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https://www.readbyqxmd.com/read/29346253/an-innovative-solution-for-prolonged-air-leaks-the-customized-endobronchial-silicone-blocker
#1
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rakesh Godara, Chakravarthi Lokanath, Michael Cutaia
BACKGROUND: Prolonged air leak (PAL) is a life-threatening condition that can present either as bronchopleural fistula, or alveolar-pleural fistula (APF). Although numerous bronchoscopic treatments are described, they are either expensive, not widely available in the developing world or have limited success. We describe our experience with a novel customized endobronchial silicone blocker (CESB) for PAL treatment. METHODS: This is a retrospective study of PAL patients who underwent CESB placement...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29345325/a-new-retrograde-transillumination-technique-for-videolaryngoscopic-tracheal-intubation
#2
P Biro, E Fried, M Schlaepfer, M S Kristensen
This single-centre, prospective trial was designed to assess the efficacy of a new retrograde transillumination device called the 'Infrared Red Intubation System' (IRRIS) to aid videolaryngoscopic tracheal intubation. We included 40 adult patients, who were undergoing elective urological surgery under general anaesthesia. We assessed the ability to differentiate the transilluminated glottis from other structures and found a median (IQR [range]) larynx recognition time of 8 (5-14 [3-28]) s. The difference in laryngeal visibility on the screen between the deactivated vs...
January 18, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29343044/bronchial-blocker-positioning-learning-curve-and-confidence-in-its-use
#3
Marco Rispoli, Gianluca Zani, Federico Bizzarri, Moana R Nespoli, Dario M Mattiacci, Vanni Agnoletti, Alfonso Fiorelli, Antonio Corcione, Salvatore Buono
BACKGROUND: Despite simple and safe to use and cheap, EZ Blocker remains underused probably because it requires particular skills in recognizing airway and in using fiber- bronchoscopy to check the exact position of their cuffs. Thus, we planned an education training program on the use of EZB for novices in anaesthesia and evaluated the number of procedures required for the acquisition of the skills of this technique. METHODS: The educational training program included three different phases as follows...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29342445/case-report-of-an-uncommon-case-of-drain-site-hernia-after-colorectal-surgery
#4
M Manigrasso, P Anoldo, F Milone, G D De Palma, M Milone
BACKGROUND: trocar site herniation is a rare but potentially serious complication of laparoscopic surgery. Data about drain site hernia after laparoscopic surgery is scarce and anecdotal. CASE PRESENTATION: we report an uncommon case of drain site hernia in a man undergone laparoscopic left colectomy for a colonic adenocarcinoma who developed small bowel herniation in a 10 mm port site, in which a 24 FR drain was inserted leaving a real free space of 2 mm. DISCUSSION: laparoscopic approach has gained widespread acceptance in each surgical fields because of the perceived better postoperative outcomes in terms of less pain, faster recovery, and lower risk of incisional hernia...
January 9, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#5
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29341986/pulmonary-dead-space-fraction-and-extubation-success-in-children-after-cardiac-surgery
#6
Renee L Devor, Paul Kang, Chasity Wellnitz, John J Nigro, Daniel A Velez, Brigham C Willis
OBJECTIVES: 1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. DESIGN: A retrospective chart review. SETTING: Cardiac ICU in a quaternary care free-standing children's hospital...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29340625/seen-through-the-patients-eyes-surgical-safety-and-checklists
#7
Jochen Bergs, Frank Lambrechts, Melissa Desmedt, Johan Hellings, Ward Schrooten, Annemie Vlayen, Dominique Vandijck
Objective: We sought to explore the views patients have towards surgical safety and checklists. As a secondary aim, we explored if previous experience of error or other patient characteristics influence these views. Design: A cross-sectional survey study design was applied. Participants: The Flemish Patients' Platform network and social media were used to recruit participants. Main outcome measure(s): An 11-item questionnaire was designed to assess the following constructs: perception of surgical safety, attitudes towards the WHO surgical safety checklist and attitudes regarding checklist usage...
January 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29339193/a-pilot-study-on-the-biomechanical-assessment-of-obstructive-sleep-apnea-pre-and-post-bariatric-surgery
#8
Ahmed M Al-Jumaily, Sherif Ashaat, Bryn Martin, Rachael Pohle-Krauza, Matthew Krauza, Adrian Dan, John Zografakis
Obesity is a major risk factor for obstructive sleep apnea patients. In obese patients the severity of this risk can be reduced by bariatric surgery. This pilot study investigates the perioperative effects of bariatric surgery on obstructive sleep apnea and on the physical and biomechanical characteristics of the upper airway. Polysomnography and computer tomography data for 10 morbid obese patients promoted for bariatric surgery were conducted before surgery and at 6 and 12 months postoperatively for assessment of the oropharyngeal anatomy, and subsequent three-dimensional modelling of the airway...
