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https://www.readbyqxmd.com/read/28096586/comparison-of-intubating-laryngeal-mask-airway-and-fiberoptic-bronchoscopy-for-endotracheal-intubation-in-patients-undergoing-cervical-discectomy
#1
Kolli S Chalam, Jyothi Gupta
BACKGROUND AND AIMS: Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094480/anesthetic-complications-during-general-anesthesia-without-intravenous-access-in-pediatric-ophthalmologic-clinic-assessment-of-5216-cases
#2
Chun W Hung, Lauren Licina, David H Abramson, Vittoria Arslan-Carlon
BACKGROUNDː General anesthesia utilizing inhalational agents without intravenous (IV) access for minor procedures is controversial1. Eliminating IV access increases efficiency and patient satisfaction; however, the ability to introduce rapid acting medications into the circulation during an unanticipated emergency becomes challenging. The objective of this study was to examine complication risk following pediatric ophthalmologic examinations under anesthesia (EUA) without IV placement. METHODSː A retrospective review of consecutive pediatric patients who underwent EUA for retinoblastoma management was performed from 2004 to 2014...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28074798/proseal-laryngeal-mask-airway-as-an-alternative-to-standard-endotracheal-tube-in-securing-upper-airway-in-the-patients-undergoing-beating-heart-coronary-artery-bypass-grafting
#3
Kalpana Shah
BACKGROUND: ProSeal laryngeal mask airways (PLMAs) are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies. In long duration surgeries, use of endotracheal tube (ETT) is associated with various hemodynamic complications, which are minimally affected during PLMA use. However, except for few studies, there are no significant data available that promote the use of laryngeal mask during cardiac surgery...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28065557/manual-laryngeal-fixation-facilitates-tracheal-intubation-during-chest-compression-a-randomized-crossover-manikin-study
#4
Takanobu Fujisawa, Nobuyasu Komasawa, Kazuo Hattori, Ryosuke Mihara, Toshiaki Minami
PURPOSE: We compared the effectiveness of external manual laryngeal fixation (MLF) for tracheal intubation during chest compression using three laryngoscopes, the Macintosh laryngoscope (McL), McGRATH® MAC (McGRGTH), and Pentax-AWS Airwayscope® (AWS) on an adult manikin. METHODS: Sixteen novice doctors and 15 experienced anesthesiologists performed tracheal intubation during chest compression on an adult manikin using the McL, McGRATH, and AWS with or without MLF...
December 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28059945/airway-management-with-a-stereotactic-headframe-in-situ-a-mannequin-study
#5
Melissa Brockerville, Zoe Unger, Nathan C Rowland, Francesco Sammartino, Pirjo H Manninen, Lashmi Venkatraghavan
BACKGROUND: Stereotactic headframe-based imaging is often needed for target localization during surgery for insertion of deep brain stimulators. A major concern during this surgery is the need for emergency airway management while an awake or sedated patient is in the stereotactic headframe. The aim of our study was to determine the ease of emergency airway management with a stereotactic headframe in situ. MATERIALS AND METHODS: We conducted an observational study using a mannequin...
January 4, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28032947/controversies-in-the-management-of-caustic-ingestion-injury-an-evidence-based-review
#6
J H Bird, S Kumar, C Paul, J D Ramsden
BACKGROUND: Caustic ingestion of acid or alkaline substances can cause damage to the upper respiratory and upper digestive tract. Initial presentation following caustic ingestion can include oropharyngeal pain, dysphagia and stridor. Due to this clinical presentation that the resident otolaryngologist is consulted to review and examine these patients to assess for airway compromise and commence initial management and care until airway concern has passed. OBJECTIVE OF REVIEW: This review aims to provide evidence based guidance in the management of those presenting with acute ingestion injury so that informed initial medical therapy can be commenced and appropriate investigations arranged to optimise patient outcome...
