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Failed airway management

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https://www.readbyqxmd.com/read/28183552/comparison-of-the-macintosh-and-airtraq-laryngoscopes-in-morbidly-obese-patients-a-randomized-and-prospective-study
#1
Caridad G Castillo-Monzón, Hugo A Marroquín-Valz, Miguel Fernández-Villacañas-Marín, Matilde Moreno-Cascales, Blas García-Rojo, César A Candia-Arana
STUDY OBJECTIVE: Morbid obesity is associated with a difficult management of the airway. There is no agreement on these patients being difficult to intubate, but if they are difficult to ventilate with facial mask, then the fast control of their airway becomes a priority. This study compares the quickness and success in tracheal intubation, glottic view, hemodynamic response, and complications from the use of the Macintosh and Airtraq laryngoscopes in morbidly obese patients for scheduled surgery...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183550/airway-management-for-glossopexy-in-infants-with-micrognathia-and-obstructive-breathing
#2
Yoshinari Morimoto, Aiko Ohyamaguchi, Mika Inoue, Chizuko Yokoe, Hiroshi Hanamoto, Uno Imaizumi, Mitsutaka Sugimura, Hitoshi Niwa
STUDY OBJECTIVES: To identify airway management and tracheal intubation techniques for glossopexy in infants with preexisting airway obstruction under general anesthesia. DESIGN: Retrospective, observational study. SETTINGS: Operating room of a university hospital between January 2003 and March 2015. All operations were performed by oral and maxillofacial surgeons. PATIENTS: Thirteen patients who received general anesthesia for glossopexy and reversal after 7 months...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181359/general-anesthesia-with-a-native-airway-for-patients-with-mucopolysaccharidosis-type-iii
#3
Mineto Kamata, Christopher McKee, Kristen V Truxal, Kevin M Flanigan, Kim L McBride, Shawn C Aylward, Joseph D Tobias, Marco Corridore
BACKGROUND: Mucopolysaccharidosis type III is a progressive disease with worsening airway, pulmonary, and cardiac involvement that may complicate anesthetic care. AIM: To prospectively evaluate the incidence of airway issues and complications during magnetic resonance imaging (MRI) and lumbar puncture (LP) during general anesthesia with a native airway for patients with mucopolysaccharidosis type III. METHOD: The study was a part of the natural history study...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28146296/nasal-intermittent-positive-pressure-ventilation-nippv-versus-nasal-continuous-positive-airway-pressure-ncpap-for-preterm-neonates-after-extubation
#4
REVIEW
Brigitte Lemyre, Peter G Davis, Antonio G De Paoli, Haresh Kirpalani
BACKGROUND: Previous randomised trials and meta-analyses have shown that nasal continuous positive airway pressure (NCPAP) is a useful method for providing respiratory support after extubation. However, this treatment sometimes 'fails' in infants, and they may require endotracheal re-intubation with its attendant risks and expense. Nasal intermittent positive pressure ventilation (NIPPV) can augment NCPAP by delivering ventilator breaths via nasal prongs. Older children and adults with chronic respiratory failure benefit from NIPPV, and the technique has been applied to neonates...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28098417/delivery-of-anesthesia-for-children-with-mucopolysaccharidosis-type-iii-sanfilippo-syndrome-a-review-of-86-anesthetics
#5
Marc A Cohen, Grant M Stuart
BACKGROUND: Sanfilippo syndrome (MPS III) is rare, with 97 cases in the United Kingdom between 1988 and 1998. Mucopolysaccharide infiltration of tissues in mucopolysaccharidosis (MPS) causes multi-systemic pathology including difficult airways and cardiac disease. Published anesthesia case reviews of Sanfilippo syndrome have included limited numbers of patients to date. AIM: To identify the perioperative management and complications of anesthesia in children with mucopolysaccharidosis Type III at Great Ormond Street Hospital...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28089815/do-patients-hospitalized-with-copd-have-airflow-obstruction
#6
Huimin Wu, Robert A Wise, Ann E Medinger
BACKGROUND: Guidelines recommend the confirmation of a COPD diagnosis with spirometry. ICD-9-CM diagnostic codes are used frequently to identify patients with COPD for administrative purposes. However, coding the diagnosis of COPD does not require spirometric confirmation. The purpose of this study was to determine how often the discharge diagnoses of COPD is supported by spirometric measurements in the VA health system. METHODS: We reviewed records of patients hospitalized for COPD in a VA teaching hospital between 2005 and 2015...
