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endoscopic procedures and sedation

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https://www.readbyqxmd.com/read/28230608/specialized-imaging-and-procedures-in-pediatric-pancreatology-a-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-clinical-report
#1
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP)...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28210094/endoscopic-ultrasound-sedation-in-the-united-kingdom-is-life-without-propofol-tolerable
#2
Jennifer Anne Campbell, Andrew James Irvine, Andrew Derek Hopper
There is compelling evidence to support the quality, cost effectiveness and safety profile of non-anesthesiologist-administered propofol for endoscopic ultrasound (EUS). However in the United Kingdom, it is recommended that the administration and monitoring of propofol sedation for endoscopic procedures should be the responsibility of a dedicated and appropriately trained anaesthetist only. The majority of United Kingdom EUS procedures are performed with opiate and benzodiazepine sedation rather than anaesthetist led propofol lists due to anaesthetist resource availability...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28181898/-placement-of-nasoenteral-feeding-tubes-by-nurses
#3
T H Mungroop, A Gerritsen, A Duflou, O R Busch, E M Mathus-Vliegen, M G Besselink
Electromagnetic-guided placement of nasoenteral feeding tubes by nurses is an alternative to endoscopic placement by gastroenterologists. During placement, the electromagnetic signal that is emitted by the tip of the guidewire enables visualisation of the position of the tube on a portable monitor. The procedure can be performed by a trained endoscopy nurse at the bedside of the patient. This could have logistic advantages, as the patient transport is not necessary and confirmation of the position of the tube by an abdominal X-ray is not required...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28181706/efficacy-of-midazolam-versus-propofol-based-sedations-by-non-anesthesiologists-during-therapeutic-endoscopic-retrograde-cholangiopancreatography-in-elderly-patients-over-80-years
#4
Su Jung Han, Tae Hoon Lee, Sang-Heum Park, Young Sin Cho, Yun Nah Lee, Yunho Jung, Hyun Jong Choi, Il-Kwun Chung, Sang-Woo Cha, Jong Ho Moon, Young Deok Cho, Sun-Joo Kim
BACKGROUND: As society ages, the need for ERCP is increasing. This prospective comparative study evaluated the safety and efficacy of midazolam- versus propofol-based sedations by non-anesthesiologists during therapeutic ERCP in patients over 80 years of age. METHODS: A total of 100 patients over 80 years of age who required therapeutic ERCP were enrolled and randomly received midazolam + fentanyl (MF group) or propofol + fentanyl (PF group) sedation. Endoscopic sedation was titrated to a moderate level and performed by trained registered nurses...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28179979/flexible-gastro-intestinal-endoscopy-clinical-challenges-and-technical-achievements
#5
REVIEW
Niehls Kurniawan, Martin Keuchel
Flexible gastro-intestinal (GI) endoscopy is an integral diagnostic and therapeutic tool in clinical gastroenterology. High quality standards for safety, patients' comfort, and efficiency have already been achieved. Clinical challenges and technical approaches are discussed in this short review. Image enhanced endoscopy for further characterization of mucosal and vascular patterns includes dye-spray or virtual chromoendoscopy. For confocal laser endoscopy, endocytoscopy, and autofluorescence clinical value has not yet been finally evaluated...
2017: Computational and Structural Biotechnology Journal
https://www.readbyqxmd.com/read/28176512/respiratory-adverse-events-during-upper-digestive-endoscopies-in-children-under-ketamine-sedation
#6
Jose C Flores-González, Alfonso M Lechuga Sancho, Mónica Saldaña Valderas, Gema Jimenez Gonzalez, Maria D Cruzado Garcia, Cristina Perez Aragon, Jose A Blanca Garcia
BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations. METHODS: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28158875/asa-classification-pre-endoscopic-procedures-a-retrospective-analysis-on-the-accuracy-of-gastroenterologists
#7
Shoba Theivanayagam, Kristi T Lopez, Michelle L Matteson-Kome, Matthew L Bechtold, Akwi W Asombang
OBJECTIVES: Before an endoscopic procedure, an evaluation to assess the risk of sedation is performed by the gastroenterologist. To risk stratify based on medical problems, the American Society of Anesthesiologists (ASA) classification scores are used routinely in the preprocedure evaluation. The objective of our study was to evaluate among physicians the ASA score accuracy pre-endoscopic procedures. METHODS: At a single tertiary-care center an institutional review board-approved retrospective study was performed...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28154379/editorial-endoscopic-sedation-who-which-when
#8
John M Inadomi
The costs of medical care are rising and media has focused attention on the costs of colonoscopy as a potential cause. A major component of procedural costs is the sedation, which is a combination of the drugs used and who administers them. An analysis of advanced endoscopic procedures revealed that the rate of sedation failure was significantly lower among patients administered sedation by anesthesia compared with patients who received moderate sedation administered by endoscopy staff. The authors argue that all endoscopic retrograde cholangiopancreatography (ERCP) should be performed with anesthesia-administered sedation...
