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Endobronchial tube

Mark Wigginton, Laura Lehrian
We compare airway management and lung isolation methods in two pediatric cases of congenital central hypoventilation syndrome undergoing bilateral throacoscopic phrenic-nerve-stimulator surgery. One child received lung isolation using a 7Fr bronchial blocker in conjunction with a 6.0 cuffed endotracheal tube; and the second received a technique of endobronchial intubation using a 3.5 microcuffed tube via the tracheostomy stoma in conjunction with 5.0 cuffed endotracheal intubation; a technique previously undescribed in pediatric patients...
October 20, 2016: Paediatric Anaesthesia
Charles Bakhos, Peter Doelken, Stevan Pupovac, Ashar Ata, Tom Fabian
BACKGROUND: Prolonged pulmonary air leaks (PALs) are associated with increased morbidity and extended hospital stay. We sought to investigate the role of bronchoscopic placement of 1-way valves in treating this condition. METHODS: We queried a prospectively maintained database of patients with PAL lasting more than 7 days at a tertiary medical center. Main outcome measures included duration of chest tube placement and hospital stay before and after valve deployment...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Young-Chang P Arai, Jun Kawanishi, Yoshikazu Sakakima, Koichi Ohmoto, Akihiro Ito, Yuki Maruyama, Tatsunori Ikemoto
INTRODUCTION: Pulmonary collapse after intubation is common, and it is caused by a variety of factors. CASE PRESENTATION: A 21-year-old man presented at our operation room to undergo an appendectomy. Except for a history of cigarette smoking, his history was negative. Anesthesia was induced with 100% oxygen and sevoflurane, remifentanil infusion, and propofol. Neuromuscular block was obtained with rocuronium. The tip and cuff of a tracheal tube were lubricated with a topical metered-dose of 8% Lidocaine pump spray...
June 2016: Anesthesiology and Pain Medicine
Amit Kumar Mittal, Namrata Gupta
In the era of evidence-based medicine, ultrasonography has emerged as an important and indispensable tool in clinical practice in various specialties including critical care. Lung ultrasound (LUS) has a wide potential in various surgical and clinical situations for timely and easy detection of an impending crisis such as pulmonary edema, endobronchial tube migration, pneumothorax, atelectasis, pleural effusion, and various other causes of desaturation before it clinically ensues to critical level. Although ultrasonography is frequently used in nerve blocks, airway handling, and vascular access, LUS for routine intraoperative monitoring and in crisis management still necessitates recognition...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Franziska C Trudzinski, Anna J Höink, Daniela Leppert, Sebastian Fähndrich, Heinrike Wilkens, Thomas P Graeter, Frank Langer, Robert Bals, Peter Minko, Philipp M Lepper
BACKGROUND: Patients with a forced expiratory volume in 1 s (FEV1) below 20% of the predicted normal values (pred.) and either homogeneous emphysema or low diffusing capacity for carbon monoxide (DLCO) have a high risk for adverse events including death when undergoing surgical lung volume reduction. OBJECTIVES: We hypothesized that selected patients can benefit from endoscopic lung volume reduction (eLVR) despite a very low FEV1. METHODS: This study is a retrospective analysis of consecutive patients with severe airflow obstruction, an FEV1 ≤20% of pred...
2016: Respiration; International Review of Thoracic Diseases
Ilaria Campo, Maurizio Luisetti, Matthias Griese, Bruce C Trapnell, Francesco Bonella, Jan Grutters, Koh Nakata, Coline H M Van Moorsel, Ulrich Costabel, Vincent Cottin, Toshio Ichiwata, Yoshikazu Inoue, Antonio Braschi, Giacomo Bonizzoni, Giorgio A Iotti, Carmine Tinelli, Giuseppe Rodi
BACKGROUND: Whole lung lavage (WLL) is the current standard of care treatment for patients affected by pulmonary alveolar proteinosis (PAP). However, WLL is not standardized and international consensus documents are lacking. Our aim was to obtain a factual portrayal of WLL as currently practiced with respect to the procedure, indications for its use, evaluation of therapeutic benefit and complication rate. METHODS: A clinical practice survey was conducted globally by means of a questionnaire and included 27 centers performing WLL in pediatric and/or adult PAP patients...
