Drug-induced sleep endoscopy (DISE) is a reliable upper airway evaluation tool, widely used to improve surgical results in patients with obstructive sleep apnea (OSA). Several factors, including sleeping position and depth of sedation, affect DISE findings. This study aimed to evaluate the impact of physical stress on DISE findings. Eighty-five patients with OSA underwent two DISE examinations at the same level of sedation. The "first DISE" (control group) was performed after polysomnography, while the "second DISE" (test group) performed immediately after a treadmill stress test...
May 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28526465/-selective-lobar-blockade-with-a-coopdech-blocker-combined-with-a-double-lumen-endotracheal-tube-for-lung-metastases-resection-by-laser
#3
Patricia Cruz, Hugo David Orozco, Ignacio Garutti Martinez, Gloria Hernández Fernández
In recent years, laser resection of lung metastases has been established as the standard procedure worldwide. To avoid airway fire, it is necessary to collapse the surgical lung. The selective lobar bronchial blockade is a technique that allows one-lung ventilation while the operated lobe is collapsed in patients with previous pulmonary resection requiring subsequent resection or with limited pulmonary reserve. We report a clinical case about our experience of a selective lobar bronchial blockade technique with a bronchial blocker (Coopdech endobronchial blocker) that was employed successfully with a double-lumen endotracheal tube in a patient with previous contralateral pulmonary resection who was scheduled for atypical resections of pulmonary metastases by laser...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#4
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Adult patients scheduled for elective thoracic surgery with a predicted risk (evaluated preoperatively using the Arné score) or history of difficult intubation were allocated randomly to one of two groups: a Glidescope group and an Airtraq group...
May 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28521967/does-pterygomaxillary-disjunction-in-surgically-assisted-rapid-maxillary-expansion-influence-upper-airway-volume-a-prospective-study-using-dolphin-imaging-3d
#5
J Rômulo de Medeiros, M Ferraro Bezerra, F W Gurgel Costa, T Pinheiro Bezerra, C R de Araújo Alencar, E C Studart Soares
Surgically assisted rapid maxillary expansion has been used for the treatment of transverse maxillary deficiency. This prospective study aimed to evaluate the effect of this surgery (with or without pterygomaxillary disjunction) on the upper airway volume. The patients were randomly divided into two groups: without pterygomaxillary disjunction (-PD) and with pterygomaxillary disjunction (+PD). Eleven patients per group were estimated to obtain a representative sample (90% of power and 95% of confidence level)...
May 15, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28516964/barbed-reposition-pharyngoplasty-in-multilevel-robotic-surgery-for-obstructive-sleep-apnoea
#6
C Vicini, G Meccariello, G Cammaroto, M Rashwan, F Montevecchi
The surgical treatment of obstructive sleep apnoea in patients who are non-compliant with continuous positive airway pressure therapy still represents a valid alternative. In recent years, the multilevel approach is becoming more diffuse in routine surgical practice, especially since the introduction of transoral robotic surgery. Barbed reposition pharyngoplasty in multilevel robotic surgery for OSA may represent a valid option to surgically approach the soft palate. Herein, we describe the technique and preliminary results of our experience...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28515525/management-of-an-intraoperatively-damaged-endotracheal-tube-in-a-case-of-difficult-airway-using-fibre-optic-bronchoscope-with-minimal-apnoea-period
#7
Jayachandran Himarani, S Mary Nancy, V B Krishna Kumar Raja, S Shanmuga Sundaram
Damage to the endotracheal tube (ETT) is common in head and neck surgeries, especially in maxillary osteotomy. Airway management in such a crisis is crucial as there is risk of aspiration of blood into lungs, hypoxia and apnoea. This case illustrates a patient with an anticipated difficult airway who had an intraoperative damage to the ETT and was successfully managed by re-intubation with fiberoptic bronchoscope in a minimal apnoea period of <15 s using a new technique.