February 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28135793/-patient-monitoring-and-associated-devices-during-endoscopic-sedation
#9
REVIEW
Sung Hoon Moon, Hyung Keun Kim, Dae Seong Myung, Soon Man Yoon, Won Moon
Sedation is an essential component for gastrointestinal endoscopy. It allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. For the safety during endoscopic sedation, patient monitoring is crucial. Minimal monitoring requirements during endoscopic sedation are periodic assessment of blood pressure and application of continuous pulse oximetry...
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28112967/will-societies-of-anesthesiologists-partake-in-the-take-off-of-non-anesthesiologist-administration-of-propofol
#10
Jean-Marc Dumonceau
Propofol sedation is increasingly used for standard and advanced endoscopies due to its advantages over traditional sedation based on benzodiazepines and/or opioids. These include a better sedation, greater patient cooperation, and higher patient satisfaction for most endoscopic procedures; it also decreases time to sedation and decreases recovery and discharge times. As anesthesiologists have typically provided propofol-based sedation, the increase in its use is limited by anesthesiologists' availability and cost...
February 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28100064/a-risk-stratifying-tool-to-facilitate-safe-late-stage-percutaneous-endoscopic-gastrostomy-in-als
#11
Alexander G Thompson, Victoria Blackwell, Rachael Marsden, Emma Millard, Clare Lawson, Annabel H Nickol, James E East, Kevin Talbot, Philip J Allan, Martin R Turner
BACKGROUND: The safety of percutaneous endoscopic gastrostomy (PEG) insertion in amyotrophic lateral sclerosis (ALS) patients with significant respiratory compromise has been questioned. OBJECTIVES: To review the characteristics of an ALS clinic patient cohort undergoing PEG, and the introduction of a risk stratification tool with procedural adaptations for higher-risk individuals. METHODS: Patients undergoing PEG insertion were analysed (n = 107)...
January 19, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28095614/over-the-scope-clip-closure-for-treatment-of-post-pancreaticogastrostomy-occurring-pancreatic-fistula-a-case-series
#12
Santi Mangiafico, Angelo Caruso, Raffaele Manta, Giuseppe Grande, Helga Bertani, Vincenzo Mirante, Flavia Pigò, Luigi Magnano, Mauro Manno, Rita Conigliaro
BACKGROUND AND AIM: The over-the-scope clip (OTSC) system is a recently developed endoscopic device. In the last few years it has been successfully used for severe bleeding or deep wall lesions, or perforations of the GI tract. We hereby report a series of patients with post pancreaticogastrostomy occuring pancreatic fistula in whom OTSCs were used as endoscopic treatment. METHODS: We prospectively collected data from January 2012 to July 2015 about cases of postoperative pancreatic fistula...
January 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28058020/high-flow-nasal-oxygen-availability-for-sedation-decreases-the-use-of-general-anesthesia-during-endoscopic-retrograde-cholangiopancreatography-and-endoscopic-ultrasound
#13
Roman Schumann, Nikola S Natov, Klifford A Rocuts-Martinez, Matthew D Finkelman, Tom V Phan, Sanjay R Hegde, Robert M Knapp
AIM: To examine whether high-flow nasal oxygen (HFNO) availability influences the use of general anesthesia (GA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) and associated outcomes. METHODS: In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras (era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era (era 2)...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28004964/patient-safety-under-deep-sedation-for-digestive-endoscopic-procedures
#14
Julián Álvarez, Rafael Cabadas, Manuel de la Matta
Deep sedation with Propofol has become popular in recent years. The safety of this technique when administered by non-anaesthesiologists has created much controversy which at times is masked in a contentious debate on the economic sustainability of the health system. In 2011, the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy, along with 20 other organisations from European countries, revoked the recommendations of the European Society of Gastrointestinal Endoscopy on the administration of Propofol by non-anaesthesiologists, citing that it is "extremely dangerous for the safety and quality of endoscopic procedures"...
