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https://www.readbyqxmd.com/read/29346253/an-innovative-solution-for-prolonged-air-leaks-the-customized-endobronchial-silicone-blocker
#1
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rakesh Godara, Chakravarthi Lokanath, Michael Cutaia
BACKGROUND: Prolonged air leak (PAL) is a life-threatening condition that can present either as bronchopleural fistula, or alveolar-pleural fistula (APF). Although numerous bronchoscopic treatments are described, they are either expensive, not widely available in the developing world or have limited success. We describe our experience with a novel customized endobronchial silicone blocker (CESB) for PAL treatment. METHODS: This is a retrospective study of PAL patients who underwent CESB placement...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29332778/cricothyrotomy-in-helicopter-emergency-medical-service-transport
#2
Kevin High, Jeremy Brywczynski, Jin H Han
OBJECTIVE: Airway management is a requisite skill set for helicopter emergency medical service (HEMS) providers. Cricothyrotomy is a potentially lifesaving skill that is used when other airway maneuvers fail. The authors reviewed all transports by a helicopter program in which cricothyrotomy was performed to assess the frequency, success, and technique. METHODS: This was a retrospective chart review of air medical patient records from an electronic medical record system over a 112-month period...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29303285/-non-cf-bronchiectasis-of-adults-short-review-for-clinical-practice-position-paper-of-board-of-disease-with-bronchial-obstruction-czech-pulmonological-and-phthiseological-society-czech-medical-association-of-j-e-purkyne
#3
Zuzana Antušová, Libor Fila, Vladimír Herout, Eva Kočová, Kateřina Neumannová, Jaromír Zatloukal, Vladimír Koblížek
Bronchiectasis is a clinically important, but poorly understood, pulmonary condition characterized by dilated and thick-walled bronchi. Bronchiectasis remains a significant cause of morbidity and mortality around the world. Targeted effort to early high-resolution computed tomography diagnosis and detailed confirmation of causation are in the spotlight of respiratory physicians in the developed countries. The risk population consists of subjects with persistent and/or productive cough, where another clear diagnosis has not been performed...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29246209/airway-administration-of-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-premature-infants-a-meta-analysis-with-trial-sequential-analysis
#4
Zhi-Qun Zhang, Ying Zhong, Xian-Mei Huang, Li-Zhong Du
BACKGROUND: Uncertainly prevails with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. The meta-analysis with sequential analysis was designed to evaluate the efficacy and safety of airway administration (inhalation or instillation) of corticosteroids for preventing bronchopulmonary dysplasia (BPD) in premature infants. METHODS: We searched MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL from their inceptions to February 2017...
December 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29230133/invasive-insular-thyroid-carcinoma-presenting-as-nonparalytic-dysphonia
#5
Blake S Raggio, Blair M Barton, Maria C Grant, Judith A Fornadley, Jeffrey P Marino
Background: Patients with suspected thyroid malignancy often undergo preoperative laryngeal examination with a focus on vocal fold mobility. We present the unique case of a patient with invasive thyroid carcinoma who presented with dysphonia despite intact vocal fold motion. Case Report: A 73-year-old female with a remote thyroid lobectomy presented with dysphonia. Thyroid ultrasound and fine-needle aspiration revealed a 1.1-cm nodule consistent with a colloid cyst...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#6
REVIEW
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29200833/positive-airway-pressure-adherence-and-subthreshold-adherence-in-posttraumatic-stress-disorder-patients-with-comorbid-sleep-apnea
#7
Barry J Krakow, Jessica J Obando, Victor A Ulibarri, Natalia D McIver
Study objectives: Patients with comorbid posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) manifest low adherence to continuous positive airway pressure (CPAP) due to fixed, pressure-induced expiratory pressure intolerance (EPI), a subjective symptom and objective sign aggravated by anxiety sensitivity and somatosensory amplification. As advanced PAP therapy modes (ie, auto-bilevel PAP [ABPAP] or adaptive servo-ventilation [ASV]) may address these side effects, we hypothesized such treatment would be associated with decreased expiratory intolerance and increased adherence in posttraumatic stress patients with co-occurring OSA...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29189209/temporal-trends-in-difficult-and-failed-tracheal-intubation-in-a-regional-community-anesthetic-practice
#8
Rebecca A Schroeder, Richard Pollard, Ishwori Dhakal, Mary Cooter, Solomon Aronson, Katherine Grichnik, William Buhrman, Miklos D Kertai, Joseph P Mathew, Mark Stafford-Smith
BACKGROUND: When tracheal intubation is difficult or unachievable before surgery or during an emergent resuscitation, this is a critical safety event. Consensus algorithms and airway devices have been introduced in hopes of reducing such occurrences. However, evidence of improved safety in clinical practice related to their introduction is lacking. Therefore, we selected a large perioperative database spanning 2002 to 2015 to look for changes in annual rates of difficult and failed tracheal intubation...
November 20, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29173286/an-airway-rapid-response-system-implementation-and-utilization-in-a-large-academic-trauma-center
#9
Joshua H Atkins, Christopher H Rassekh, Ara A Chalian, Jing Zhao
BACKGROUND: Rapid response teams mobilize resources to patients experiencing acute deterioration. Failed airway management results in death or anoxic brain injury. A codified, systems-based approach to bring personnel and equipment to the bedside for multidisciplinary airway assessment and rescue was reflected in the initial implementation of an airway rapid response (ARR) team. METHODS: A retrospective review of records of 117 ARR events in a 40-month period (August 2011-November 2014) was undertaken at the Hospital of the University of Pennsylvania, a 789-bed, academic, urban, tertiary care, Level 1 trauma center...
