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Difficult intubation

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https://www.readbyqxmd.com/read/28797305/improved-success-rates-using-videolaryngoscopy-in-unexperienced-users-a-randomized-crossover-study-in-airway-manikins
#1
Hendrik Eismann, Lion Sieg, Nicola Etti, Lars Friedrich, Christian Schröter, Philipp Mommsen, Christian Krettek, Christian Zeckey
BACKGROUND: Videolaryngoscopy has been proven to be a safe procedure managing difficult airways in the hands of airway specialists. Information about the success rates in unexperienced users of videolaryngoscopy compared to conventional laryngoscopy is sparse. Therefore, we aimed to evaluate if there might be more success in securing an airway if the unexperienced provider is using a videolaryngoscope in simulated airways in a randomized manikin study. Differences between commonly used videolaryngoscopes were elucidated...
August 10, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#2
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
https://www.readbyqxmd.com/read/28781848/successful-difficult-airway-management-of-a-child-with-coffin-siris-syndrome
#3
Ahmet Selim Ozkan, Sedat Akbas, Mehmet Ridvan Yalin, Emine Ozdemir, Zeynep Koylu
Management of airway in patients who have Coffin-Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C-MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28771680/safety-and-efficacy-of-rescue-flexible-bronchoscopic-intubation-using-the-bentson-floppy-tip-guidewire-via-a-supraglottic-airway-in-critically-ill-children
#4
D Cross, A Nyman, P James, A Durward
Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation...
August 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28763433/injury-and-liability-associated-with-spine-surgery
#5
Rachel Kutteruf, Deva Wells, Linda Stephens, Karen L Posner, Lorri A Lee, Karen B Domino
BACKGROUND: Although spine surgery is associated with significant morbidity, the anesthesia liability profile for spine surgery is not known. We examined claims for spine procedures in the Anesthesia Closed Claims Project database to evaluate patterns of injury and liability. MATERIALS AND METHODS: A retrospective cohort study was performed. Inclusion criteria were anesthesia claims provided for surgical procedures in 2000 to 2014. We compared mechanisms of injury for cervical spine to thoracic or lumbar spine procedures using χ and the Fisher exact test...
July 31, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28763154/best-practices-in-peri-operative-management-of-patients-with-skeletal-dysplasias
#6
Klane K White, Viviana Bompadre, Michael J Goldberg, Michael B Bober, Tae-Joon Cho, Julie E Hoover-Fong, Melita Irving, William G Mackenzie, Shawn E Kamps, Cathleen Raggio, Gregory J Redding, Samantha S Spencer, Ravi Savarirayan, Mary C Theroux
Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia...
August 1, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#7
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28757825/sternomental-distance-and-sternomental-displacement-as-predictors-of-difficult-laryngoscopy-and-intubation-in-adult-patients
#8
Smita Prakash, Parul Mullick, Shyam Bhandari, Amitabh Kumar, Anoop Raj Gogia, Rajvir Singh
BACKGROUND: Several morphometric airway measurements have been used to predict difficult laryngoscopy (DL). This study evaluated sternomental distance (SMD) and sternomental displacement (SMDD, difference between SMD measured in neutral and extended head position), as predictors of DL and difficult intubation (DI). MATERIALS AND METHODS: We studied 610 adult patients scheduled to receive general anesthesia with tracheal intubation. SMD, SMDD, physical, and airway characteristics were measured...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28748861/current-evidences-for-the-use-of-uescope-in-airway-management
#9
REVIEW
Fu-Shan Xue, Ben-Quan Yang, Ya-Yang Liu, Hui-Xian Li, Gui-Zhen Yang
OBJECTIVE: UEscope is a new angulated videolaryngoscope (VL). This review aimed to describe the features of UEscope and provide clinical evidences regarding the efficacy and safety of this video device in adult tracheal intubation and its roles in airway management teaching. DATA SOURCES: The Wan Fang Data, CNKI, PubMed, Embase, Cochrane Library, and Google Scholar were searched for relevant English and Chinese articles published up to January 15, 2017, using the following keywords: "HC video laryngoscope", "UE videolaryngoscope", "video laryngoscope", and "videolaryngoscopy"...
August 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28745802/progressive-subglottic-stenosis-in-a-child-with-pallister-killian-syndrome
#10
Tadashi Shiohama, Katsunori Fujii, Kenji Shimizu, Hirofumi Ohashi, Tomozumi Takatani, Nobuhiko Okamoto, Gen Nishimura, Mitsuhiro Kato, Naoki Shimojo
Pallister-Killian syndrome (PKS) is rare genetic disorder caused by tetrasomy 12p mosaicism with supernumerary isochromosome 12p that manifests with intellectual disability, craniofacial dysmorphism, and epilepsy. Although PKS presents as a multisystem morphological defect, respiratory system involvement is rare, except for diaphragmatic hernia. We are the first to report a case of PKS with progressive subglottic stenosis. Subglottic stenosis is a potentially lethal condition due to severe respiratory obstruction and difficult intubation; therefore, further accumulation of cases is required to assess the causal link between PKS and subglottic stenosis...
July 26, 2017: Congenital Anomalies
https://www.readbyqxmd.com/read/28743345/-application-of-low-damage-endotracheal-intubation-in-patients-undergoing-extra-long-term-endotracheal-intubation-a-case-report
#11
Hao Wang, Baochun Ding
OBJECTIVE: To approach the effect of low damage endotracheal intubation on reducing the occurrence of cuff-related intubation complication and prolonging the intubation time. METHODS: On January 7th, 2015, 1 patient with respiratory failure after subarachnoid hemorrhage were admitted to Huludao Central Hospital. Immediate endotracheal intubation and ventilator assisted ventilation were performed. When the trachea was difficult to be removed in a short time, and tracheotomy was refused, a low damage endotracheal intubation was used for a long term...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#12
REVIEW
Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu, Gui-Zhen Yang
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28739243/heaven-criteria-derivation-of-a-new-difficult-airway-prediction-tool
#13
Daniel P Davis, David J Olvera
OBJECTIVE: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. METHODS: A retrospective descriptive analysis was performed in a population of air medical rapid sequence intubation patients requiring more than 1 attempt...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28738893/anaphylaxis-with-delayed-appearance-of-skin-manifestations-during-general-anesthesia-two-case-reports
#14
Hiroshi Hanamoto, Fumi Kozu, Aiko Oyamaguchi, Mika Inoue, Chizuko Yokoe, Hitoshi Niwa
BACKGROUND: Anaphylaxis is difficult to diagnose in the absence of skin or mucosal signs and symptoms. We report two cases of anaphylaxis under general anesthesia, in which the initial presentation was in the form of respiratory signs, followed by skin manifestations 10-15 min later. Diagnosis of anaphylaxis was delayed because skin symptoms were absent early on in the presentation. CASE PRESENTATION: In the first case, a 23-year-old male patient with jaw deformity was scheduled to undergo maxillary alveolar osteotomy...
July 24, 2017: BMC Research Notes
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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