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Upper airway emergency

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https://www.readbyqxmd.com/read/28331381/retrospective-nonrandomized-controlled-study-on-autoadjusting-dual-pressure-positive-airway-pressure-therapy-for-a-consecutive-series-of-complex-insomnia-disorder-patients
#1
Barry Krakow, Natalia D McIver, Victor A Ulibarri, Michael R Nadorff
PURPOSE: Emerging evidence shows that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) in chronic insomnia patients (proposed "complex insomnia" disorder) leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP) is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28303104/mathematical-modeling-of-streptococcus-pneumoniae-colonization-invasive-infection-and-treatment
#2
Elisa Domínguez-Hüttinger, Neville J Boon, Thomas B Clarke, Reiko J Tanaka
Streptococcus pneumoniae (Sp) is a commensal bacterium that normally resides on the upper airway epithelium without causing infection. However, factors such as co-infection with influenza virus can impair the complex Sp-host interactions and the subsequent development of many life-threatening infectious and inflammatory diseases, including pneumonia, meningitis or even sepsis. With the increased threat of Sp infection due to the emergence of new antibiotic resistant Sp strains, there is an urgent need for better treatment strategies that effectively prevent progression of disease triggered by Sp infection, minimizing the use of antibiotics...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28275860/parameters-affecting-length-of-stay-in-a-pediatric-emergency-department-a-retrospective-observational-study
#3
Kevin D Hofer, Rotraud K Saurenmann
Prolonged emergency department (ED) length of stay (LOS) is used as a proxy for ED overcrowding and is associated with adverse outcomes of patients requiring therapy and reduced patient satisfaction. Our aim was to identify and quantify variables which affect ED-LOS. Patients admitted to the pediatric ED of a large regional Swiss hospital during a 1-year period were analyzed for LOS (in minutes). Predictor variables included patient-associated parameters (time of admission and discharge, ED occupancy, triage score, diagnosis, and demographic data) and external factors (weekday, time, and season)...
March 8, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28268756/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#4
Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De
Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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
#5
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/28239576/cut-throat-injury-our-experience-in-rural-set-up
#6
Debdulal Chakraborty, Chiranjib Das, Arvind Kumar Verma, Rajesh Hansda
Cut throat injuries are one of the emergency conditions managed by ENT specialists. If not treated in time, they may lead to death. Prevention of these complications depends on immediate resuscitation by securing the airway by tracheostomy or intubation, prompt control of hemorrhage and blood replacement. The present study was conducted to study the sociodemographic profile of patients of cut throat injury, motives behind cut throat injury, site and depth of the injury, treatment given at our hospital and outcome...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28237950/emergency-cricothyroidotomy-following-tracheobronchial-stenting
#7
Simon Robert Cavinato, Mike Denning, Brendan P Madden
A man aged 51 years was referred for tracheobronchial stenting after a poorly differentiated oesophageal carcinoma had progressed to cause stridor. Bronchoscopy revealed a left vocal cord palsy and tumour infiltration into the trachea. A tracheobronchial stent was placed, and after distal migration was endoscopically resited. Returning from theatre, the patient developed severe upper airway obstruction that progressed to cause CO2 narcosis and loss of consciousness. A rapid sequence induction was initiated, and a Glidescope revealed bilateral vocal cord palsy with severe oedema causing an inability to pass a tube or stylet...
February 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28226944/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#8
Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De, Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De, Suvranu De, Marc DeMoya, Kathryn L Butler, Ganesh Sankaranarayanan, Adam Ryason
Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225496/impact-of-nasal-symptoms-on-the-evaluation-of-asthma-control
#9
Chien-Chia Huang, Po-Hung Chang, Pei-Wen Wu, Chun-Hua Wang, Chia-Hsiang Fu, Chi-Che Huang, Hsiao-Jung Tseng, Ta-Jen Lee
The united airways concept suggests that patients with asthma typically exhibit parallel inflammation in the upper airway. The resulting nasal symptoms should reduce quality of life and substantially affect the evaluation of asthma control among these patients. This study aimed to assess the association of nasal symptoms with the evaluation of asthma control.Fifty-eight patients with asthma and persistent nasal symptoms were prospectively recruited for evaluations of their sinonasal symptoms and asthma control in a cross-sectional study from August 2013 to June 2016...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225162/mandibular-position-and-movements-suitability-for-diagnosis-of-sleep-apnoea
#10
Jean-Benoit Martinot, Jean-Christian Borel, Valérie Cuthbert, Hervé Jean-Pierre Guénard, Stéphane Denison, Philip E Silkoff, David Gozal, Jean-Louis Pepin
BACKGROUND AND OBJECTIVE: Mandibular movements (MMs) and position during sleep reflect respiratory efforts related to increases in upper airway resistance and micro-arousals. The study objective was to assess whether MM identifies sleep-disordered breathing (SDB) in patients with moderate to high pre-test probability. METHODS: This was a prospective study of 87 consecutive patients referred for an in-laboratory sleep test. Magnetometer-derived MM signals were incorporated into standard polysomnography (PSG)...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28213068/an-unusual-cause-of-severe-dyspnea-a-laryngeal-live-leech-case-report
#11
Said Anajar, Rachid Ansari, Jawad Hassnaoui, Reda Abada, Mohammed Roubal, Mohammed Mahtar
INTRODUCTION: Foreign bodies in the upper airways are one of the most challenging otolaryngology emergencies, leeches present a very rare cause of airway foreign bodies around the world. CASE REPORT: A 6-year-old girl was referred to our otolaryngology department at a tertiary university hospital with a severe dyspnea and hemoptysis. Nasofibroscopy revealed a dark living leech in the supraglottic area which extends to the glottis. The patient was urgently admitted to the operating room, the leech was grasped and removed with a foreign body forceps with a full length of more than 6cm...
