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Difficult intubation

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https://www.readbyqxmd.com/read/29775510/educational-intervention-on-delirium-assessment-using-confusion-assessment-method-icu-cam-icu-in-a-general-intensive-care-unit
#1
Vimala Ramoo, Harlinna Abu, Vineya Rai, Surindar Kaur Surat Singh, Ayuni Asma' Baharudin, Mahmoud Danaee, Raveena Rajalachimi R Thinagaran
AIMS AND OBJECTIVES: The primary objective was to assess intensive care unit nurses' knowledge of intensive care unit delirium and delirium assessment before and after an educational intervention. In addition, nurses' perception on the usefulness of a delirium assessment tool and barriers against delirium assessment were assessed as secondary objectives. BACKGROUND: Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29766735/-a-case-of-post-intubation-tracheal-stenosis-mimicking-bronchial-asthma-case-report
#2
Monika Šatánková, Kristián Brat, Zdeněk Merta, Miloš Šteffl
Postintubation tracheal stenosis (PITS) is one of the most frequent causes of lower airways obstruction. Usually, PITS is the consequence of prolonged intubation period, but may occur also after short-term intubation. Diagnosis may be difficult if stridor is not present and the post-extubation period is many years long. Bronchoscopy and CT scanning are the diagnostic gold standard. In some cases, lung function tests may also be helpful. Treatment options include conservative treatment, surgery and endoscopic methods...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29761867/airway-physical-examination-tests-for-detection-of-difficult-airway-management-in-apparently-normal-adult-patients
#3
REVIEW
Dominik Roth, Nathan L Pace, Anna Lee, Karen Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner
BACKGROUND: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. OBJECTIVES: The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757793/technique-utilizing-a-modified-oral-ring-adair-elwyn-tube-to-provide-continuous-oxygen-and-sevoflurane-delivery-during-nasotracheal-intubation-in-an-infant-with-a-difficult-airway-a-case-report
#4
Janice Y Man, John E Fiadjoe, Grace Hsu
Managing the airway of an infant with Pierre Robin sequence (PRS) is particularly challenging for anesthesiologists. Patients with PRS have the triad of micrognathia, glossoptosis, and airway obstruction that potentially and frequently leads to difficulty with both ventilation and intubation. Thus continuous oxygenation and spontaneous ventilation during intubation are essential. We describe a new method to deliver continuous oxygen and volatile anesthetic during nasotracheal intubation in an infant with PRS...
May 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29756059/pre-selection-of-primary-intubation-technique-is-associated-with-a-low-incidence-of-difficult-intubation-in-patients-with-a-bmi-of-35-kg-m-2-or-higher
#5
Tiberiu Ezri, Ronen Waintrob, Yuri Avelansky, Alexander Izakson, Katia Dayan, Mordechai Shimonov
Background: The incidence of difficult intubation (DI) in obese patients may reach a two-digit figure. No studies have assessed the effect of primary use of special intubation devices on lowering the incidence of DI. We assessed the effect of primary selection of special intubation techniques on the incidence of DI in patients with a BMI of 35 kg/m2 or higher. Patients and methods: Data from 546 patients with a BMI of 35 kg/m2 or higher who underwent bariatric surgery at Wolfson Medical Center from 2010 through 2014 was retrospectively extracted and analyzed for demographics, predictors of DI and intubation techniques employed...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29744389/orotracheal-intubation-in-a-patient-with-difficult-airway-by-using-fiberoptic-nasotracheal-intubation-a-case-report
#6
Hye Joo Yun, Eunsun So, Myong-Hwan Karm, Hyun Jeong Kim, Kwang-Suk Seo
In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube...
April 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29744387/dexamethasone-treatment-for-bilateral-lingual-nerve-injury-following-orotracheal-intubation
#7
Saeyoung Kim, Seung-Yeon Chung, Si-Jeong Youn, Younghoon Jeon
Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman...