January 12, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29338821/factors-influencing-regional-cerebral-oxygen-saturation-during-one-lung-ventilation-in-thoracic-surgery
#9
Ya Hong Gong, Wei Jia Wang, Wei Wei, Yu Guang Huang
Objective To identify factors influencing regional cerebral oxygen saturation (rScO2) during one-lung ventilation (OLV) in thoracic surgery. Methods Totally 33 patients with an ASA physical status of 1-3 scheduled for elective thoracic surgery with one-lung ventilation under general anesthesia were recruited. After anesthesia was induced with propofol,fentanyl/sufentanil,and rocuronium. All patients received balanced anesthesia using sevoflurane. During OLV,volume-controlled ventilation was used with a tidal volume of 6-7 ml/kg and an inspiration:expiration ratio of 1:1...
December 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29338145/association-between-bispectral-index-system-bistm-and-airway-obstruction-an-observational-prospective-cohort-analysis-during-third-molar-extractions
#10
A Sassan Sabouri, Alireza Jafari, Paul Creighton, Adam Shepherd, Timothy J Votta, Hao Deng, Christopher Heard
BACKGROUND: Sedation regimes during oral procedures frequently associated with airway obstruction. The aim of this study was to define the association of bispectral index (BIS) to the depth of sedation and airway obstruction events. METHODS: 47 patients between 1421 years old who were candidates for 3rd molar teeth extraction were enrolled in this study. Patients received a total of 4mg midazolam, 100 microgram fentanyl followed by titrated incremental propofol in 10mg...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336401/bleeding-in-the-lung-complicates-a-routine-intracardiac-repair-what-went-wrong
#11
Neeti Makhija, Rohan Magoon, Minati Choudhury, Sivasubramanian Ramakrishnan
Cyanotic congenital heart disease presents an increased tendency to bleed in view of subtle coagulation defects. Airway bleeding can be particularly difficult to manage while maintaining an adequate ventilation. An isolated lung bleed with the exclusion of possible traumatic, medical and surgical causes of bleeding, should alert the attending anesthesiologist to the possibility of the collateral-related bleeding. Preoperative coil embolization remains an important initial management step in a case of tetralogy of Fallot (TOF) with major aortopulmonary collaterals...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29334510/comparing-peri-operative-complications-of-paediatric-and-adult-anaesthesia-a-retrospective-cohort-study-of-81%C3%A2-267-cases
#12
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29333841/-granular-cell-tumor-of-the-larynx-in-the-child-case-report
#13
Giselle Cuestas, Verónica Rodríguez, Flavia Doormann, Patricio Bellia Munzón, Gastón Bellia Munzón
Laryngeal tumors are uncommon in children, accounting only for 2% of the laryngeal anomalies. Ninety-eight percent are benign; the most frequent ones are recurrent respiratory papillomatosis and haemangioma. Granular cell tumor, also called Abrikossoff tumor, is an unusual benign neoplasm, especially in the larynx. Clinical manifestations depend on the size and location of the tumor. Dysphonia is the main presenting symptom. The diagnosis is confirmed by the biopsy. The treatment of choice is surgery. We present a 9-year-old girl with dysphonia and exertion dyspnea due to a granular cell tumor of the larynx, and we emphasize the importance of considering the endoscopic evaluation of the airway in every child with progressive or persistent dysphonia in order to determine the etiology...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29331494/a-novel-difficult-airway-prediction-tool-for-emergency-airway-management-validation-of-the-heaven-criteria-in-a-large-air-medical-cohort
#14
Edward Kuzmack, Travis Inglis, David Olvera, Allen Wolfe, Kona Seng, Daniel Davis
BACKGROUND: Difficult-airway prediction tools help identify optimal airway techniques, but were derived in elective surgery patients and may not be applicable to emergency rapid sequence intubation (RSI). The HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) may be more relevant to emergency RSI patients. OBJECTIVE: To validate the HEAVEN criteria for difficult-airway prediction in emergency RSI using a large air medical cohort...
