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Awake endotracheal intubation

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https://www.readbyqxmd.com/read/28436022/ventilation-via-the-2-4%C3%A2-mm-internal-diameter-tritube-%C3%A2-with-cuff%C3%A2-new-possibilities-in-airway-management
#1
REVIEW
M S Kristensen, M W P de Wolf, L S Rasmussen
BACKGROUND: A small tube may facilitate tracheal intubation and improve surgical access. We describe our initial experience with the Tritube(®) that is a novel cuffed endotracheal tube with a 2.4 mm internal diameter. METHODS: The Tritube(®) was used in seven adult Ear-Nose-and Throat surgical patients with airway narrowing or whose surgical access was facilitated by this small-bore endotracheal tube. Ventilation through Tritube(®) is performed with the manually operated Ventrain(®) -ventilator that allows active suctioning during expiration, therefore facilitating normoventilation through small diameter airways...
April 23, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28277256/-anesthetic-considerations-for-awake-craniotomy-case-report
#2
Cassiano Hamacek de Freitas, Celso Homero Santos Oliveira, Daniel Câmara de Rezende, Joyce Romano, Henrique Rodrigues Lemos Silva, Ivana Mares Trivellato
BACKGROUND AND OBJECTIVES: The conscious patient cooperation during neurological procedures has become necessary for the delimitation of areas to be managed by a neurosurgeon, with better results in the treatment of tumor lesions, vascular or epileptic foci, and sequelae minimization. The need for perioperative awareness (responsiveness to commands) challenges anesthesiologists to further ensure patient safety during the procedure. Several techniques have been described for this purpose...
October 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28267939/the-tracheal-accordion-and-the-position-of-the-endotracheal-tube
#3
S T Herway, J L Benumof
The purpose of this review is to, first, determine the static factors that affect the length of the human trachea across different populations and, second, to investigate whether or not there are dynamic factors that cause the length of the human trachea to vary within the same individual. We also investigated whether these changes in tracheal length within the same individual are significant enough to increase the risk of endobronchial intubation or accidental extubation. A PubMed/MEDLINE and a Web of Science database English-language literature search was conducted in May 2016 with relevant keywords and MeSH terms when available...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28235524/awake-tracheal-intubation-in-anticipated-difficult-airways-lma-fastrach-vs-flexible-bronchoscope-a-pilot-study
#4
Sherine F Hanna, Marianne Mikat-Stevens, James Loo, Raj Uppal, W Scott Jellish, Matthew Adams
STUDY OBJECTIVE: To compare the use of LMA Fastrach intubating laryngeal mask airway (ILMA) to flexible bronchoscopy (FB) for awake intubation in patients with difficult airways. DESIGN: Randomized prospective study. SETTING: Large academic medical center. PATIENTS: Forty adult patients, American Society of Anesthesiologists I-IV, meeting the criteria for awake intubation based on history and physical examination. INTERVENTIONS: After sedation and airway topicalization, patients were randomized to either FB group, n=19, or ILMA group, n=21...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28221200/pathogenic-link-between-postextubation-pneumonia-and-ventilator-associated-pneumonia-an-experimental-study
#5
Emanuele Rezoagli, Alberto Zanella, Massimo Cressoni, Lorenzo De Marchi, Theodor Kolobow, Lorenzo Berra
BACKGROUND: The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28007874/new-tubeless-video-assisted-thoracoscopic-surgery-for-small-pulmonary-nodules
#6
Shuben Li, Long Jiang, Keng-Leong Ang, Hanzhang Chen, Qinglong Dong, Hanyu Yang, Jingpei Li, Jianxing He
OBJECTIVE: Problems associated with intubation, chest drainage and urinary catheterization can have a negative impact on patient's recovery after thoracic surgery. We therefore evaluated the feasibility of a new tubeless (spontaneous ventilation without tracheal intubation, urinary catheterization, and no post-operative chest drain placement) approach to perform video-assisted thoracoscopic surgery (VATS) for small pulmonary nodules (SPN) less than 2cm in diameter. METHODS: From 1 January 2012 to 31 December 2014, 34 patients with SPNs were treated using tubeless VATS in our centre...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27833492/submandibular-intubation-in-awake-patient-of-panfacial-trauma
#7
S K Kamra, H K Khandavilli, P Banerjee
Maxillofacial trauma patients present with airway problems. Submandibular intubation is an effective means of intubation to avoid tracheostomy for operative procedures. Airway is secured with oral endotracheal intubation in paralyzed patient and tube is then transplaced in sub mental or submandibular region. However there may be instances when paralyzing such trauma patients is not safe and short term tracheostomy is the only airway channel available for conduction of anesthesia. We report a case of submandibular intubation in awake patient of maxillofacial trauma with anticipated intubation problems...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27599477/use-of-a-macintosh-blade-in-extrahepatic-portal-vein-obstruction-with-difficult-intubation-two-case-reports
#8
Azho Kezo, Rajendra D Patel, Shraddha Mathkar, Sonal Butada
BACKGROUND: We report the management of two patents from the Indian subcontinent with extrahepatic portal vein obstruction presenting with anticipated difficult airway. A Macintosh blade was used to secure the airway after using various instruments designed for difficult airway. To the best of our knowledge, no case has previously been reported in which a Macintosh blade was used successfully in patients with extrahepatic portal vein obstruction with a difficult airway. CASE PRESENTATION: Two women (case 1 and case 2) of South Asian ethnicity with extrahepatic portal vein obstruction presented for an elective splenorenal shunt...