January 13, 2017: Chest
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
#7
RANDOMIZED CONTROLLED TRIAL
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/28033203/outcomes-of-extracorporeal-life-support-during-surgery-for-the-critical-airway-stenosis
#8
Seon Hee Kim, Seunghwan Song, Yeong Dae Kim, Hoseok I, Jeong Su Cho, Hyo Yeong Ahn, Jonggeun Lee, Do Hyung Kim, Bong Soo Son
Anesthetic management of critical airway stenosis is often very challenging. Extracorporeal membrane oxygenation (ECMO) may provide adequate respiratory support when conventional approaches fail. We report our experience of ECMO support for critical airway surgery. Between April 2012 and March 2015, nine patients underwent ECMO-supported airway operation. The reason for surgery was tracheal stenosis in nine patients, and tracheomalacia, tracheal tumor, and external tracheal compression by mediastinal mass in one patient each...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#9
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28003690/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-adults
#10
Sheila Nainan Myatra, Amit Shah, Pankaj Kundra, Apeksh Patwa, Venkateswaran Ramkumar, Jigeeshu Vasishtha Divatia, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Syed Moied Ahmed, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Rakesh Garg
The All India Difficult Airway Association (AIDAA) guidelines for management of the unanticipated difficult airway in adults provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in adults. They have been developed based on the available evidence; wherever robust evidence was lacking, or to suit the needs and situation in India, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27990628/action-plans-with-brief-patient-education-for-exacerbations-in-chronic-obstructive-pulmonary-disease
#11
REVIEW
Maxwell Howcroft, E Haydn Walters, Richard Wood-Baker, Julia Ae Walters
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are a major driver of decline in health status and impose high costs on healthcare systems. Action plans offer a form of self-management that can be delivered in the outpatient setting to help individuals recognise and initiate early treatment for exacerbations, thereby reducing their impact. OBJECTIVES: To compare effects of an action plan for COPD exacerbations provided with a single short patient education component and without a comprehensive self-management programme versus usual care...
December 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27930894/the-i-gel-supraglottic-airway-as-a-conduit-for-fibreoptic-tracheal-intubation-a-randomized-comparison-with-the-single-use-intubating-laryngeal-mask-airway-and-ctrach-laryngeal-mask-in-patients-with-predicted-difficult-laryngoscopy
#12
Pavel Michálek, Will Donaldson, Francis McAleavey, Alexander Abraham, Rachel J Mathers, Claire Telford
Fibreoptic intubation through a supraglottic airway is an alternative plan for airway management in difficult or failed laryngoscopy. The aim of this study was to compare three supraglottic airways as conduits in patients with at least one predictor for difficult laryngoscopy. The i-gel was compared with the single-use intubating laryngeal mask airway (sILMA) and CTrach laryngeal mask in 120 adult patients scheduled for elective surgeries under general anaesthesia using a prospective, randomized and single-blinded design...
2016: Prague Medical Report
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
#13
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/27884665/airway-management-for-cesarean-delivery-performed-under-general-anesthesia
#14
S Rajagopalan, M Suresh, S L Clark, B Serratos, S Chandrasekhar
BACKGROUND: With the increasing popularity of neuraxial anesthesia, there has been a decline in the use of general anesthesia for cesarean delivery. We sought to examine the incidence, outcome and characteristics associated with a failed airway in patients undergoing cesarean delivery under general anesthesia. METHODS: A retrospective review of airway management in women undergoing cesarean delivery under general anesthesia over an eight-year period from 2006-2013 at an academic medical center was conducted...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27871589/trainee-experience-and-success-of-urgent-airway-management
#15
Thomas E Schulte, Kyle J Ringenberg, Steven J Lisco, Harlan Sayles, Sasha K Shillcutt
BACKGROUND: There are limited data regarding emergent, non-operating room, intubations performed by all levels of anesthesia residents. This study was a large retrospective review of all non-operating room emergent intubations performed at a single tertiary medical center. The study evaluated the rate of difficult intubations by level of resident training, compared success rates for direct versus video laryngoscopy and evaluated the rate and success of rescue video laryngoscopy following failed direct laryngoscopy...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871535/lingual-tonsil-hypertrophy-rescuing-the-airway-with-videolaryngoscopy
#16
Fouad Ghazi Souki, Shweta Rahul Yemul-Golhar, Yosaf Zeyed, Ernesto A Pretto
Lingual tonsils are lymphatic tissues located at the base of the tongue that may hypertrophy causing difficulty and sometimes inability to ventilate or intubate during anesthesia. Routine airway assessment fails to diagnose lingual tonsil hypertrophy. There is limited experience with use of videolaryngoscopy in cases of lingual tonsil hypertrophy. We present a case of difficult airway due to unanticipated lingual tonsil hypertrophy successfully managed by atypical video laryngoscope positioning.
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871527/two-lost-airways-and-one-unexpected-problem-undiagnosed-tracheal-stenosis-in-a-morbidly-obese-patient
#17
Miguel A Cobas, Nicole D Martin, Heather B Barkin
Anesthetic care of the morbidly obese is complex due to anatomic and physiologic alterations. Airway management in particular can be challenging. High body mass index is predictive of difficult ventilation and possibly difficult intubation. Other airway anomalies, such as tracheal stenosis, add to the complexity of airway management. Tracheal stenosis, a form of central airway obstruction, may be challenging to diagnose, especially in the obese. Comorbidities can mask the diagnosis and routine imaging may fail to identify the pathology...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#18
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27867577/when-continuous-positive-airway-pressure-cpap-fails
#19
REVIEW
Jagdeep S Virk, Bhik Kotecha
Obstructive sleep apnoea (OSA) is increasingly prevalent, particularly in the context of the obesity epidemic, and is associated with a significant social, health and economic impact. The gold standard of treatment for moderate to severe OSA is continuous positive airway pressure (CPAP). However compliance rates can be low. Methodology to improve patient tolerance to CPAP alongside with alternative, non-surgical and surgical, management strategies are discussed. All patients that fail CPAP therapy would benefit from formal upper airway evaluation by the otolaryngologist to identify any obvious causes and consider site-specific surgical therapies...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27836871/patient-safety-events-in-out-of-hospital-paediatric-airway-management-a-medical-record-review-by-the-csi-ems
#20
Matthew Hansen, Garth Meckler, William Lambert, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management. METHODS: We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing...
November 11, 2016: BMJ Open
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