December 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29137881/comparison-between-chloral-hydrate-and-propofol-ketamine-as-sedation-regimens-for-pediatric-auditory-brainstem-response-testing
#10
Kamal Abulebda, Vinit J Patel, Sheikh S Ahmed, Alvaro J Tori, Riad Lutfi, Samer Abu-Sultaneh
INTRODUCTION: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHODS: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study...
October 28, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#11
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#12
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29100647/subglottic-stenosis-in-granulomatosis-with-polyangiitis-the-role-of-laryngotracheal-resection
#13
Christina L Costantino, John L Niles, Cameron D Wright, Douglas J Mathisen, Ashok Muniappan
BACKGROUND: Granulomatosis with polyangiitis (GPA) is associated with development of subglottic stenosis in about one-fourth of all patients. Although endoscopic management is the primary treatment method for tracheobronchial stenosis, some patients have refractory disease, and tracheostomy is required. It is unclear if laryngotracheal resection and reconstruction (LTRR) can be safely performed in patients with GPA. METHODS: A retrospective review was performed of 11 patients with GPA undergoing LTRR...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29096887/definitive-airway-management-after-prehospital-supraglottic-rescue-airway-in-pediatric-trauma
#14
Matthew C Hernandez, Ryan M Antiel, Karthik Balakrishnan, Martin D Zielinski, Denise B Klinkner
INTRODUCTION: Supraglottic airway (SGA) use and outcomes in pediatric trauma are poorly understood. We compared outcomes between patients receiving prehospital SGA versus bag mask ventilation (BVM). METHODS: We reviewed pediatric multisystem trauma patients (2005-2016), comparing SGA and BVM. Primary outcome was adequacy of oxygenation and ventilation. Additional measures included tracheostomy, mortality and abbreviated injury scores (AIS). RESULTS: Ninety patients were included (SGA, n=17 and BVM, n=73)...
October 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29082910/the-use-of-intubating-lightwand-in-difficult-airway-patients-with-limited-management-options
#15
Olumuyiwa A Bamgbade
The intubating lightwand is a recommended airway management tool in patients with failed direct laryngoscopy or intubation; but the device is under-utilised. This study reports successful lightwand intubation in a cohort of 22 consecutive adult patients with difficult airway; who required endotracheal general anaesthesia, in the presence of limited management options. Patients underwent different procedures: tonsillectomy (2), pharyngeal biopsy (6), abdominal surgery (5), thoracoscopy (3) and maxillofacial surgery (6)...
July 2017: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29063583/infrared-red-intubation-system-irris-guided-flexile-videoscope-assisted-difficult-airway-management
#16
M S Kristensen, E Fried, P Biro
BACKGROUND: Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis. METHODS: The IRRIS is placed over the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde transillumination, showing the pathway to the trachea...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29051828/intubation-following-high-dose-rocuronium-in-a-cat-with-protracted-laryngospasm
#17
Graeme M Doodnaught, Daniel Sj Pang
CASE SUMMARY: An 11-year-old spayed female domestic shorthair cat with a history of laryngospasm at induction of general anesthesia presented for dental evaluation and treatment. The cat was premedicated with hydromorphone (0.05 mg/kg) and alfaxalone (0.5 mg/kg) intravenously, pre-oxygenated for 5 mins (3 l/min, face mask) and anesthesia was induced with alfaxalone (to effect) intravenously. Lidocaine (0.1 ml, 2%) was applied topically to the arytenoid cartilages following loss of jaw tone...
July 2017: JFMS Open Reports
https://www.readbyqxmd.com/read/28971804/a-randomised-trial-to-compare-truview-pcd%C3%A2-c-mac%C3%A2-and-macintosh-laryngoscopes-in-paediatric-airway-management
#18
Ranju Singh, Nishant Kumar, Aruna Jain
AIM: To evaluate and compare the Truview PCD and C-MAC laryngoscopes to the standard Macintosh laryngoscope in paediatric patients. METHODS: One hundred and fifty ASA I-II patients in the age group of 1-6 years (10-20 kg) scheduled for elective surgery were randomised into three equal groups for laryngoscopy and intubation with either Truview PCD (Group T), C-MAC (Group C) or Macintosh (Group M) laryngoscopes under general anaesthesia. Percentage of glottic opening (POGO) score, application of external laryngeal manoeuvre, time to intubation, number of attempts at intubation, failed intubations, episodes of desaturation and trauma caused were recorded and statistically analysed...
June 2017: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28958272/inclusion-of-the-acute-care-surgeon-in-the-difficult-airway-protocol-a-nine-year-experience
#19
Seong K Lee, Andrew A Rosenthal, Dafney L Davare, Chauniqua Kiffin, Rafael Sanchez, Michael Hurtado, Eddy H Carrillo
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28953490/anterior-laryngeal-web-leading-to-unanticipated-difficult-tracheal-intubation-in-a-neonate-diagnosed-and-managed-successfully-with-cmac-video-laryngoscope-a-case-report
#20
Anju Gupta, Nishkarsh Gupta
Anterior laryngeal web is a rare anomaly which is usually asymptomatic in infancy. This translates into a high incidence of unanticipated difficult intubation in these patients with consequent airway morbidity in the form of tracheostomy. We are reporting a case of unsuspected difficult intubation in a neonate due to the presence of a congenital anterior laryngeal web. After multiple failed intubation attempts with direct laryngoscopy, use of CMAC video laryngoscope improved the glottic view, enabled us to diagnose the presence of a thick anterior laryngeal web and intubate the child...
September 26, 2017: A & A Case Reports
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