2016: Orphanet Journal of Rare Diseases
In-Kyung Song, Soo-Hyun Kim, Jaehui Ryu, Eunju Lee, Hyung-Min Oh, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
BACKGROUND: Optimal positioning of endotracheal tubes (ETTs) decreases the risk of accidental extubation or endobronchial intubation. This study evaluated the usefulness of external anatomical landmarks as practical references for determining an insertion depth of an ETT in pediatric patients. METHODS: Computed tomography images of the necks of 183 pediatric patients (≤16 years of age) were reviewed. Levels corresponding to the vocal cords, cricoid cartilage, suprasternal notch, manubriosternal junction, and carina were identified on sagittal reconstructed images...
August 19, 2016: Paediatric Anaesthesia
Manabu Hayama, Shingo Sato, Takayuki Shiroyama, Takuji Nishida, Takashi Nishihara, Norio Okamoto
A 68-year-old woman with interstitial lung disease related to dermatomyositis and systemic scleroderma was admitted to our hospital with fever and dyspnoea. Although the fever was reduced after antibiotic therapy, a left pneumothorax suddenly occurred on day 27 after admission. A continuous air leak persisted despite chest drainage with three tubes and repeated pleurodesis. Chest computed tomography (CT) images showed a cavitary lesion with a pinhole in the left upper division, which was suspected to be the affected lesion with the air leak...
July 2016: Respirology Case Reports
Rakesh Garg, Ambika Kumari, Nishkarsh Gupta, Vinod Kumar
One-lung ventilation is challenging in patients with difficult airway who require lung surgery. The choice of airway technique remains limited in patients with permanent tracheostomy after total laryngectomy. Conventional airway management techniques and available airway equipment have limited the options for securing airway in such patients, and dedicated airway equipment is not available for the management of such patients. Here, using endobronchial blocker through adult silicon hyperflex tracheostomy tube with an adjustable flange, we report a successful airway management for 1-lung ventilation in a patient with total laryngectomy with permanent tracheostomy...
September 15, 2016: A & A Case Reports
Murali Chakravarthy, Muralimanohar Veerappa, Vivek Jawali, Nischal Pandya, Jayaprakash Krishnamoorthy, Geetha Muniraju, Antony George, Jitumoni Baishya
BACKGROUND: Minimal invasive surgeries are carried out to benefit the patient with less pain, blood loss, mechanical ventilation and hospital stay; a smaller scar is not the aim. Minimal invasive cardiac surgeries are carried out via small sternotomy, small thoracotomy and via robotic arms. Subxiphoid route is a novel method and avoids sternotomy. AIM: This case series is an attempt to understand the anesthetic modifications required. Secondly, whether it is feasible to carry out subxiphoid coronary artery bypass surgery...
July 2016: Annals of Cardiac Anaesthesia
Nina Sulen, Barbara Petani, Ivan Bacić, Domagoj Morović
Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near fatal cardiorespiratory complications have been reported. We describe anesthetic management of a patient with posterior mediastinal mass compressing the trachea and the left main bronchus presented for left thoracotomy and tumor excision...
March 2016: Acta Clinica Croatica
Thomas L Bauer, David B Berkheim
The bronchoscope has gone through much advancement from its origin as a thin metal tube. It has become a highly sophisticated tool for clinicians. Both rigid and the flexible bronchoscopes are invaluable in the diagnosis and treatment of non-small cell lung cancer. Treatment of this disease process hinges on accurate diagnosis and lymph node staging. Technologies, such as endobronchial ultrasound, navigational bronchoscopy, and autofluorescence, have improved efficacy of endobronchial diagnosis and sample collection...
July 2016: Surgical Oncology Clinics of North America
Byung-Hee Choi, Yong-Cheol Lee
BACKGROUND: Sufentanil is a potent opioid analgesic frequently used in clinical anesthesia. Double-lumen endobronchial intubation induces profound cardiovascular responses in comparison with ordinary endotracheal intubation because of the larger tube diameter and direct irritation of the carina. OBJECTIVES: The purpose of this study was to determine the effective bolus dose of sufentanil to attenuate hemodynamic changes in response to laryngoscopic double-lumen endobronchial intubation...
