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https://www.readbyqxmd.com/read/28314604/a-prospective-randomised-study-comparing-double-balloon-colonoscopy-and-conventional-colonoscopy-in-pre-defined-technically-difficult-cases
#1
Edward J Despott, Alberto Murino, Masanao Nakamura, Leonidas Bourikas, Chris Fraser
BACKGROUNDS AND AIM: Technically 'difficult' (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures. Double-balloon colonoscopy (DBC) may facilitate TD colonoscopy. The primary outcome was to compare the time taken to achieve caecal intubation during conventional colonoscopy (CC) and DBC in patient with a TD colon. METHODS: We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy. Patients were screened for parameters predictive of TD colonoscopy using an original scoring system and randomised to DBC or CC...
February 14, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28302228/anaesthetic-management-in-a-child-with-goldenhar-syndrome
#2
Waqas Ahmed Khan, Bushra Salim, Ausaf Ahmed Khan, Shakaib Chughtai
Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain. The boy had various features of Goldenhar syndrome, e.g. cleft palate, absent right eye and ear, right mandibular hypoplasia, micrognathia, and preauricular tags...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28299194/recent-trends-in-airway-management
#3
REVIEW
Joelle Karlik, Michael Aziz
Tracheal intubation remains a life-saving procedure that is typically not difficult for experienced providers in routine conditions. Unfortunately, difficult intubation remains challenging to predict and intubation conditions may make the event life threatening. Recent technological advances aim to further improve the ease, speed, safety, and success of intubation but have not been fully investigated. Video laryngoscopy, though proven effective in the difficult airway, may result in different intubation success rates in various settings and in different providers' hands...
2017: F1000Research
https://www.readbyqxmd.com/read/28298802/infantile-cystic-hygroma-an-unusual-perioperative-course
#4
Suman Saini, Madhu Dayal, Amita Gupta
Airway management of an infant with a giant cervical lump may be a difficult task. The anesthesiologist must be prepared to face associated challenges during securing the airway in such patients. We report our experience with One year old infant who presented with huge cystic hygroma in the cervical region leading to recurrent episodes of respiratory tract infection and distress. Surgical removal was needed as sclerotherapy proved ineffective in reducing its size. Proseal laryngeal mask airway was used as a conduit after inhalational induction since airway could not be maintained with bag and mask...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298796/anaesthetic-management-of-a-neuroectodermal-tumor-of-infancy-a-rare-case-report
#5
Pravin Ubale, Namita Baldwa, Pinakin Gujjar
Melanotic neuroectodermal tumor of infancy is a relatively uncommon osteolytic-pigmented neoplasm that primarily affects the jaws of infants. We report a 5-month-old male child who presented with a swelling in the right upper tooth region of upper jaw in which we face difficult mask ventilation as well as difficult intubation. Wide surgical excision was performed under general anesthesia. The uneventful course of anesthesia in the presented case was due to the thorough systemic evaluation and careful anesthetic strategy...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298771/attenuation-of-hemodynamic-response-to-skull-pin-head-holder-insertion-intravenous-clonidine-versus-intravenous-lignocaine-infusion
#6
Nethra H Nanjundaswamy, Vinay Marulasiddappa
BACKGROUND: Insertion of skull pin induces a significant increase in heart rate (HR), blood pressure (BP) and intracranial pressure. Alpha 2 agonist clonidine and intravenous (i.v.) lignocaine are effective in attenuating stress response. Local infiltration of pin site and scalp block with lignocaine are commonly used techniques for prevention of hemodynamic response to skull pin insertion. We compared the effectiveness of i.v. clonidine infusion and i.v. lignocaine infusion in suppressing the hemodynamic response to skull pin head holder insertion...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298767/airway-management-in-patients-with-tracheal-compression-undergoing-thyroidectomy-a-retrospective-analysis
#7
Binu Sajid, K Rekha
BACKGROUND: Airway management in large and retrosternal goiters with tracheal compression is often fraught with challenges and is a source of apprehension among anesthesiologists globally. AIMS: In this study we attempt to delineate the preferred techniques of airway management of such cases in our institution and also to assess whether airway management was unnecessarily complicated. SETTING AND DESIGN: Retrospective analysis. MATERIALS AND METHODS: A retrospective review was conducted of thyroidectomies performed in our institution over a three year period from January 2013...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298751/comparative-study-of-two-laryngeal-mask-airways-proseal-laryngeal-mask-airway-and-supreme-laryngeal-mask-airway-in-anesthetized-paralyzed-adults-undergoing-elective-surgery
#8
Ravneet Kaur Gill, Abhijit Tarat, Debagopal Pathak, Suneeta Dutta
CONTEXT: Supraglottic airway devices can act as an alternative to endotracheal intubation in both normal and difficult airway. LMA Proseal (P-LMA) and LMA Supreme (S-LMA) alongwith acting as effective ventilating device, provide port for gastric drainage. AIM: The objective of this study was to compare the two devices for effective ventilation and complications. SETTING AND DESIGN: A prospective, randomized, single-blinded study was conducted in a tertiary care teaching hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28295147/a-prospective-randomised-trial-of-pre-oxygenation-strategies-available-in-the-pre-hospital-environment
#9
C J Groombridge, E Ley, M Miller, T Konig
Pre-oxygenation before tracheal intubation aims to increase safe apnoea duration by denitrogenation of the functional residual capacity of the lungs, and increasing oxygen stores at the onset of apnoea. Pre-oxygenation options in the pre-hospital environment are limited due to oxygen availability and equipment portability. The aim of this study was to evaluate the effectiveness of strategies available in this setting. This was a prospective, randomised, crossover study of 30 healthy volunteers who underwent 3-min periods of pre-oxygenation by tidal volume breathing with a non-rebreather mask, a bag-valve-mask and a portable ventilator...