December 22, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27995433/direct-percutaneous-endoscopic-jejunostomy-dpej-tube-placement-a-single-institution-experience-and-outcomes-to-30-days-and-beyond
#15
Andrew T Strong, Gautam Sharma, Matthew Davis, Michael Mulcahy, Suriya Punchai, Colin P O'Rourke, Stacy A Brethauer, John Rodriguez, Jeffrey L Ponsky, Matthew D Kroh
INTRODUCTION: Patients with prior foregut surgery requiring long-term enteral access typically undergo operative jejunostomy tube placement; however, direct percutaneous endoscopic jejunostomy (DPEJ) is a viable alternative. METHODS: All de novo DPEJ procedures performed by surgical and advanced endoscopists from May 2003 to June 2015 were retrospectively reviewed following approval by the Institutional Review Board. There were 59 cases identified. RESULTS: Our cohort had a mean age of 50...
December 19, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27992862/endobronchial-valves-for-endoscopic-lung-volume-reduction-best-practice-recommendations-from-expert-panel-on-endoscopic-lung-volume-reduction
#16
Dirk-Jan Slebos, Pallav L Shah, Felix J F Herth, Arschang Valipour
Endoscopic lung volume reduction (ELVR) is being adopted as a treatment option for carefully selected patients suffering from severe emphysema. ELVR with the one-way endobronchial Zephyr valves (EBV) has been demonstrated to improve pulmonary function, exercise capacity, and quality of life in patients with both heterogeneous and homogenous emphysema without collateral ventilation. In this "expert best practices" review, we will highlight the practical aspects of this therapy. Key selection criteria for ELVR are hyperinflation with a residual volume >175% of predicted, forced expiratory volume <50% of predicted, and a 6-min walking distance >100 m...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27990602/endoscopic-tympanoplasty-learning-curve-for-a-surgeon-already-trained-in-microscopic-tympanoplasty
#17
Sedat Doğan, Cem Bayraktar
The aim of this study was to evaluate the learning curve of endoscopic tympanoplasty for a surgeon already trained in microscopic tympanoplasty. We analyzed the clinical records of 81 patients who underwent transcanal endoscopic type 1 tympanoplasty and 30 control patients who underwent microscopic tympanoplasty between 2013 and 2015 in a tertiary hospital. All operations were performed by a single surgeon already trained in microscopic tympanoplasty. Patients were divided into four groups according to the date of surgery chronologically (group 1 early stage, group 2 intermediate stage, group 3 advanced stage and group 4 control)...
December 18, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27984382/diagnostic-yield-and-complications-of-ebus-tbna-performed-under-bronchoscopist-directed-conscious-sedation-single-center-experience-of-1004-subjects
#18
Sahajal Dhooria, Inderpaul S Sehgal, Nalini Gupta, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can be performed under either conscious sedation or general anesthesia. Herein, we describe the diagnostic yield and complications of EBUS-TBNA performed under bronchoscopist-directed conscious sedation. METHODS: This is a retrospective analysis of data collected in the bronchoscopy suite of this center on EBUS-TBNA or endoscopic ultrasound with a bronchoscope-guided fine needle aspiration (EUS-B-FNA) procedures performed between July 2011 and January 2016...
January 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27979641/awake-laryngoscopy-in-the-emergency-department
#19
Joseph E Tonna, Peter M C DeBlieux
BACKGROUND: Many emergency physicians gain familiarity with the laryngeal anatomy only during the brief view achieved during rapid sequence induction and intubation. Awake laryngoscopy in the emergency department (ED) is an important and clinically underutilized procedure. DISCUSSION: Providing benefit to the emergency physician through a slow, controlled, and deliberate examination of the airway, awake laryngoscopy facilitates confidence in the high-risk airway and eases the evolution to intubation, should it be required...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27931639/complications-in-pediatric-endoscopy
#20
REVIEW
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
The experience of the "endoscopic community" in pediatric patients is limited, but during recent years increased skills of the endoscopists and technological improvements lead to a standardization of pediatric endoscopy and the development of specialized pediatric endoscopy unit. Adverse events related to diagnostic and therapeutic endoscopy in children are usually rare. Diagnosis, prevention and treatment of complications in pediatric endoscopy is crucial when dealing with benign diseases in children. The complication rate of diagnostic EGD and colonoscopy in children are extremely low...
October 2016: Best Practice & Research. Clinical Gastroenterology
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