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Orotracheal Intubation

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https://www.readbyqxmd.com/read/28225467/comparison-of-anesthetic-management-and-outcomes-in-patients-having-either-transnasal-or-transoral-endoscopic-odontoid-process-surgery
#1
Matthew A Sexton, Arnoley S Abcejo, Jeffrey J Pasternak
BACKGROUND: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. METHODS: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively)...
February 20, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28207549/stylet-angulation-for-routine-endotracheal-intubation-with-mcgrath-videolaryngoscope
#2
Jiyoung Lee, Jong Yeop Kim, Se Yoon Kang, Hyun Jeong Kwak, Dongchul Lee, Sook Young Lee
BACKGROUND: The McGrath videolaryngoscope (VL) provides excellent laryngoscopic views, but directing an endotracheal tube can be difficult, and thus the routine use of a stylet is recommended. The goal of this study is to determine the appropriate angle (60° vs 90°) of the stylet when using the McGrath VL by comparing the time to intubation (TTI). METHODS: One hundred and forty patients aged 19 to 70 years (American Society of Anesthesiologists classification I or II) who required tracheal intubation for elective surgery were randomly allocated to 1 of 2 groups, at the 60° angle (n = 70) or the 90° angle (n = 70)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28186425/influence-of-two-administration-rates-of-propofol-at-induction-of-anaesthesia-on-its-relative-potency-in-cats-a-pilot-study
#3
Sébastien H Bauquier, Wendy Bayldon, Leon N Warne, Jennifer E Carter, Thierry Beths
Objectives This was a randomised, blinded trial to investigate the influence of administration rate on the dose of propofol required for the orotracheal intubation of cats. Methods Twenty-four female domestic cats undergoing ovariohysterectomy were premedicated with oral tramadol (6 mg/kg) or intramuscular tramadol (4 mg/kg), and intramuscular dexmedetomidine (0.007 mg/kg). Oral or intramuscular (IM) tramadol was administered 60 or 30 mins prior to induction of anaesthesia, respectively. Dexmedetomidine was administered 30 mins prior to anaesthetic induction...
February 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28144067/stenting-of-critical-tracheal-stenosis-with-adjuvant-cardio-pulmonary-bypass
#4
Himanshu Bhardwaj, Ahmed Awab, Houssein A Youness, Brent Brown
Severe and critical central airway obstruction causing impaired ventilation and/or oxygenation can impose tremendous challenges on the interventional pulmonologist. Near total airway obstruction can rapidly evolve into potentially fatal complete airway occlusion during bronchoscopic airway manipulation under moderate sedation; as well as during the induction of the general anesthesia. Although there are currently interventional pulmonary procedures available to tackle the critical airway obstruction in extreme situations, cardio-pulmonary bypass should be considered prior to the intervention to maintain the adequate gas exchange during the procedure...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28120594/a-15-month-old-boy-with-respiratory-distress-and-parapharyngeal-abscess-a-case-report
#5
Behdad Gharib, Masoud Mohammadpour, Meisam Sharifzadeh, Fatemeh Mirashrafi, Bahareh Yaghmaie, Neda Pak, Mehrzad Mehdizadeh, Hamid Eshaghi, Mojtaba Gorji, Sara Memarian
Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress...
December 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28118659/video-laryngoscopy-vs-direct-laryngoscopy-on-successful-first-pass-orotracheal-intubation-among-icu-patients-a-randomized-clinical-trial
#6
Jean Baptiste Lascarrou, Julie Boisrame-Helms, Arthur Bailly, Aurelie Le Thuaut, Toufik Kamel, Emmanuelle Mercier, Jean-Damien Ricard, Virginie Lemiale, Gwenhael Colin, Jean Paul Mira, Ferhat Meziani, Jonathan Messika, Pierre Francois Dequin, Thierry Boulain, Elie Azoulay, Benoit Champigneulle, Jean Reignier
Importance: In the intensive care unit (ICU), orotracheal intubation can be associated with increased risk of complications because the patient may be acutely unstable, requiring prompt intervention, often by a practitioner with nonexpert skills. Video laryngoscopy may decrease this risk by improving glottis visualization. Objective: To determine whether video laryngoscopy increases the frequency of successful first-pass orotracheal intubation compared with direct laryngoscopy in ICU patients...