March 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28277485/flexible-co2-laser-treatment-for-subglottic-stenosis
#10
Rasit Cevizci, Alper Dilci, Ilknur Haberal Can, Burak Kersin, Yildirim Bayazit
OBJECTIVES: To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample. METHODS: Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center...
March 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28274023/evaluation-of-fastrach-laryngeal-mask-airway-as-an-alternative-to-fiberoptic-bronchoscope-to-manage-difficult-airway-a-comparative-study
#11
Radhey Shyam, Ajay Kumar Chaudhary, Pushplata Sachan, Prithvi Kumar Singh, Gyan Prakash Singh, Vinod Kumar Bhatia, Girish Chandra, Dinesh Singh
INTRODUCTION: Awake intubation via Fiberoptic Bronchoscope (FB) is the gold standard for management of difficult airway but patients had to face problems like oxygen desaturation, tachycardia, hypertension and anxiety due to awake state. This study was conducted to assess feasibility of Fastrach Laryngeal Mask Airway (FLMA) to manage difficult airway as a conduit for intubation as well as for ventilation. MATERIALS AND METHODS: After ethical approval and informed consent, 60 patients with difficult airway were randomly enrolled in FB group and FLMA group...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28267945/validation-of-a-difficult-endotracheal-intubation-simulator-designed-for-use-in-anaesthesia-training
#12
S Brettig, M Shurgott, S J Quinn, H Owen
There is a need for a validated endotracheal intubation trainer that has variable difficulty settings for the training and assessment of medical practitioners. In this study three anatomical modifications were retrofitted to a commercial manikin and then validated. These modifications included restricted movements of the mandible as well as changes to the upper incisors. A total of 130 participants comprising specialists, trainees and medical students volunteered for this study. Validity was tested using randomised between-groups comparison of the time taken to intubate the manikin on all settings...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28262247/use-of-the-totaltrack-vlm-for-emergent-endotracheal-intubation-in-predicted-difficult-airway-with-obstruction-by-expanding-space-occupying-lesions-and-reduced-interincisor-opening
#13
B Izquierdo-González, M Á Gómez-Ríos, E Freire-Vila
Acute cervical pathology may lead to serious airway compromise resulting from anatomical distortion secondary to obstruction or deviation of the upper airway, scenarios where any airway device can be fallible. Passage of a fiberoptic bronchoscopy to expose the glottis may be very difficult and tracheostomy may be impractical or risky in advanced cases. We present the use of the TotalTrack VLM to secure the airway for emergent surgery in 2 uncooperative patients with difficult airway due to Ludwig's angina and neck hematoma, respectively, both accompanied by trismus...
March 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28260232/generative-anatomy-modeling-language-gaml
#14
Doga Demirel, Alexander Yu, Seth Baer-Cooper, Tansel Halic, Coskun Bayrak
BACKGROUND: This paper presents the Generative Anatomy Modeling Language (GAML) for generating variation of 3D virtual human anatomy in real-time. This framework provides a set of operators for modification of a reference base 3D anatomy. The perturbation of the 3D models is satisfied with nonlinear geometry constraints to create an authentic human anatomy. METHODS: GAML was used to create 3D difficult anatomical scenarios for virtual simulation of airway management techniques such as Endotracheal Intubation (ETI) and Cricothyroidotomy (CCT)...