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515521/comparative-evaluation-of-airtraq%C3%A2-optical-laryngoscope-and-miller-s-blade-in-paediatric-patients-undergoing-elective-surgery-requiring-tracheal-intubation-a-randomized-controlled-trial
#8
Bikramjit Das, Arijit Samanta, Subhro Mitra, Shahin Nikhat Jamil
BACKGROUND AND AIMS: The Airtraq™ optical laryngoscope is the only marketed videolaryngoscope for paediatric patients besides the fibre-optic bronchoscope. We hypothesized that intubation would be easier with Airtraq™ compared to Miller blade. Hence, we compared Airtraq™ with the Miller laryngoscope as intubation devices in paediatric patients. METHODS: This prospective, randomized study was conducted in a tertiary care teaching hospital. Sixty children belonging to American Society of Anesthesiologists' Grade I-II, aged 2-10 years, posted for routine surgery requiring tracheal intubation were randomly allocated to undergo intubation using a Miller (n = 30) or Airtraq™ (n = 30) laryngoscope...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515520/a-comparative-evaluation-of-video-stylet-and-flexible-fibre-optic-bronchoscope-in-the-performance-of-intubation-in-adult-patients
#9
Syed Hussain Amir, Qazi Ehsan Ali, Sonali Bansal
BACKGROUND AND AIMS: Video Stylet (VS) is a new intubating modality that provides real-time video of endotracheal intubation (ETI). This device does not need alignment of the oral, pharyngeal and tracheal axes to view glottis and can be used in patients with limited mouth opening. The aim of this study was to compare flexible fibre-optic (FO) bronchoscope with VS in elective surgical patients in apparently normal airway patients requiring oral ETI. METHODS: Sixty patients undergoing elective surgery under general anaesthesia of age group 20-60 years, weight 40-70 kg, American Society of Anesthesiologist 1 and 2 and modified Mallampatti I and II were included in the study...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28513521/otorhinolaryngological-emergencies-in-a-tertiary-hospital-in-port-harcourt
#10
U M Ibekwe
BACKGROUND: Emergencies are not uncommon in a typical otorhinolaryngological (ORL) clinic. The knowledge of the profile and prevalence of these emergencies will go a long way in helping to equip as well as aid proper and prompt management of these conditions so as to reduce their morbidity and mortality. PATIENTS AND METHODS: A descriptive retrospective 8 years review of all patients that presented to the ENT Surgery Department from January 2004 to December 2012...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28508288/repetitive-postoperative-extubation-failure-and-cardiac-arrest-due-to-laryngomalacia-after-general-anesthesia-in-an-elderly-patient-a-case-report
#11
Jun Takeshita, Kei Nishiyama, Masashi Fujii, Hiroyuki Tanaka, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
The authors report a case involving an elderly patient who experienced repetitive perioperative cardiac arrest caused by laryngomalacia. The patient underwent surgery under general anesthesia; however, 2 h after initial extubation, he experienced cardiopulmonary arrest. Return of spontaneous circulation was achieved by immediate resuscitation. Four hours later, a second extubation was performed without any neurological complications. However, 2 h later, he experienced cardiopulmonary arrest again. Immediately after the third extubation, 12 h after the second cardiopulmonary arrest, fiberoptic laryngoscopy revealed laryngomalacia...
May 15, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28506413/nasotracheal-prolonged-safe-extubation-in-acute-respiratory-failure-post-thyroidectomy-an-efficacious-technique-to-avoid-tracheotomy-a-retrospective-analysis-of-a-large-case-series
#12
F Ferraro, C Gambardella, D Testa, L Santini, R Marfella, P Fusco, C P Lombardi, A Polistena, A Sanguinetti, N Avenia, G Conzo
BACKGROUND: Acute respiratory failure is a rare life threatening complication following thyroid surgery and its incidence is reported as high as 0.9%. Clinical presentation of severe acute respiratory failure is characterized by dyspnea, inspiratory airways distress, hypoxia and its standard current management is the orotracheal intubation and safe extubation. In case of persistent distress, tracheotomy is mandatory. The Authors, analysing a large acute respiratory failure clinical series, describe an innovative treatment of this severe condition: the nasotracheal prolonged safe extubation...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#13
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504356/bronchoscopy-in-children-with-tetralogy-of-fallot-pulmonary-atresia-and-major-aortopulmonary-collaterals
#14
Douglas R Sidell, Andrew M Koth, Holly Bauser-Heaton, Doff B McElhinney, Lisa Wise-Faberowski, Michael C Tracy, Frank L Hanley, Ritu Asija
OBJECTIVE: Children with Tetralogy of Fallot, Pulmonary Atresia, and Major Aortopulmonary Collaterals (TOF/PA/MAPCAs) undergoing unifocalization surgery are at risk for developing more postoperative respiratory complications than children undergoing other types of congenital heart surgery. Bronchoscopy is used in the perioperative period for diagnostic and therapeutic purposes. In this study, we describe bronchoscopic findings and identify factors associated with selection for bronchoscopy...
