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Orotracheal Intubation

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https://www.readbyqxmd.com/read/28537983/comparison-of-the-mallampati-classification-in-sitting-and-supine-position-to-predict-difficult-tracheal-intubation-a-prospective-observational-cohort-study
#1
Jean-Luc Hanouz, Vincent Bonnet, Clément Buléon, Thérèse Simonet, Dorothée Radenac, Guillaume Zamparini, Marc Olivier Fischer, Jean-Louis Gérard
BACKGROUND: The Mallampati classification (MLPT) is normally evaluated in the sitting position. However, many patients cannot be evaluated in the sitting position for medical reasons. Thus, we compared the MLPT in sitting and supine positions in predicting difficult tracheal intubation (DTI). We hypothesized that the diagnostic accuracy of the MLPT performed in sitting and supine positions would differ. METHODS: We performed a single-center prospective observational study in adult patients who received general anesthesia and orotracheal intubation for noncardiac surgery...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28523090/penetrating-craniomaxillofacial-injury-caused-by-a-pneumatic-nail-gun
#2
Kevin Jae Choi, Marisa Ann Ryan, Tracy Cheng, David Powers
Craniomaxillofacial injuries can be complex, requiring a multidisciplinary approach. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. A 26-year-old man presented with a penetrating nail gun injury through the oral and nasal cavities. He did not present in extremis but required elective endotracheal intubation for intraoperative assessment and treatment. Airway management was enhanced by the use of lingual nerve and inferior alveolar nerve blocks via the Vazirani-Akinosi technique to maintain spontaneous respiration while the tongue was distracted from the palate...
June 2017: Craniomaxillofacial Trauma & Reconstruction
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
#3
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/28480810/traumatic-laryngotracheal-stenosis-treated-by-hyoid-sternohyoid-osseomuscular-flap-combined-with-xenogenic-acellular-dermal-matrix-a-case-report-and-literature-review
#4
Hang Yang, Zhe Chen, Shui-Hong Zhou, Qin-Yin Wang, Li-Xia Weng, Fang Wang, Ting-Ting Wu, Min-Li Zhou, Yang-Yang Bao
Objective The treatment of laryngotracheal stenosis is a major therapeutic challenge. Various treatments include observation, medical management, and surgical management. The most effective surgical management is resection and reconstruction. To the authors' knowledge, no reports have described the use of xenogenic acellular dermal matrix (ADM) for laryngotracheal stenosis. Methods A 27-year-old man presented with hemoptysis of the neck due to a traffic accident. Emergency orotracheal intubation was performed...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28457415/clinical-and-nutritional-factors-associated-with-early-mortality-after-heart-transplantation
#5
L Giglio Canelhas de Abreu, L Proença Vieira, T Teixeira Gomes, F Bacal
OBJECTIVE: The aim of this work was to verify the association between clinical and nutritional factors and mortality in the 1st 30 days after heart transplantation. METHODS: This was a retrospective study of patients who underwent heart transplantation in a public hospital in Brazil from January 2013 to August 2015. The clinical and nutritional factors analyzed were: body mass index, body surface area, cachexia, infection, duration of orotracheal intubation, ejection fraction, mean pulmonary pressure, Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score, hemoglobin, and diabetes mellitus...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28444079/use-of-noninvasive-ventilation-in-severe-acute-respiratory-distress-syndrome-due-to-accidental-chlorine-inhalation-a-case-report
#6
Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443290/comparison-of-a-supraglottic-airway-device-v-gel-%C3%A2-with-blind-orotracheal-intubation-in-rabbits
#7
Sarah Engbers, Amy Larkin, Nicolas Rousset, Melanie Prebble, Mahesh Jonnalagadda, Cameron G Knight, Daniel S J Pang
INTRODUCTION: Achieving a secure airway in rabbits is generally considered more difficult than in cats or dogs. Their relatively large tongue, small oropharyngeal cavity and glottis limit direct visualization. A rabbit-specific supraglottic airway device (SGAD) may offer benefits over blind orotracheal intubation. ANIMALS AND METHODS: Fifteen adult New Zealand white rabbits were randomized to SGAD or orotracheal intubation (ETT). All animals were sedated with dexmedetomidine (0...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28431900/-quality-of-initial-trauma-care-in-paediatrics
#8
Vicente Ibáñez Pradas, Rut Pérez Montejano
INTRODUCTION: Trauma care in Spain is not provided in specific centres, which means that health professionals have limited contact to trauma patients. After the setting up of a training program in paediatric trauma, the aim of this study was to evaluate the quality of the initial care provided to these patients before they were admitted to the paediatric intensive care unit (PICU) of a third level hospital (trauma centre), as an indirect measurement of the increase in the number of health professionals trained in trauma...