April 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29743844/difficult-colonoscopy-air-carbon-dioxide-or-water-insufflation
#8
Alisha Chaubal, Vikas Pandey, Ruchir Patel, Prateik Poddar, Aniruddha Phadke, Meghraj Ingle, Prabha Sawant
Background/Aims: This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation). Methods: Patients with body mass index (BMI) less than 18 kg/m2 or more than 30 kg/m2 , or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy...
April 2018: Intestinal Research
https://www.readbyqxmd.com/read/29743774/indolent-systemic-mastocytosis-manifesting-as-protracted-anaphylactic-shock
#9
Manidipam Chatterjee, Saikat Sengupta, Chandrashish Chakravarty, Suresh Ramasubban, Shilpa Bhartia, Sujoy Khan, Vikash Kumar Agarwal
Systemic mastocytosis is a rare disease due to abnormal proliferation of mast cells (MCs). A case of indolent systemic mastocytosis is presented here. After anesthetic induction for elective thyroid swelling with propofol and atracurium followed by endotracheal intubation, a 57-year-old female patient developed acute hypotension, sinus tachycardia, red rashes, increased airway pressure along with difficult ventilation, and desaturation. She developed multiorgan failure subsequently. MC tryptase level was persistently high...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29733530/another-cause-of-difficult-airway-in-an-elderly-patient-tongue-base-abscess
#10
Murat Binar, Fatih Arslan, Umit Aydin
OBJECTIVE: An abscess of the tongue base is rare, but it can be a potentially life-threatening situation in elderly patients. CASE REPORT: A 72-year-old male patient presented with mid-anterior neck swelling, odynophagia, poor oral hygiene and severe dyspnoea. After a difficult intubation, the muscles were dissected via a submental suprahyoid approach and the abscess was drained. CONCLUSION: Poor oral hygiene may predispose elderly patients to tongue-base abscesses...
June 2018: Gerodontology
https://www.readbyqxmd.com/read/29732908/airway-anomalies-in-patients-with-22q11-2-deletion-syndrome-a-5-year-review
#11
Joel W Jones, Meghan Tracy, Mollie Perryman, Jill M Arganbright
OBJECTIVES: To characterize the frequency of airway anomalies in patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Retrospective review of patients with 22q11DS who had undergone microlaryngoscopy/bronchoscopy (MLB) for aerodigestive symptoms at a tertiary care children's hospital from 2011 to 2016. RESULTS: Thirty patients underwent an MLB due to the following indications: aspiration (11), stridor (10), chronic respiratory failure due to ventilator dependence (8), and difficult intubation (1)...
May 1, 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29728755/ed50-of-remifentanil-for-providing-excellent-intubating-conditions-when-co-administered-with-a-single-standard-dose-of-propofol-without-the-use-of-muscle-relaxants-in-children-dose-finding-clinical-trial
#12
Andre Hideo Ono, Thiago Rocha Moura, Cátia Sousa Govêia, Gabriel Magalhães Nunes Guimarães, Luís Cláudio de Araújo Ladeira, Helga Bezerra Gomes da Silva
PURPOSE: Previous studies evidenced that orotracheal intubation without neuromuscular blockers is feasible in children and has some potential advantages. Remifentanil has favorable pharmacodynamic and pharmacokinetic properties as an opioid for orotracheal intubation, but its dose for excellent intubation conditions when co-administered with propofol has not been established. This study was designed to find the minimum effective dose of remifentanil for excellent intubation conditions of children when co-administered with propofol, without neuromuscular relaxant drugs...
May 4, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29721247/anesthesia-in-mowat-wilson-syndrome-information-on-11-italian-patients
#13
Marianna Spunton, Livia Garavelli, Paola Cerutti Mainardi, Uta Emmig, Enrico Finale, Andrea Guala
Mowat-Wilson syndrome is a genetic disease caused by heterozygous mutations or deletions of the ZEB2 gene and characterized by typical clinical features. The congenital malformations typical of this syndrome call for early diagnostic and surgical procedures requiring general anesthesia, but few information about the anesthesiology management of such patients is available. We enrolled 11 families of patients with Mowat-Wilson syndrome who had undergone surgical or diagnostic procedures requiring general anesthesia, and sent them a retrospective questionnaire including 16 open questions about the procedures...