December 29, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28024711/-progressive-hematoma-in-anterior-neck-after-endovascular-treatment-of-middle-cerebral-artery-aneurysm
#7
Aysun Ankay Yilbas, Cigdem Kanburoglu, Filiz Uzumcugil, Coskun Cifci, Ozge Ozen Saralp, Heves Karagoz, Seda Banu Akinci, Anil Arat
BACKGROUND: Cervical hematomas can lead to airway compromise, a life threatening condition, regardless of the cause. The following case is the first presentation of cervical hematoma as a complication of endovascular treatment of middle cerebral artery aneurysm. CASE REPORT: A 49 year-old woman was scheduled for stent placement under general anesthesia for middle cerebral artery aneurysm. Few days before intervention, acetyl salicylic acid and clopidogrel treatment was started...
December 23, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28004199/the-effect-of-esophagogastroduodenoscopy-probe-insertion-on-the-intracuff-pressure-of-airway-devices-in-children-during-general-anesthesia
#8
Onur Balaban, Mineto Kamata, Mumin Hakim, Dmitry Tumin, Joseph D Tobias
Given the size of the esophagogastroduodenoscopy (EGD) probe and the compressibility of the pediatric airway, the EGD probe may increase the intracuff pressure (IP) of an airway device. The current study evaluated IP changes during EGD examination under general anesthesia in pediatric patients. Following the induction of anesthesia, a laryngeal mask airway (LMA) or endotracheal tube (ETT) was placed without neuromuscular blockade. The IP was measured at baseline, during EGD probe insertion, while the EGD probe was in place, and after probe removal...
December 21, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27968957/technique-for-improved-safety-in-the-endoscopic-management-of-subglottic-stenosis
#9
Stephanie Hulstein, Henry Hoffman
OBJECTIVE: To identify a safe approach to airway management during the endoscopic balloon dilation of subglottic stenosis BACKGROUND: Subglottic stenosis is an abnormal narrowing of the upper airway commonly managed by endoscopic technique performed on an unsecured airway. METHODS: Review of surgical treatment of subglottic stenosis cases by the senior author. TECHNIQUE: Following steroid injection and radial cuts performed either under jet anesthesia or mask ventilation with brief periods of apnea, a small endotracheal tube may be passed beyond the narrowing to permit adjacent balloon dilation with the airway secured...
November 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27941484/challenging-airway-secondary-to-purpura-fulminans-with-face-and-neck-bullae-in-a-premature-infant
#10
Rhashedah A Ekeoduru, Matthew R Greives, Eric A Nesrsta
A former 25-week-old neonate presented at 34 weeks postconceptual age with necrotizing fasciitis and purpura fulminans because of Group B Streptococcus infection. He was septic and coagulopathic when he was intubated, and the endotracheal tube was secured with adhesives. When he subsequently developed large purpuric, bullous lesions on the face and neck, he presented to the operating room for excision and debridement of his facial lesions. No change was made in how the endotracheal tube was secured. Midprocedure, an unintentional extubation occurred...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27935771/preparing-anesthetists-to-manage-cannot-intubate-cannot-ventilate-situations
#11
Kenneth A Wofford
Cannot intubate/cannot ventilate (CICV) situations during anesthesia are rare, potentially catastrophic to the patient, and difficult to predict. Widely adopted practice guidelines advocate an algorithmic approach to CICV situations in which the anesthetist: (a) recognizes the CICV situation, (b) calls for help, (c) steadily progresses through a variety of methods to ventilate the patient and secure the airway, (d) restores ventilation via an infraglottic airway if the patient cannot be safely awakened prior to becoming moribund...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27928826/a-feasibility-study-of-awake-videolaryngoscope-assisted-intubation-in-patients-with-periglottic-tumour-using-the-channelled-king-vision-%C3%A2-videolaryngoscope
#12
L Markova, T Stopar-Pintaric, T Luzar, J Benedik, I Hodzovic
Airway management in patients with periglottic tumour is a high-risk procedure with potentially serious consequences. There is no consensus on how best to secure the airway in this group of patients. We conducted a feasibility study of awake tracheal intubation using a King Vision(®) videolaryngoscope with a channelled blade in a cohort of 25 patients, with a periglottic tumour requiring diagnostic or radical surgery. We used 10% and 4% lidocaine to topicalise the airway and midazolam and remifentanil for sedation...