April 18, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28414605/use-of-a-novel-surgical-approach-for-treatment-of-complete-bilateral-membranous-choanal-atresia-in-an-alpaca-cria
#9
Karine Pader, Patrick M Burns, Anne-Claire Brisville, Marjolaine Rousseau, Laurent Blond, Geoffrey Truchetti, Hélène Lardé, Catherine Lapointe, David Francoz
CASE DESCRIPTION A 4-hour-old 6.3-kg (13.9-lb) female alpaca cria was evaluated because of severe respiratory distress and difficulty nursing since birth. CLINICAL FINDINGS The cria had open-mouth breathing and cyanotic membranes, with no airflow evident from either nostril. Supplemental oxygen was delivered, and the patient was anesthetized and intubated orotracheally; a CT evaluation of the head confirmed bilateral membranous obstruction of the nasal cavities, consistent with complete bilateral choanal atresia...
May 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28412028/-effectiveness-of-erlotinib-in-critical-care-unit-in-patients-with-non-small-cell-lung-cancer-with-egfr-mutation
#10
M Dewolf, C Dayen, C Garoute, W Khamis, M Fourrier, F Rousselle, M Sadki, F Le Meunier, R Suguenot, E Lecuyer, H Bentayeb, Y Douadi, P Berna
INTRODUCTION: The search for mutations epidermal growth factor receptor (EGFR) has changed the therapeutic approach and prognosis of non-small cell lung cancer (NSCLC). The effectiveness of tyrosine kinase inhibitors (TKI) has been demonstrated orally in patients with EGFR mutation. We report the case of a patient for whom treatment with TKI was started effectively in a Critical Care Unit. OBSERVATION: A patient of 59 years is followed for a stage IV lung adenocarcinoma with metastases in liver, brain, adrenal, lung and pleura...
April 12, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28410258/behavioral-disturbance-causing-sudden-respiratory-distress-in-a-3-year-old-after-tracheocutaneous-fistula-closure-a-case-report
#11
Rhashedah A Ekeoduru, Hassan M Aijazi, Amy D Graham-Carlson
A 3-year-old boy underwent tracheostomy at age 5 months for respiratory failure. The tracheostomy tube was removed a year later but a tracheocutaneous fistula developed requiring fistulectomy and primary skin closure. After an initial uneventful course in the postanesthesia care unit, the patient became agitated, began to scream, and suddenly developed rapidly progressing subcutaneous emphysema over his chest, face, and abdomen. Orotracheal intubation was emergently performed and chest radiograph revealed pneumothorax and pneumomediastinum...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28358178/time-to-intubation-in-obese-patients-a-randomized-study-comparing-direct-laryngoscopy-and-videolaryngoscopy-in-experienced-anaesthetists
#12
Fredrik Ander, Anders Magnuson, Lars Berggren, Rebecca Ahlstrand, Alex de Leon
BACKGROUND: Airway management may be difficult in obese patients. Moreover, during prolonged intubation, oxygen desaturation develops rapidly. Videolaryngoscopy improves the view of the larynx, and the Storz® C-MACTM has been shown to be superior to other videolaryngoscopes in terms of intubation time in obese patients. However, no effort has been made to compare the Storz® C-MACTM with direct laryngoscopy. The aim of the study was to evaluate if the use of Storz® C-MACTM may reduce intubation time when compared to direct laryngoscopy (classic Macintosh® blade)...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28238448/visually-guided-tube-thoracostomy-insertion-comparison-to-standard-of-care-in-a-large-animal-model
#13
Matthew C Hernandez, David Vogelsang, Jeff R Anderson, Cornelius A Thiels, Gregory Beilman, Martin D Zielinski, Johnathon M Aho
INTRODUCTION: Tube thoracostomy (TT) is a lifesaving procedure for a variety of thoracic pathologies. The most commonly utilized method for placement involves open dissection and blind insertion. Image guided placement is commonly utilized but is limited by an inability to see distal placement location. Unfortunately, TT is not without complications. We aim to demonstrate the feasibility of a disposable device to allow for visually directed TT placement compared to the standard of care in a large animal model...
April 2017: Injury
https://www.readbyqxmd.com/read/28225467/comparison-of-anesthetic-management-and-outcomes-in-patients-having-either-transnasal-or-transoral-endoscopic-odontoid-process-surgery
#14
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
#15
RANDOMIZED CONTROLLED TRIAL
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
#16
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
#17
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
#18
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
#19
RANDOMIZED CONTROLLED TRIAL
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...
February 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
#20
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
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