7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28106355/comparative-study-of-fiberoptic-guided-versus-intubating-laryngeal-mask-airway-assisted-awake-orotracheal-intubation-in-patients-with-unstable-cervical-spine-a-randomized-controlled-trial
#7
Tanmay Jadhav, Kamath Sriganesh, Madhusudan K Reddy, Dhritiman Chakrabarti
BACKGROUND: A safe airway technique minimizes intubation-associated cervical-spine movement and consequent neurological injury in patients with unstable cervical spine (UCS). Awake fiberoptic-guided intubation (FGI) is preferred in patients with UCS. Alternatively, intubating laryngeal mask airway assisted intubation (ILMA-AI) can be performed both during elective and emergency, requires less expertise and is cost-effective. This study evaluated cervical-spine movement during FGI and ILMA-AI in patients with UCS...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28050517/prosthodontic-approach-in-management-of-prolonged-neonatal-intubation
#8
Vikas B Kamble, Shital K Shah, Vishnu B Rathod, Priyanka S Ambadkar, Charudutt N Patil
Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28006946/a-novel-experimental-model-of-acute-respiratory-distress-syndrome-in-pig
#9
M Otáhal, M Mlček, I Vítková, O Kittnar
Acute respiratory distress syndrome (ARDS) is severe medical condition occurring in critically ill patients and with mortality of 33-52 % is one of the leading causes of death in critically ill patients. To better understand pathophysiology of ARDS and to verify novel therapeutical approaches a reliable animal model is needed. Therefore we have developed modified lavage model of ARDS in the pig. After premedication (ketamine and midazolam) 35 healthy pigs were anesthetized (propofol, midazolam, morphin, pipecuronium) and orotracheally intubated and ventilated...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/27995626/difficult-tracheal-tube-passage-and-subglottic-airway-injury-during-intubation-with-the-glidescope-%C3%A2-videolaryngoscope-a-randomised-controlled-comparison-of-three-tracheal-tubes
#10
K Su, X Gao, F-S Xue, G-N Ding, Y Zhang, M Tian
Difficulty during placement of the tracheal tube is a known problem when intubating with the GlideScope(®) , which may lead to subglottic airway injury. This randomised, controlled clinical trial was designed to compare the resistance to passage of PVC (polyvinyl chloride), reinforced or BlockBuster tracheal tubes during intubation with the GlideScope. Secondary outcomes included the time taken to intubate and assessment of subglottic airway injury. One-hundred and seventy-seven patients were included in the data analysis...
December 20, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27940505/a-previously-healthy-adolescent-with-acute-encephalopathy-and-decorticate-posturing
#11
Yu Kawai, Andrea G DeMonbrun, Rebecca S Chambers, Danielle A Nolan, Bram A Dolcourt, Nasuh M Malas, Michael W Quasney
A 14-year-old previously healthy female was transferred from a local emergency department after being found unresponsive at home. Parental questioning revealed she had fever and pharyngitis 2 weeks before presentation. Past mental health history was negative, including concern for past or present suicidal ideation/attempts, suspected substance use, or toxic ingestion. In the emergency department, she was orotracheally intubated due to a Glasgow Coma Scale of 3. She was hemodynamically stable and euglycemic...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27924286/submental-intubation-in-patients-with-complex-maxillofacial-injuries
#12
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/27902612/intubation-without-use-of-stylet-for-mcgrath-videolaryngoscopy-in-patients-with-expected-normal-airway-a-randomized-noninferiority-trial
#13
RANDOMIZED CONTROLLED TRIAL
Hyun Jeong Kwak, Sook Young Lee, Su Youn Lee, Yong Beom Kim, Jong Yeop Kim
BACKGROUND: During McGrath videolaryngoscope (VL) intubation, a styletted endotracheal tube maintaining an upward distal tip angle is recommended by some manufacturers. However, a styletted endotracheal tube can elicit rare but potentially serious complications. The purpose of this study was to demonstrate that a nonstyletted tube with exaggerated curvature would be noninferior to a styletted tube for orotracheal intubation using McGrath VL in patients with expected normal airway, by comparing the time to intubation and ease of intubation...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27887662/the-effects-of-water-lubrication-of-tracheal-tubes-on-post-intubation-airway-complications-study-protocol-for-a-randomized-controlled-trial
#14
Eugene Kim, Seong Mi Yang, So Jeong Yoon, Jae-Hyon Bahk, Jeong-Hwa Seo
BACKGROUND: Water is known to have lubricating properties, thus it is used for lubrication of tracheal tubes to reduce airway injuries caused by intubation. However, there is no definite evidence to substantiate the beneficial effects of lubricating tracheal tubes using water for attenuating airway injuries. Moreover, the lubrication pretreatment may cause contamination of the tube, leading to respiratory infections. Therefore, this trial aims to assess whether no pretreatment of tracheal tubes does not increase post-intubation airway complications as compared with water lubrication of tubes...
