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Difficult intubation

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https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#1
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28422820/comparison-of-the-etview-single-lumen-and-macintosh-laryngoscopes-for-endotracheal-intubation-in-an-airway-manikin-with-immobilized-cervical-spine-by-novice-paramedics-a-randomized-crossover-manikin-trial
#2
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Barak Cohen, Kurt Ruetzler, Lukasz Szarpak
CONTEXT: Management of the airway of a trauma victim is considered challenging. Various approaches have been described to achieve airway control in this setup; many of them include video-assited viewing of the larynx during intubation. ETView Single Lumen (SL) is a novice single-use endotracheal tube equiped with a video camera and a light source at its distal tip. Its use was previously described in seeral clinical and training setups. OBJECTIVE: The aim was to evaluate the efficacy of the VivaSight SL compared with classic direct laryngoscopy performed with a Macintosh blade in a manikin-simulated trauma setup presenting various degrees of airway challenge when performed by inexperienced physicians...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28413282/comparison-of-success-of-tracheal-intubation-using-macintosh-laryngoscope-assisted-bonfils-fiberscope-and-truview-video-laryngoscope-in-simulated-difficult-airway
#3
Bangaru Vivek, R Sripriya, Gayatri Mishra, M Ravishankar, S Parthasarathy
BACKGROUND AND AIMS: Restriction of head and neck movements prevents the alignment of the oral, pharyngeal, and laryngeal axes and increases the incidence of difficult tracheal intubation in patients with cervical spine fractures. Video laryngoscopes have gained an important role in the management of difficult intubation, especially in situations with limited head and neck movements. This study compares the success of intubation using Macintosh laryngoscope assisted Bonfils(®) fiberscope (ML-BF) with Truview(PCD) video laryngoscope (TV) in patients with simulated restricted head and neck movements...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28410931/a-model-of-recovery-from-inhalation-injury-and-cutaneous-burn-in-ambulatory-swine
#4
David M Burmeister, Matthew K McIntyre, Brendan Beely, Bryan Jordan, Kerfoot P Walker, James K Aden, Andriy Batchinsky, Kevin K Chung, Leopoldo C Cancio, Robert J Christy
Inhalation injury commonly accompanies thermal injury, increasing the likelihood of mortality and multiple organ dysfunction (MOD). Large animal models have given important insight into the pathophysiology of this injury; however recapitulating late MOD has remained difficult. The current report describes experiments using a smoke inhalation and burn model, with follow-up of ambulatory swine for 14days with bronchoscopy, CT scanning, and bronchoalveolar lavage fluid (BALF)/blood collection. Clinically, animals cleared airway damage in the first several days after-injury...
April 11, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28409758/improving-neonatal-intubation-safety-a-journey-of-a-thousand-miles
#5
T Sawyer, E E Foglia, L Dupree Hatch, A Moussa, A Ades, L Johnston, A Nishisaki
Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is extremely difficult, and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28408955/masticatory-muscle-tendon-aponeurosis-hyperplasia-a-new-clinical-entity-of-limited-mouth-opening
#6
REVIEW
Tsuyoshi Sato, Tetsuya Yoda
Limited mouth opening is a common health problem that interferes with eating, makes examination of the oral cavity difficult, and may increase the mortality rate during emergency intubation. Here we introduce a disease designated as masticatory muscle tendon-aponeurosis hyperplasia, which is a new clinical condition of limited mouth opening. Most oral surgeons and dentists are still unaware of this disease condition, thus increasing the risk of incorrect diagnosis as some other disease, such as temporomandibular joint disorder...
May 2016: Japanese Dental Science Review
https://www.readbyqxmd.com/read/28408081/-nondepolarizing-muscle-relaxant-improves-direct-laryngoscopy-view-with-no-effect-on-face-mask-ventilation
#7
Marwan S Rizk, Salah M Zeineldine, Mohamad F El-Khatib, Vanda G Yazbeck-Karam, Sophie D Ayoub, Pierre K Bou-Khalil, Elie Abi-Nader, Marc M Ghabach, Chakib M Ayoub
BACKGROUND: Difficult or impossible face mask ventilation complicated with difficult tracheal intubation during anesthesia induction occurs in 0.4% of adult anesthesia cases, possibly leading to life-threatening complications. Because of such catastrophes, muscle relaxants have been recommended to be administered after confirming adequate face mask ventilation without a solid scientific validation of this principal. METHODS: In this observational study, the ease of ventilation and the scores of direct laryngoscopy views before and after administration of cisatracurium were assessed in ninety young healthy adults, without anesthetic risks and without foreseen difficult intubation and who were scheduled for general elective surgeries...
April 10, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28405043/anaesthetic-management-of-a-child-with-stone-man-syndrome-look-before-you-leap
#8
Geeta Kamal, Anju Gupta, Sapna Batla, Nishkarsh Gupta
Stone Man syndrome or fibrodysplasia ossificans progressiva (FOP) is an extremely rare (1 in 2 million) genetic disorder characterised by ectopic ossification of the skeletal and connective tissues leading to progressive fusion of axial and appendicular skeleton. Surgery and anaesthesia-induced trauma can lead to disease flare-up if due precautions are not taken and disable the patient further. However, rarity of the disease may lead to its common misdiagnosis and anaesthesiologist may be caught unaware. There is relative paucity of literature regarding anaesthetic management of children with FOP...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28405036/rapidity-and-efficacy-of-ultrasonographic-sliding-lung-sign-and-auscultation-in-confirming-endotracheal-intubation-in-overweight-and-obese-patients
#9
Sunil Rajan, Jayasankar Surendran, Jerry Paul, Lakshmi Kumar
BACKGROUND AND AIMS: Obese individuals are predisposed to difficult airway and intubation. They usually yield confusing or misleading auscultatory findings. We aimed to assess the rapidity and efficacy of ultrasonographic (USG) sliding lung sign for confirming endotracheal intubation in normal as well as overweight and obese surgical patients. METHODS: This prospective, observational study was performed in forty surgical patients. Twenty patients with body mass index (BMI) <25 were recruited to Group A, whereas twenty patients with BMI ≥25 constituted Group B...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28404553/airway-emergencies-presenting-to-the-paediatric-emergency-department-requiring-advanced-management-techniques
#10
Leopold Simma, Domenic Cincotta, Stefan Sabato, Elliot Long
BACKGROUND: Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. AIMS: This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. METHODS: A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia...