April 2016: Anesthesiology and Pain Medicine
Thomas Koshy, Satyajeet Misra, Nilay Chatterjee, Baiju S Dharan
OBJECTIVES: The incidence of endotracheal tube (ETT) malposition in children with various described methods is 15% to 30%. Chest x-ray (CXR) is the gold standard for confirming appropriate ETT position. The aim of this study was to measure the accuracy of a preoperative CXR-based method in determining depth of insertion of ETTs and to compare it with methods based on the intubation depth mark or formulae (age, height, and ETT internal diameter) in children undergoing cardiac surgery. DESIGN: Prospective observational study...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Shagun Bhatia Shah, Ajay Kumar Bhargava, Uma Hariharan, Amit Kumar Mittal, Nitesh Goel, Manish Choudhary
BACKGROUND AND AIMS: Several devices enabling double-lumen tube (DLT) placement for thoracic surgeries are available, but there are no studies for D-blade video laryngoscope-guided DLT insertion. We compared the CMac D-blade videolaryngoscope™ and the Macintosh laryngoscope for DLT endobronchial intubation using parameters of time and attempts required for intubation, glottic view, incidence of complications and haemodynamic changes. METHODS: Prospective, parallel group, randomised controlled clinical trial where sixty American Society of Anesthesiologists I and II patients aged 18-80 years scheduled for thoracic surgeries entailing DLT placement were randomly allocated in two groups based on the laryngoscopic device used for endobronchial intubation...
May 2016: Indian Journal of Anaesthesia
Hee Young Kim, Seung-Hoon Baek, Hyung Gon Je, Tae Kyun Kim, Hye Jin Kim, Ji Hye Ahn, Soon Ji Park
BACKGROUND: Minimally invasive cardiac surgery (MICS) has been more commonly performed due to the reduced amount of bleeding and transfusion and length of hospital stay. We investigated the feasibility of performing MICS using single-lumen endotracheal tube (SLT). METHODS: We conducted a retrospective review of clinical data of 112 patients who underwent MICS between July 2012 and March 2015. The patients underwent MICS using a SLT or a double lumen endotracheal tube (DLT)...
May 2016: Journal of Thoracic Disease
Hironori Ishibashi, Masashi Kobayashi, Chihiro Takasaki, Seiji Ishikawa, Yutaka Miura, Koshi Makita, Kenichi Okubo
BACKGROUND: The use of double-lumen endobronchial tubes (DLTs) is necessary for differential lung ventilation during pulmonary lobectomy. However, when used with conventional extubation procedures, coughing is more likely and is associated with an increased risk for parenchymal air leak along the staple line and possible subsequent lung injury. We examined the prevalence of coughing-associated air leaks at extubation and the efficacy of using supraglottic airways (SGAs) to prevent air leaks with post-lobectomy extubation...
August 2016: World Journal of Surgery
Mohamed Faisal, Hafaruzi Harun, Tidi M Hassan, Andrea Y L Ban, Sanjay H Chotirmall, Jamalul Azizi Abdul Rahaman
BACKGROUND: Tracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency. CASE PRESENTATION: We present a 24-year old lady with previous pulmonary tuberculosis and laryngeal tuberculosis in 2007 and 2013 respectively who presented with worsening dyspnoea and stridor...
2016: BMC Pulmonary Medicine
Monali Patil, Kassem Harris, Amita Krishnan, Abdul H Alraiyes, Samjot S Dhillon
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration is an effective, safe, and cost-effective diagnostic bronchoscopy technique for the work-up of mediastinal lymphadenopathy. Concern has been raised, however, about the high cost of convex-probe EBUS bronchoscope repairs. The damage is usually due to breakage of the insertion tube (the flexible part that is advanced into the airways), moisture invasion and damages to the working channel, image guide bundle, or umbilical cord. Understanding the root cause of EBUS scope damage is important for its prevention...
July 2016: Journal of Bronchology & Interventional Pulmonology
Tariq M Wani, Mahmood Rafiq, Rayan Terkawi, Melissa Moore-Clingenpeel, Mazen AlSohaibani, Joseph D Tobias
BACKGROUND: Lung isolation in the pediatric population can be problematic. The diameter and length of the right and left mainstem bronchi are not well described in young children. Information regarding these measurements may help determine the appropriate size of endotracheal tubes for endobronchial intubation as well as the development of lung isolation devices for the pediatric population. The present study is based on computed tomography (CT) measurements to evaluate airway dimensions...
June 2016: Paediatric Anaesthesia
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