November 25, 2016: Trials
https://www.readbyqxmd.com/read/27886977/can-submandibular-tracheal-intubation-be-an-alternative-to-tracheotomy-during-surgery-for-major-maxillofacial-fractures
#15
Ahmed Gaber Hassanein, Ahmed M A Abdel Mabood
PURPOSE: During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. MATERIALS AND METHODS: This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27882535/evaluation-of-three-unchannelled-videolaryngoscopes-and-the-macintosh-laryngoscope-in-patients-with-a-simulated-difficult-airway-a-randomised-controlled-trial
#16
M Kleine-Brueggeney, M Buttenberg, R Greif, S Nabecker, L Theiler
This prospective randomised, controlled trial compares the performance of three unchannelled videolaryngoscopes (KingVision(™) , Airtraq(™) , A.P. Advance(™) MAC) and the standard Macintosh laryngoscope. With ethics committee approval and written informed consent, 480 patients were included. A difficult airway was created with a cervical collar, limiting mouth opening and neck movement. Primary outcome was first-attempt orotracheal intubation success. Overall success, laryngeal view, intubation difficulty scale, handling, intubation times and side-effects were secondary outcomes...
November 24, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27876327/endotracheal-intubation-with-the-king-laryngeal-tube%C3%A2-in-situ-using-video-laryngoscopy-and-a-bougie-a-retrospective-case-series-and-cadaveric-crossover-study
#17
Kenneth W Dodd, Rebecca L Kornas, Matthew E Prekker, Lauren R Klein, Robert F Reardon, Brian E Driver
BACKGROUND: Removal of a functioning King laryngeal tube (LT) prior to establishing a definitive airway increases the risk of a "can't intubate, can't oxygenate" scenario. We previously described a technique utilizing video laryngoscopy (VL) and a bougie to intubate around a well-seated King LT with the balloons deflated; if necessary, the balloons can be rapidly re-inflated and ventilation resumed. OBJECTIVE: Our objective is to provide preliminary validation of this technique...
November 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27874166/-massive-cerebral-air-embolism-following-endoscopic-retrograde-cholangiopancreatography-a-case-report-and-review-of-the-literature
#18
J Fernandez-Fernandez, H Real-Noval, E Rodriguez-Rodriguez
INTRODUCTION: Cerebral air embolism following endoscopic processes is an infrequent complication, but can have catastrophic consequences. CASE REPORT: An 85-year-old male diagnosed with distal cholangiocarcinoma with criteria for unresectability who was submitted to placement of a biliary drainage prosthesis. Endoscopic retrograde cholangiopancreatography was performed to change the prosthesis. After the procedure, the patient's vital signs and level of consciousness underwent a decline, and orotracheal intubation was required...
December 1, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27871566/known-difficult-airway-in-a-patient-with-pheochromocytoma-a-case-report
#19
Laura Alonso Guardo, Carlos Cano Gala, Antonio Rodriguez Calvo, Adriana M Buritica Aguirre, Nadia A Dávila Arango, Elena García Fernández, Carmen Ruiz Chirosa, David Sánchez Poveda, Agustín Díaz Álvarez
: The manipulation of an airway is always a critical moment in the anesthetic management of patients with pheochromocytoma due to the high incidence of undesirable hemodynamic events in relation with the stimulus represented by the laryngoscopy. A known difficult airway in which it is necessary to carry out an orotracheal intubation while preserving spontaneous ventilation subjects the patient to a stressful situation. The objective is to obtain an acceptable level of comfort and sedation avoiding respiratory depression (Anesthesiol Clin 2015;33:233-40)...
December 2016: Journal of Clinical Anesthesia
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
#20
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
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