April 12, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28403413/can-tongue-thickness-measured-by-ultrasonography-predict-difficult-tracheal-intubation
#11
W Yao, Bin Wang
Background.: Increased tongue thickness is likely to be associated with difficult airways. However, no methods to evaluate tongue thickness were available. Currently, tongue thickness can be measured by ultrasonography. The present study investigated the predictive value of tongue thickness to predict difficult tracheal intubation. Methods.: Adult patients undergoing tracheal intubation and general anaesthesia were enrolled in the study. Tongue thickness was assessed using submental ultrasonography in the median sagittal plane before anaesthesia...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#12
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10 - 17% in the general population. Its prevalence in the surgical population seems to be higher. However, a proportion of up to 60% of patients may not have a formal diagnosis at the moment of preoperative visit. OSA is associated with a number of comorbidities and increased perioperative risks. However, most interventions for the perioperative management of OSA patients lack high quality evidence...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#13
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28393782/thyromental-height-test-for-prediction-of-difficult-laryngoscopy-in-patients-undergoing-coronary-artery-bypass-graft-surgical-procedure
#14
Nilesh Jain, Sucharita Das, Muralidhar Kanchi
BACKGROUND: Patients undergoing coronary artery bypass graft (CABG) procedures have higher incidence of difficult laryngoscopy and intubation than general surgery population. Accurate prediction of difficult laryngoscopy in CABG patients is desirable to reduce the hemodynamic response and myocardial oxygen requirements. Recently, thyromental height test (TMHT) has been proposed as one of the highly sensitive and specific bedside tests to predict difficult airway. We, in our prospective observational study, evaluated the accuracy of the TMHT in predicting difficult laryngoscopy...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28383450/long-term-outcomes-after-continent-ileostomy-creation-in-patients-with-crohn-s-disease
#15
Erman Aytac, David W Dietz, Jean Ashburn, Feza H Remzi
BACKGROUND: Patients with Crohn's disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis. OBJECTIVE: We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn's disease diagnosis and aimed to assess long-term outcomes. DESIGN: This was a retrospective cohort study. SETTINGS: The investigation took place in a high-volume, specialized colorectal surgery department...
May 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28382880/a-comparison-of-three-maneuvers-and-their-effect-on-laryngoscopic-view-time-to-intubate-and-intubation-outcome-by-novice-intubators-in-a-simulated-airway
#16
Christopher Stein, Louis Gerber, Denis Curtin, Nicole Oberem, Mike Wells
Aim The goal of this study was to compare the relative effectiveness of three adjunctive maneuvers - head elevation (HE), forward laryngoscope traction (FT), and external laryngeal manipulation (ELM) - on laryngoscopic view, intubation time, and intubation success performed by a sample of novice intubators using a simulated airway. METHODS: Twenty-two second year university paramedic students were required to perform laryngoscopy and intubation on a simulator four times on two separate days...
April 6, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28376741/neck-circumference-to-inter-incisor-gap-ratio-a-new-predictor-of-difficult-laryngoscopy-in-cervical-spondylosis-patients
#17
Yong-Zheng Han, Yang Tian, Mao Xu, Cheng Ni, Min Li, Jun Wang, Xiang-Yang Guo
BACKGROUND: Preoperative airway assessment help anticipate a difficult airway. We hypothesized that a close association existed between difficult laryngoscopy and the neck circumference/inter-incisor gap ratio (RNIIG). Our aim was to determine its utility in predicting difficult laryngoscopy in cervical spondylosis patients. METHODS: Two hundred thirteen consecutive patients, aged 20-70 years, scheduled to undergo cervical spine surgery under general anesthesia, were recruited...
April 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28375709/a-novel-hands-free-abdominal-compression-device-for-colonoscopy-significantly-decreases-cecal-intubation-time-a-prospective-single-blinded-pilot-study
#18
Allison R Schulman, Marvin Ryou, Walter W Chan
BACKGROUND: Colonoscopy outcome is limited by endoscope looping, which leads to patient discomfort, prolonged procedure, and increased sedation requirement. Traditional manual abdominal pressure is imprecise and manually intensive. A hands-free abdominal compression device (ACD) may improve colonoscopy outcome. We aimed to assess the effect of a novel ACD on colonoscopy outcomes compared to manual pressure. MATERIALS AND METHODS: This was a prospective single-blinded study of patients undergoing outpatient colonoscopy...
April 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28368915/reduction-of-pressure-related-complications-with-an-improved-method-of-securing-endotracheal-tubes-in-burn-patients-with-facial-burns
#19
Angela B Whitley, Rachel M Nygaard, Frederick W Endorf
Facial burns are extremely common in the burn population, as is the need for endotracheal intubation. However, securing the endotracheal tube in these patients can be difficult. Our institution's historically preferred method of securing tubes with twill tape was effective but had a high rate of device-related pressure ulcers. The introduction of new silicone pressure-reducing strips for use in conjunction with twill tape was effective in reducing the incidence of pressure ulcers in this patient population from 21% to 5% (P = ...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28366293/procedural-difficulties-during-successful-intubation-in-octogenarians-a-prospective-observational-study
#20
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
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