March 22, 2018: Pediatric Reports
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#14
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29717916/risk-factors-associated-with-the-development-of-acquired-airway-disease-after-congenital-heart-surgery-a-retrospective-cohort-study
#15
Andrew J Matisoff, Pranathi Ari, David Zurakowski, Alexandra G Espinel, Nina Deutsch, Brian K Reilly
OBJECTIVE: In this single-center, retrospective review, we sought to determine the risk factors associated with the development of severe acquired airway disease (AAD; vocal cord paralysis [VCP] or subglottic stenosis [SGS]) in pediatric patients who had undergone surgery for congenital heart disease (CHD) with cardiopulmonary bypass. All patients who required surgical treatment for CHD using cardiopulmonary bypass at our institution between 2010 and 2015 were reviewed. We defined severe AAD as either clinically significant VCP, SGS, or both, requiring consultation with the otolaryngology (ENT) service for evaluation...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29708570/longer-operative-time-is-associated-with-increased-adverse-events-after-anterior-cervical-diskectomy-and-fusion-15-minute-intervals-matter
#16
Nathaniel T Ondeck, Daniel D Bohl, Ryan P McLynn, Jonathan J Cui, Patawut Bovonratwet, Kern Singh, Jonathan N Grauer
Little is known about the impact of operative time, as an independent and interval variable, on general health perioperative outcomes following anterior cervical diskectomy and fusion. Therefore, patients undergoing a 1-level anterior cervical diskectomy and fusion were identified in the American College of Surgeons National Surgical Quality Improvement Program. Operative time (as an interval variable) was tested for association with perioperative outcomes using a multivariate regression that was adjusted for differences in baseline characteristics...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29707376/is-laryngeal-mask-airway-general-anesthesia-feasible-for-minimally-invasive-esophagectomy
#17
Rui-Xiang Zhang, Yin Li, Xian-Ben Liu, Xi-Hua Lu, Hai-Bo Sun, Zong-Fei Wang, Shi-Lei Liu, Yan Zheng, Xiao-Fei Liu, Xiu-Xia Wu
Minimally invasive esophagectomy (MIE) has been identified as an oncological method with lower mortality and morbidity. This procedure is usually performed under general anesthesia using double endotracheal tube intubation and one-lung ventilation for a good visualization like other video-assisted thoracoscopic surgery (VATS). However, it is difficult to differentiate weather the postoperative hoarseness is caused by intubation or by recurrent laryngeal nerve injury during operation, and some complications related to intubation also are the focus of thoracic surgeons...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29706113/neck-haematoma-after-carotid-endarterectomy-risks-rescue-and-prevention
#18
Tomonori Tamaki, Akio Morita
OBJECTIVE: This study was performed to identify risk factors for neck haematoma requiring re-exploration after carotid endarterectomy. Neck haematoma is a well-known complication after carotid endarterectomy, but there has been little discussion about intraoperative techniques for its prevention. We also investigated an intraoperative neck flexion technique for prevention of neck haematoma. METHODS: A retrospective study reviewed 384 carotid endarterectomies performed at our institution from 2003 to 2016...
April 28, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#19
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696123/comparative-analysis-of-the-usefulness-of-the-glidescope-%C3%A2-macintosh-and-mccoy-laryngoscopes-for-endotracheal-intubation-in-patients-with-obesity-a-randomized-clinical-trial
#20
Seyed Reza Akbarzadeh, Maryar Taghavi Gillani, Masoumeh Tabari, Negar Morovatdar
Background: Difficult intubation is dangerous and sometimes fatal, especially in patients with obesity. In difficult intubation cases the best device should be applied to decrease the risk of complications. The current study aimed at comparing laryngoscopes, Macintosh, McCoy, GlideScope® and devices for intubation purposes. Methods: A total of 102 patients with obesity and ASA (American society of anesthesiologists) class I or II, and body mass index (BMI) of > 30 kg/m2 were selected...
December 2017: Anesthesiology and Pain Medicine
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