September 6, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27555201/ultrasound-guided-airway-blocks-using-a-curvilinear-probe
#9
Martin Krause, Bahareh Khatibi, Jacklynn F Sztain, Pariza Rahman, Anna B Shapiro, NavParkash S Sandhu
We describe a novel technique of real-time ultrasound-guided superior laryngeal nerve and translaryngeal blocks in 4 patients with anticipated difficult airways. All patients had altered neck anatomy, and 1 had a prior unsuccessful awake fiberoptic bronchoscopic intubation. For block performance, an 11-mm broadband curved array transducer with a scanning frequency between 8 and 5 MHz (Sonosite, Bothell, WA) was used for anatomical structure identification, needle guidance toward each superior laryngeal nerve and through the cricothyroid membrane, and deposition of local anesthetic in the appropriate location...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27484783/dexmedetomidine-versus-remifentanil-for-sedation-during-awake-intubation-using-a-shikani-optical-stylet-a-randomized-double-blinded-controlled-trial
#10
Ting Xu, Min Li, Cheng Ni, Xiang-Yang Guo
BACKGROUND: The purpose of this study was to compare the efficacy and safety of dexmedetomidine versus remifentanil for sedation during awake intubation using a Shikani optical stylet (SOS). METHODS: Sixty-eight patients with cervical trauma or severe cervical spondylosis undergoing cervical spinal surgery were enrolled in this prospective study. They were randomly assigned to receive dexmedetomidine (Group D) or remifentanil (Group R). In Group D, the patients received an intravenous loading dose of dexmedetomidine 1 μg · kg(-1) over 10 min followed by a continuous infusion of 0...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27400991/awake-emergency-endotracheal-intubation-using-sheath-assisted-technique-for-patients-having-malignant-tracheal-stenosis-under-fluoroscopy-guidance-a-retrospective-study
#11
Dechao Jiao, Xinwei Han, Gang Wu, Jianzhuang Ren, Zhen Li, Ling Wang
Background For patients having a severe larynx or tracheal stenosis, emergency endotracheal intubation (EEI) may be needed due to respiratory failure. Purpose To evaluate the feasibility and effectiveness of awake EEI using a fluoroscopy-guided sheath-assisted technique for adult patients having a malignant tracheal stenosis. Material and Methods From October 2009 to May 2015, 219 patients having a malignant tracheal stenosis causing dyspnea or asphyxia required EEI. Of these, 32 patients who experienced intubation difficulties or failure were included in this study...
April 2017: Acta Radiologica
https://www.readbyqxmd.com/read/27342461/nasotracheal-intubation-of-a-patient-with-restricted-mouth-opening-using-a-mcgrath-mac-x-blade-and-magill-forceps
#12
Zehra İpek Arslan, P Ozdal, D Ozdamar, H Agır, M Solak
We experienced a case of successful nasotracheal intubation using the X-Blade of the McGrath MAC in a 28-year-old woman with a 2.5-cm mouth opening. She had no teeth on the right side, her neck movement was limited, her mandibular protrusion was grade C, and her Mallampati could not be evaluated. Her tongue was fixed to the left wall during a previous surgery. We evaluated the awake glottic view using the McGrath MAC X-Blade and topical oral anesthesia. We obtained a Cormack-Lehane grade II view and then decided to administer general anesthesia...
October 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27290947/awake-intubating-laryngeal-mask-airway-placement-in-a-morbidly-obese-patient-with-ankylosing-spondylitis-and-unstable-thoracic-spine
#13
Abbey G Herman, Michael E Mahla
Intubating laryngeal mask airways can be used to provide continuous ventilation throughout intubation. This is a case of a morbidly obese (body mass index = 58) 65-year-old woman with T10 and T11 compression fractures. Optimal positioning for airway management was hindered by her unstable spine, minimal neck range of motion, and extreme pain with any movement. An intubating laryngeal mask airway was placed in the awake, topically anesthetized patient, and the laryngeal mask airway and endotracheal tube combination was left in place throughout surgery...