May 15, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28502060/comparison-of-univent-tube-and-ez-blocker-in-one-lung-ventilation-airway-pressures-and-gas-exchange
#15
Tülay Hoşten, Can Aksu, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Mine Solak
Univent tube (UT) and EZ-blocker were used for one-lung ventilation (OLV). UT is a single lumen tube with a small separate lumen containing a bronchial blocker. EZ-blocker differs with its unique y-shaped double-cuffed distal end. We aimed to compare these two airway devices effects on airway pressures, oxygenation, ventilation and haemodynamics during OLV. Patients undergoing elective thoracotomy for the first time were included in this prospective randomized study. Patients were divided into two groups as UT and EZ...
May 13, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28500875/upper-airway-changes-after-mandibular-setback-and-or-advancement-genioplasty-in-obese-patients
#16
Wen Du, Dongming He, Yiyao Wang, Hanghang Liu, Chuhang Liao, Wei Fei, En Luo
PURPOSE: Orthognathic surgeries, such as bilateral sagittal split ramus osteotomy (BSSO) and genioplasty, can influence the pharyngeal airway space (PAS) and this has been supported by previous studies. The purpose of this study was to assess changes of the PAS in patients with a high body mass index (BMI) likely to have narrow airways before and after setback BSSO with or without advancement genioplasty surgery by 3-dimensional computed tomography. MATERIALS AND METHODS: Thirty-five adults with a BMI of at least 24...
April 19, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28498266/use-of-positive-airway-pressure-following-middle-ear-surgery-a-practice-survey-of-otologists
#17
Douglas S Ruhl, Anthony M Tolisano, Bradley W Kesser, George T Hashisaki, Macario Camacho
BACKGROUND: Positive airway pressure (PAP) devices are used as treatment for obstructive sleep apnea (OSA). PAP may increase middle ear pressure which is of interest to otologic surgeons. There is a lack of data to guide management of PAP therapy after middle ear surgery. OBJECTIVE: To elucidate how otologic surgeons manage PAP in their patients after ear surgery. STUDY DESIGN: A survey e-mailed to practicing members of the American Neurotology Society...
May 11, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28495241/the-natural-course-of-prevertebral-soft-tissue-swelling-after-anterior-cervical-spine-surgery-how-long-will-it-last
#18
Seok Woo Kim, Chulyoung Jang, Myung Ho Yang, Seonjong Lee, Je Hyun Yoo, Yoon Hae Kwak, Ji Hyo Hwang
BACKGROUND CONTEXT: Prevertebral soft tissue swelling (PSTS) after anterior cervical spine surgery (ACSS) has been regarded as one of the critical complications that cause airway obstruction. Still, however, no research has dealt with how PSTS returns to pre-surgery status after ACSS; most recommendations are being performed without information about its natural course, focusing on acute-phase swelling after surgery. PURPOSE: To examine how long post-surgery PSTS lasts and when it returns to its pre-surgery state; to analyze the actual influence of a number of factors to observe the natural progress of post-surgery PSTS...
May 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#19
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28492439/retrobulbar-block-in-pediatric-vitreoretinal-surgery-eliminates-the-need-for-intraoperative-fentanyl-and-postoperative-analgesia-a-randomized-controlled-study
#20
Lan Yao, Hong Zhao, Bailin Jiang, Yi Feng
BACKGROUND AND OBJECTIVES: Pediatric ophthalmologic surgery is traditionally accomplished by general anesthesia with opioids, but respiratory depression remains a major concern. Our study compared the efficacy of retrobulbar block with systemic fentanyl on pain, hemodynamic, and stress response in pediatric vitreoretinal surgery. METHODS: A prospective double-blind, randomized controlled study was performed comparing retrobulbar block with intravenously administered fentanyl in 28 children aged 1 to 6 years undergoing vitreoretinal surgery...
May 10, 2017: Regional Anesthesia and Pain Medicine
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