December 7, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27924286/submental-intubation-in-patients-with-complex-maxillofacial-injuries
#13
Yuseon Cheong, Seong Sik Kang, Minsoo Kim, Hee Jeong Son, Jaewoo Park, Jeong-Mo Kim
Airway management in patients with complex maxillofacial injuries is a challenge to anesthesiologists. Submental intubation is a useful technique that is less invasive than tracheostomy in securing the airways where orotracheal and nasotracheal intubation cannot be performed. This procedure avoids the use of tracheostomy and bypasses its associated morbidities. A flexible and kink-resistant reinforced endotracheal tube with detachable universal connector is commonly used for submental intubation. Herein, we report cases involving submental intubation using a reinforced endotracheal tube with a non-detachable universal connector in patients with complex maxillofacial injuries...
September 2016: Journal of Lifestyle Medicine
https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#14
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#15
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27884557/laryngeal-trauma-following-an-inhalation-injury-a-review-and-case-report
#16
REVIEW
Gemma Hogg, Jay Goswamy, Sadie Khwaja, Nadeem Khwaja
The primary concern when managing a patient with inhalation injury is security of the airway. Airflow may be impeded by both edema of the upper airway and reduction of oxygen delivery to the lower respiratory tract. Although there has been much discussion regarding management of the latter, the focus of this article is the management of the former. This review aimed to determine the optimum management in burn victims with upper airway inhalation injury as an attempt to prevent laryngeal trauma leading to long-term voice disorders and upper airway dyspnea...
November 21, 2016: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/27884026/-awake-video-laryngoscopy-an-alternative-to-awake-fiberoptic-intubation
#17
Jana Lohse, Rüdiger Noppens
INTRODUCTION: Awake video laryngoscopy is a novel option in airway management that is drawing more and more attention as an alternative to awake endoscopic guided intubation.Main issues: Intubation under preserved spontaneous breathing is the safest method to secure the expected difficult airway. In direct comparisons to awake flexible endoscopic intubation, awake video laryngoscopy achieves satisfactory intubation times and a high acceptance of patients and anesthesiologists. Specific cases, in particular very limited mouth opening or sub-glottic masses, require awake flexible endoscopic intubation...
November 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27882028/patient-specific-depth-of-endotracheal-intubation-from-anthropometry-to-the-touch-and-read-method
#18
Saecheol Oh, Seunguk Bang, Woojin Kwon, Jungwoo Shim
OBJECTIVE: Knowledge of accurate airway length (AL) enables safer placement of the endotracheal tube (ETT) in the trachea. Our objective was to check the safety of a new formula (Touch and Read method) to determine ETT depth. METHODS: AL was measured in 176 patients. Patients were divided into a normal group (AL >25 cm in men, >23 cm in women) and a risk group (AL ≤25 cm in men, ≤23cm in women). A control test (Conventional method) was performed in which the ETT was secured at a depth of 23 cm from the central incisor in men and 21 cm in women...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27873529/tracheal-allotransplantation-and-regeneration
#19
P Delaere, M Molitor
Non-malignant and malignant obstruction of the tracheal airway causes significant morbidity and mortality. With increased use of artificial airways, benign and iatrogenic complications are increasing. A tracheal stenosis that is less than 5 cm in length can be resected with end-to-end anastomosis. Longer tracheal lesions can be treated in a palliative way by placement of a stent to secure airway lumen patency. The management of tracheal defects is an evolving field. Tracheal transplantation and tracheal regeneration may provide major treatment advances to cases with long-segment tracheal involvement...
2016: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/27871543/soft-palate-trauma-induced-during-glidescope-intubation
#20
Joseph P Allencherril, Linda Joseph
The GlideScope (GVL; Saturn Biomedical Systems, Burnaby, British Columbia, Canada) is a rigid indirect video laryngoscope device that facilitates exposure of the larynx for placement of the endotracheal tube. This blade also reduces the requirement for anterior displacement of the tongue. A unique feature is the acutely angled blade which provides an improved glottic view. Herein, we present 2 instances of soft palate trauma, a rare oropharyngeal complication linked to GlideScope use. In the first case, the GlideScope was used for pedagogical purposes for intubation in a knee surgery...
December 2016: Journal of Clinical Anesthesia
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