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Difficult intubation

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https://www.readbyqxmd.com/read/28720096/clinical-and-radiographic-predictors-of-acute-compartment-syndrome-in-the-treatment-of-tibial-plateau-fractures-a-retrospective-cohort-study
#1
Axel Gamulin, Anne Lübbeke, Patrick Belinga, Pierre Hoffmeyer, Thomas V Perneger, Matthieu Zingg, Gregory Cunningham
BACKGROUND: The aim of the study was to evaluate the relation between demographic, injury-related, clinical and radiological factors of patients with tibial plateau fractures and the development of acute compartment syndrome. METHODS: All consecutive adult patients with intra-articular tibial plateau fractures admitted in our urban academic medical centre between January 2005 and December 2009 were included in this retrospective cohort study. The main outcome measurement was the development of acute compartment syndrome...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#2
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#3
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28701849/blunt-trauma-neck-with-complete-tracheal-transection-a-diagnostic-and-therapeutic-challenge-to-the-trauma-team
#4
K N J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict "difficult airway" and recognize "failed airway" very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28701595/cardiovascular-operation-a-significant-risk-factor-of-arytenoid-cartilage-dislocation-subluxation-after-anesthesia
#5
Seri Tsuru, Mayuko Wakimoto, Takeshi Iritakenishi, Makoto Ogawa, Yukio Hayashi
BACKGROUND: Arytenoid cartilage dislocation/subluxation is one of the rare complications following tracheal intubation, and there have been no reports about risk factors leading this complication. From our clinical experience, we have an impression that patients undergoing cardiovascular operations tend to be associated with this complication. AIMS: We designed a large retrospective study to reveal the incidence and risk factors predicting the occurrence and to examine whether our impression is true...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28698964/iatrogenic-bilateral-hypoglossal-palsy-following-spinal-surgery
#6
Shrijit Panikkar, Govind Tol, Irfan Siddique
INTRODUCTION: Bilateral hypoglossal palsy is a rare complication during airway management in surgery. CASE PRESENTATION: Isolated bilateral hypoglossal palsy was noted post-operatively in a patient who underwent multiple spinal surgeries associated with prone anaesthesia. DISCUSSION: Risk factors include difficult, multiple intubations, prolonged surgical time, throat pack, and hyperextension of the neck during intubation. CONCLUSION: We aim to create awareness about this complication which has a significant morbidity and negative effect on patient outcomes...
July 11, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28692347/prevalence-of-difficult-intubation-and-failed-intubation-in-a-diverse-obstetric-community-based-population
#7
Richard Pollard, Matthew Wagner, Katherine Grichnik, Brittany C Clyne, Ashraf S Habib
Objective To describe the incidence of difficult and failed intubations in obstetric patients during a 6-year period monitored by a quality assurance program together with American Society of Anesthesiologists Physical Status (ASA PS) scores, and obesity (Body mass index > 30 kg/m(2)). Methods Following Institutional Review Board approval, data about obstetric patients who experienced unanticipated difficult or failed intubations from 2010-2015 were obtained from the quality assurance database of a large, community-based anesthesiology group practice...
July 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28684141/anaesthetic-management-of-a-patient-with-multiple-pterygium-syndrome-for-elective-caesarean-section
#8
V Daga, C Mendonca, F Choksey, J Elton, S Radhakrishna
We report a case of a pregnant woman with multiple pterygium syndrome who presented for elective caesarean section. Neuraxial anaesthesia failed and the backup plan of awake intubation was extremely difficult.
April 12, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#9
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28671175/a-rare-cause-of-ventilatory-failure-in-a-patient-with-post-traumatic-intracranial-hemorrhage
#10
Balamugesh Thangakunam, Shakti Kumar Bal, Ajay V Venkatapathy, Aparna Irodi, Devasahayam Jesudas Christopher
High minute ventilation is required to lower intracranial pressures in patients with intracranial bleed. Respiratory acidemia consequent to ventilatory difficulty is dangerous in such patients as it further raises intracranial tension. We describe such a case. A 24-year-old man had to be intubated and mechanically ventilated after he met with a road traffic accident and sustained extensive maxillofacial injuries and intracranial bleed. A tooth was accidentally aspirated in this injury and progressively resulted in left lower lobe collapse, pneumomediastinum, and consequent difficult ventilation...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28662709/interval-follow-up-of-a-4-day-pilot-program-to-implement-the-who-surgical-safety-checklist-at-a-congolese-hospital
#11
Michelle C White, Jennifer Peterschmidt, James Callahan, J Edward Fitzgerald, Kristin L Close
BACKGROUND: The World Health Organisation Surgical Safety Checklist (SSC) improves surgical outcomes and the research question is no longer 'does the SSC work?' but, 'how to make the SSC work?' Evidence for implementation strategies in low-income countries is sparse and existing strategies are heavily based on long-term external support. Short but effective implementation programs are required if widespread scale up is to be achieved. We designed and delivered a four-day pilot SSC training course at a single hospital centre in the Republic of Congo, and evaluated the implementation after one year...