January 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29328741/perioperative-teamwork-for-the-patient-with-a-shared-airway-a-case-study
#15
Gareth Jones
Teamwork is an essential element of perioperative care. Shared airway surgery requires additional considerations for the perioperative team. This article analyses a case study of a patient undergoing thyroid surgery. Whilst the anaesthetic team is responsible for maintaining the patient's airway, the theatre and surgical teams have their own individual roles to assist in airway management and surgical care.
March 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327045/serial-in-office-intralesional-steroid-injections-in-airway-stenosis
#16
Caitlin Bertelsen, Hagit Shoffel-Havakuk, Karla O'Dell, Michael M Johns, Lindsay S Reder
Importance: Endoscopic dilation is the mainstay treatment strategy for subglottic and proximal tracheal stenosis (SGS/PTS). Its major limitation is restenosis requiring repeated surgery. Intralesional steroid injection (ISI) is a promising adjunctive treatment aimed at prolonging the effects of dilation. Objective: To evaluate the association of serial in-office ISI after endoscopic dilation with surgery-free interval (SFI) in adults with SGS/PTS. Design, Setting, and Participants: A retrospective study of adults with SGS/PTS who underwent at least 2 consecutive in-office ISI at the University of Southern California, Keck School of Medicine, over a 3-year period was conducted...
January 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29322502/systematic-review-of-benefits-or-harms-of-routine-anaesthetist-inserted-throat-packs-in-adults-practice-recommendations-for-inserting-and-counting-throat-packs-an-evidence-based-consensus-statement-by-the-difficult-airway-society-das-the-british-association
#17
REVIEW
V Athanassoglou, A Patel, B McGuire, A Higgs, M S Dover, P A Brennan, A Banerjee, B Bingham, J J Pandit
Throat packs are commonly inserted by anaesthetists after induction of anaesthesia for dental, maxillofacial, nasal or upper airway surgery. However, the evidence supporting this practice as routine is unclear, especially in the light of accidentally retained throat packs which constitute 'Never Events' as defined by NHS England. On behalf of three relevant national organisations, we therefore conducted a systematic review and literature search to assess the evidence base for benefit, and also the extent and severity of complications associated with throat pack use...
January 10, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313906/respiratory-complications-of-anaesthesia
#18
REVIEW
G H Mills
Postoperative pulmonary complications are a major determinant of outcome for patients and consume huge resources within hospital, particularly in critical care. Prediction and anticipation of postoperative pulmonary complications are vital for patient selection and, in some cases, for informed patient consent. Being able to assess the likelihood of postoperative pulmonary complications also allows research into methods to reduce them by allowing allocation of patients to the appropriate arms of research trials...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29307026/correlation-of-symptoms-with-bronchoscopic-findings-in-children-with-a-prenatal-diagnosis-of-a-right-aortic-arch-and-left-arterial-duct
#19
Trisha V Vigneswaran, Eva Kapravelou, Aaron J Bell, Andrew Nyman, Kuberan Pushparajah, John M Simpson, Andrew Durward, Vita Zidere
A right aortic arch (RAA) with a left arterial duct (LAD) together encircle the trachea and have the potential to cause tracheobronchial compression and published guidelines recommend bronchoscopy in symptomatic patients. The aim of the study was to describe the incidence of tracheal compression in a cohort of prenatally diagnosed RAA and LAD. Retrospective review of clinical course and imaging of prenatal cases of RAA and LAD assessed with flexible bronchoscopy over an 11-year period. 34 cases of prenatally diagnosed RAA with LAD underwent bronchoscopy at median age of 9 months (range 0...
January 6, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29303285/-non-cf-bronchiectasis-of-adults-short-review-for-clinical-practice-position-paper-of-board-of-disease-with-bronchial-obstruction-czech-pulmonological-and-phthiseological-society-czech-medical-association-of-j-e-purkyne
#20
Zuzana Antušová, Libor Fila, Vladimír Herout, Eva Kočová, Kateřina Neumannová, Jaromír Zatloukal, Vladimír Koblížek
Bronchiectasis is a clinically important, but poorly understood, pulmonary condition characterized by dilated and thick-walled bronchi. Bronchiectasis remains a significant cause of morbidity and mortality around the world. Targeted effort to early high-resolution computed tomography diagnosis and detailed confirmation of causation are in the spotlight of respiratory physicians in the developed countries. The risk population consists of subjects with persistent and/or productive cough, where another clear diagnosis has not been performed...
2018: Vnitr̆ní Lékar̆ství
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