March 5, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28258945/the-performance-of-neck-circumference-and-other-airway-assessment-tests-for-the-prediction-of-difficult-intubation-in-obese-parturients-undergoing-cesarean-delivery
#15
J Eiamcharoenwit, N Itthisompaiboon, P Limpawattana, A Suwanpratheep, A Siriussawakul
BACKGROUND: Pregnancy and obesity each increase the chance of difficult tracheal intubation. This study assessed the performance of the neck circumference and other bedside tests for predicting difficult intubation, and aimed to identify the optimal cutoff point of the test(s) with the highest performance. METHODS: Parturients with a body mass index ≥30kg/m(2), undergoing a cesarean delivery employing conventional tracheal intubation, were enrolled. Preoperative neck circumference, sternomental distance and modified Mallampati test were examined...
February 5, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28255956/sound-level-intensity-severely-disrupts-sleep-in-ventilated-icu-patients-throughout-a-24-h-period-a-preliminary-24-h-study-of-sleep-stages-and-associated-sound-levels
#16
Maxime Elbaz, Damien Léger, Fabien Sauvet, Benoit Champigneulle, Stéphane Rio, Mélanie Strauss, Mounir Chennaoui, Christian Guilleminault, Jean Paul Mira
BACKGROUND: It is well recognized that sleep is severely disturbed in patients in intensive care units (ICU) and that this can compromise their rehabilitation potential. However, it is still difficult to objectively assess sleep quantity and quality and the determinants of sleep disturbance remain unclear. The aim of this study was therefore to evaluate carefully the impact of ICU sound intensity levels and their sources on ICU patients' sleep over a 24-h period. METHODS: Sleep and sound levels were recorded in 11 ICU intubated patients who met the criteria...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28246593/the-performance-of-the-intubation-difficulty-scale-among-obese-parturients-undergoing-cesarean-section
#17
Jatuporn Eiamcharoenwit, Napon Itthisompaiboon, Panita Limpawattana, Arunotai Siriussawakul
Background. There have not yet been any studies to validate the intubation difficulty scale (IDS) in obese parturients. Objectives of this study were to determine the performance of the IDS in defining difficult intubation (DI) and to identify the optimal cutoff points of the IDS among obese parturients. Methods. This was a prospective observational study. Parturients with a body mass index ≥ 30 kg/m(2) who underwent cesarean section utilizing endotracheal intubation were enrolled. The intubating performers were asked to assess the difficulty of endotracheal intubation and categorize it as easy, somewhat DI, and DI...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28244630/implementation-of-nap4-emergency-airway-management-recommendations-in-a-quaternary-level-pediatric-hospital
#18
Elliot Long, Domenic Cincotta, Joanne Grindlay, Anastasia Pellicano, Michael Clifford, Stefan Sabato
Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28236864/a-comparison-of-various-supraglottic-airway-devices-for-fiberoptical-guided-tracheal-intubation
#19
Thomas Metterlein, Anna Dintenfelder, Christoph Plank, Bernhard Graf, Gabriel Roth
BACKGROUND: Fiberoptical assisted intubation via placed supraglottic airway devices has been described as safe and easy procedure to manage difficult airways. However visualization of the glottis aperture is essential for fiberoptical assisted intubation. Various different supraglottic airway devices are commercially available and might offer different conditions for fiberoptical assisted intubation. The aim of this study was to compare the best obtainable view of the glottic aperture using different supraglottic airway devices...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235540/determination-of-the-diagnostic-value-of-the-modified-mallampati-score-upper-lip-bite-test-and-facial-angle-in-predicting-difficult-intubation-a-prospective-descriptive-study
#20
Ata Mahmoodpoor, Hassan Soleimanpour, Samad Ej Golzari, Arezoo Nejabatian, Tannaz Pourlak, Masoumeh Amani, Saeed Hajmohammadi, Hamzeh Hosseinzadeh, Robab Mehdizadeh Esfanjani
BACKGROUND: Difficult intubation is a significant cause of mortality and morbidity related to anesthesia. We decided to evaluate the value of Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in the prediction of difficult intubation. METHODS: In a prospective descriptive study, data from 132 patients who were candidates for elective maxillofacial surgeries under general anesthesia were gathered. Facial Angles were measured by a maxillofacial surgeon according to cephalometry...
February 2017: Journal of Clinical Anesthesia
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