June 29, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28660166/neuroleptic-malignant-syndrome-in-the-trauma-intensive-care-unit-diagnosis-and-management-of-a-rare-disease-in-a-challenging-population
#12
Joseph David Drews, Andrew Christopher, David Clay Evans
Neuroleptic malignant syndrome (NMS) is a life-threatening neurological disorder associated with the use of antipsychotic medications. Many of its classic signs, such as fever and altered mental status, are nonspecific in trauma intensive care unit (ICU) patients, and its rarity makes it a difficult diagnosis in this population. However, delays in treatment can be costly both in terms of hospital resources and patient outcomes. We herein report a case of a 54-year-old trauma patient with NMS precipitated by a combination of cocaine withdrawal and neuroleptic medications...
April 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28655950/comparison-of-ultrasound-and-anatomical-landmark-guided-technique-for-superior-laryngeal-nerve-block-to-aid-awake-fibre-optic-intubation-a-prospective-randomised-clinical-study
#13
Uday S Ambi, B K Arjun, Shilpa Masur, Archana Endigeri, Vinod Hosalli, S Y Hulakund
BACKGROUND AND AIMS: Ultrasonography has emerged as a novel, portable, non-invasive tool encouraging airway assessment and procedural interventions. This study assesses the feasibility of ultrasound for block of internal branch of superior laryngeal nerve (ibSLN) block during upper airway anaesthesia to aid awake fibre-optic intubation. METHODS: Forty American Society of Anesthesiologists' physical status I-II patients, aged 18-60 years, deemed to have a difficult airway (modified Mallampati class III-IV or inter-incisor distance <2...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28655086/-clinical-study-of-smt-%C3%A2-video-laryngoscope-with-difficult-airway-intubation-in-emergency-department
#14
J H Yu, Y Wang
Objective: To observe the clinical feasibility and security of SMT-Ⅱ video laryngoscope in difficult airway intubation in emergency department. Methods: This study took 90 adults with difficult airway who were admitted to the rescue room of Jingxi court of Beijing Chao-Yang Hospital, Capital Medical University from January 2015 to December 2016.The patients were randomly divided into 2 groups(SMT-Ⅱ video laryngoscope group: n=45, Macintosh direct laryngoscope group: n=45), which were treated with endotracheal intubation and ventilator assisted ventilation...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28650415/videolaryngoscopy-versus-fiber-optic-intubation-through-a-supraglottic-airway-in-children-with-a-difficult-airway-an-analysis-from-the-multicenter-pediatric-difficult-intubation-registry
#15
Nicholas E Burjek, Akira Nishisaki, John E Fiadjoe, H Daniel Adams, Kenneth N Peeples, Vidya T Raman, Patrick N Olomu, Pete G Kovatsis, Narasimhan Jagannathan
BACKGROUND: The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. METHODS: Observational data were collected from 14 sites after management of difficult pediatric airways...
June 23, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#16
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28645320/acromegaly-discovered-during-a-routine-out-patient-surgical-procedure-a-case-report
#17
Chukwudi O Chiaghana, Julia M Bauerfeind, Cheri A Sulek, J Christopher Goldstein, Caleb A Awoniyi
BACKGROUND: Acromegaly is a rare syndrome in which there is unregulated hypersecretion of growth hormone. The anesthetic management of patients with this disorder is particularly challenging due to pre-existing cardiovascular and respiratory dysfunction, as well as recognized difficulties with airway management. Because of the insidious progression of the disease and the presence of nonspecific signs and symptoms, diagnosis is often made late when characteristic acromegalic features become apparent...
June 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28642187/cheiloplasty-associated-to-a-palatal-obturator-in-a-preterm-infant-with-a-cleft-lip-and-palate
#18
H Bénateau, A-S Trentesaux, A Chatellier, J Laurent, A Bellot, A Veyssiere
INTRODUCTION: Preterm infants are commonly treated by non-invasive ventilation (NIV) and nasal continuous positive airway pressure (CPAP), which are associated with fewer complications than nasotracheal intubation. In preterm infants with a cleft lip and palate, this method of respiratory management is difficult or impossible to perform because of air leakage through the cleft defect. CASE: We report a male infant who was born at 29 weeks of gestation with a left complete unilateral cleft lip and palate...
June 19, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28640930/orotracheal-intubation-in-infants-performed-with-a-stylet-versus-without-a-stylet
#19
REVIEW
Joyce E O'Shea, Jennifer O'Gorman, Aakriti Gupta, Sanjay Sinhal, Jann P Foster, Liam Af O'Connell, C Omar F Kamlin, Peter G Davis
BACKGROUND: Neonatal endotracheal intubation is a common and potentially life-saving intervention. It is a mandatory skill for neonatal trainees, but one that is difficult to master and maintain. Intubation opportunities for trainees are decreasing and success rates are subsequently falling. Use of a stylet may aid intubation and improve success. However, the potential for associated harm must be considered. OBJECTIVES: To compare the benefits and harms of neonatal orotracheal intubation with a stylet versus neonatal orotracheal intubation without a stylet...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#20
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
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