August 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27276783/laryngeal-chondrosarcoma-successful-use-of-video-laryngoscope-in-anticipated-difficult-airway-management
#14
Vladimir Dolinaj, Sanja Milošev, Dušanka Janjević
Laryngeal chondrosarcoma is a rare mesenchymal tumor, most frequently affecting cricoid cartilage. The objective of this report is to present successful video laryngoscope usage in a patient with anticipated difficult airway who refused awake fiberoptic endotracheal intubation (AFOI). A 59-year-old male patient was admitted in our hospital due to difficulty breathing and swallowing. On clinical examination performed by ENT surgeon, preoperative endoscopic airway examination (PEAE) could not be performed properly due to the patient's uncooperativeness...
March 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/27188111/-difficult-ventilation-requiring-emergency-endotracheal-intubation-during-awake-craniotomy-managed-by-laryngeal-mask-airway
#15
Asako Matsuda, Toshiyuki Mizota, Tomoharu Tanaka, Hajime Segawa, Kazuhiko Fukuda
We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased...
April 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27134833/uniportal-thoracoscopic-surgery-from-medical-thoracoscopy-to-non-intubated-uniportal-video-assisted-major-pulmonary-resections
#16
REVIEW
Diego Gonzalez-Rivas
The development of thoracoscopy has more than one hundred years of history since Jacobaeus described the first procedure in 1910. He used the thoracoscope to lyse adhesions in tuberculosis patients. This technique was adopted throughout Europe in the early decades of the 20(th) century for minor and diagnostic procedures. It is only in the last two decades that interest in minimally invasive thoracic surgery was reintroduced by two key technological improvements: the development of better thoracoscopic cameras and the availability of endoscopic linear mechanical staplers...
March 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27111535/a-retrospective-study-of-success-failure-and-time-needed-to-perform-awake-intubation
#17
Thomas T Joseph, Jonathan S Gal, Samuel DeMaria, Hung-Mo Lin, Adam I Levine, Jaime B Hyman
BACKGROUND: Awake intubation is the standard of care for management of the anticipated difficult airway. The performance of awake intubation may be perceived as complex and time-consuming, potentially leading clinicians to avoid this technique of airway management. This retrospective review of awake intubations at a large academic medical center was performed to determine the average time taken to perform awake intubation, its effects on hemodynamics, and the incidence and characteristics of complications and failure...
July 2016: Anesthesiology
https://www.readbyqxmd.com/read/27028774/predictors-of-difficult-intubation-with-the-bonfils-rigid-fiberscope
#18
Michal Nowakowski, Stephan Williams, Jason Gallant, Monique Ruel, Arnaud Robitaille
BACKGROUND: Endotracheal intubation is commonly performed via direct laryngoscopy (DL). However, in certain patients, DL may be difficult or impossible. The Bonfils Rigid Fiberscope® (BRF) is an alternative intubation device, the design of which raises the question of whether factors that predict difficult DL also predict difficult BRF. We undertook this study to determine which demographic, morphologic, and morphometric factors predict difficult intubation with the BRF. METHODS: Four hundred adult patients scheduled for elective surgery were recruited...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26885138/central-venous-catheter-malposition-in-the-azygos-vein-and-difficult-endotracheal-intubation-in-severe-ankylosing-spondylitis-a-case-report
#19
Eunjin Moon, Hyungmo Jeong, Junyoung Chung, Jaewoo Yi
Ankylosing spondylitis (AS) can be challenging for anesthesiologists because central venous access can be difficult, and the airway can be blocked due to the fixed flexion deformity of the spine. In this case, we attempted central access via the right subclavian vein, but the catheter was repeatedly inserted into the azygos vein, which was confirmed by radiology. After several attempts, the catheter position was corrected at the superior vena cava-atrial junction. Although several useful devices have been developed to address difficult intubation, in this case, fiberoptic bronchoscopy was the only applicable safe alternative because of the patient's extremely severe chin on chest deformity and temporomandibular joint disease...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26673904/anatomic-and-physiopathologic-changes-affecting-the-airway-of-the-elderly-patient-implications-for-geriatric-focused-airway-management
#20
REVIEW
Kathleen N Johnson, Daniel B Botros, Leanne Groban, Yvon F Bryan
There are many anatomical, physiopathological, and cognitive changes that occur in the elderly that affect different components of airway management: intubation, ventilation, oxygenation, and risk of aspiration. Anatomical changes occur in different areas of the airway from the oral cavity to the larynx. Common changes to the airway include tooth decay, oropharyngeal tumors, and significant decreases in neck range of motion. These changes may make intubation challenging by making it difficult to visualize the vocal cords and/or place the endotracheal tube...
2015: Clinical Interventions in Aging
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