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https://www.readbyqxmd.com/read/28419806/tracheal-t-tubes-for-long-term-management-of-the-unreconstructable-trachea-in-adults
#1
Mark A Varvares
Management of tracheostenosis in adult patients who are either medically unreconstructable due to significant comorbidities or surgically unreconstructable remains a challenge. The tracheal T-tube offers an excellent permanent solution to the problem of the unreconstructable trachea. This article reviews 3 patients who underwent tracheofissure and placement of a tracheal T-tube after failed prior attempts at repair of tracheal stenosis. The tracheal T-tubes have been maintained for 13, 15, and 36 years, and these patients have enjoyed adequate phonatory and respiratory functions with the T-tube plugged and functioning as an airway stent...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28403406/comparison-of-effectiveness-of-two-commonly-used-two-handed-mask-ventilation-techniques-on-unconscious-apnoeic-obese-adults
#2
M Fei, J L Blair, M J Rice, D A Edwards, Y Liang, M A Pilla, M S Shotwell, Y Jiang
Background.: Mask ventilation and tracheal intubation are basic techniques for airway management and mutually inclusive rescue measures to restore ventilation. The aim of this study was to compare the effectiveness of mask ventilation between two commonly used techniques of two-handed mask ventilation in obese unconscious apnoeic adults. Methods.: Eighty-one obese adults received mask ventilation after induction using C-E clamp and modified V-E clamp techniques in a randomized crossover manner...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28373921/successful-extubation-using-heliox-bipap-in-two-patients-with-postextubation-stridor
#3
Pragya Punj, Premkumar Nattanmai, Pravin George, Christopher R Newey
Postextubation stridor is associated with significant morbidity. It commonly results in extubation failure after established medical treatment fails, such as nebulized epinephrine and/or intravenous steroids. The role of heliox (i.e., combination of helium and oxygen) in managing patients with postextubation stridor has not been fully established. We report two cases of postextubation stridor successfully treated with heliox delivered with bilevel positive airway pressure (BiPAP) after failure of standard medical therapy...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28366293/procedural-difficulties-during-successful-intubation-in-octogenarians-a-prospective-observational-study
#4
Y F Bryan, K N Johnson
OBJECTIVE: Octogenarians undergo anatomic and physiopathologic degradation, making airway management problematic, specific to intubation, bag mask ventilation, leading to desaturation and aspiration. Our study's aim was to examine the process of airway management regarding the steps involved in intubation and any deviations or delays in the tasks. MATERIALS AND METHODS: An institutional review board-approved difficult airway prospective observational study in older adults was conducted...
March 30, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28360471/thoracoscopic-foreign-body-removal-and-repair-of-bronchus-intermedius-following-injury-during-failed-bronchoscopic-retrieval
#5
Belal Bin Asaf, C L Vijay, Sukhram Bishnoi, Naresh Dua, Arvind Kumar
Aspiration of foreign body (FB) into the airways is common in children and continues to be a cause for morbidity and mortality. We report herein, successful thoracoscopic management of a child who aspirated a large magnetic FB into his right bronchus and developed a tear of bronchus intermedius (BI) during an attempt at bronchoscopic retrieval using rigid bronchoscope. The impacted FB was successfully removed thoracoscopically followed by thoracoscopic BI repair.
March 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28358178/time-to-intubation-in-obese-patients-a-randomized-study-comparing-direct-laryngoscopy-and-videolaryngoscopy-in-experienced-anaesthetists
#6
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/28350680/airway-and-feeding-outcomes-of-mandibular-distraction-tongue-lip-adhesion-and-conservative-management-in-pierre-robin-sequence-a-prospective-study
#7
Ibrahim Khansa, Courtney Hall, Lauren L Madhoun, Mark Splaingard, Adriane Baylis, Richard E Kirschner, Gregory D Pearson
BACKGROUND: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28183552/comparison-of-the-macintosh-and-airtraq-laryngoscopes-in-morbidly-obese-patients-a-randomized-and-prospective-study
#8
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
#9
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
#10
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
#11
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
#12
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...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28089815/do-patients-hospitalized-with-copd-have-airflow-obstruction
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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