January 25, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28190872/upper-airway-obstruction-requiring-emergent-tracheostomy-secondary-to-laryngeal-sarcoidosis-a-case-report
#12
Changwan Ryu, Erica L Herzog, Hongyi Pan, Robert Homer, Mridu Gulati
BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea...
February 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28178173/screening-for-hereditary-angioedema-hae-at-13-emergency-centers-in-osaka-japan-a-prospective-observational-study
#13
MULTICENTER STUDY
Tomoya Hirose, Futoshi Kimbara, Masahiro Shinozaki, Yasuaki Mizushima, Hidehiko Yamamoto, Masashi Kishi, Takeyuki Kiguchi, Shigeru Shiono, Mitsuhiro Noborio, Akihiro Fuke, Hiroshi Akimoto, Takaaki Kimura, Shinichiro Kaga, Takahiko Horiuchi, Takeshi Shimazu
Hereditary angioedema (HAE) with deficiency of C1 inhibitor (C1-INH) is an autosomal-dominant disease characterized by recurrent episodes of potentially life-threatening angioedema. The objective is to study the incidence of HAE among patients who visit the emergency department.This was a 3-year prospective observational screening study involving 13 urban tertiary emergency centers in Osaka prefecture, Japan. Patients were included if they met the following criteria: unexplained edema of the body, upper airway obstruction accompanied by edema, anaphylaxis, acute abdomen with intestinal edema (including ileus and acute pancreatitis), or asthma attack...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28174033/acute-hypotonia-in-an-infant
#14
Jimme Sierakowski, Jason Arthur, Todd Wylie
BACKGROUND: Acute flaccid myelitis (AFM) is increasing in incidence in the United States and presenting to emergency departments (EDs) across the country. This clinical entity presents as acute paralysis, with magnetic resonance imaging changes in the gray matter only in children younger than 21 years of age. The etiology is unknown, although preceding viral illnesses are common. There are no consensus guidelines regarding treatment. CASE REPORT: A 4-month-old girl presented with decreased bilateral arm movement...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28110857/phenotypic-approaches-to-obstructive-sleep-apnoea-new-pathways-for-targeted-therapy
#15
REVIEW
Danny J Eckert
People develop obstructive sleep apnoea (OSA) for different reasons. The ability to understand these reasons, easily identify them in individual patients, and develop therapies that target one or more of these reasons are the keys to unlocking new approaches for the treatment of OSA. In line with this approach, recent advances in OSA pathogenesis using upper airway and respiratory phenotyping techniques have identified four key causes of OSA. A narrow or collapsible upper airway ('impaired anatomy') is the primary cause...
December 18, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28074798/proseal-laryngeal-mask-airway-as-an-alternative-to-standard-endotracheal-tube-in-securing-upper-airway-in-the-patients-undergoing-beating-heart-coronary-artery-bypass-grafting
#16
RANDOMIZED CONTROLLED TRIAL
Kalpana Shah
BACKGROUND: ProSeal laryngeal mask airways (PLMAs) are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies. In long duration surgeries, use of endotracheal tube (ETT) is associated with various hemodynamic complications, which are minimally affected during PLMA use. However, except for few studies, there are no significant data available that promote the use of laryngeal mask during cardiac surgery...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28059860/diagnosis-and-treatment-of-upper-airway-oedema-caused-by-acute-angio-oedema-in-the-emergency-department-a-french-consensus-statement
#17
Bernard Floccard, Nicolas Javaud, Alban Deroux, Isabelle Boccon-Gibod, Olivier Fain, Stéphanie Amarger, Claire Blanchard-Delaunay, Pierre Y Jeandel, Nicolas Marmion, Yann Ollivier, Pauline Pralong, Stéphane Gayet, Aurélie Du-Thanh, Fabien Pelletier, Laurent Sailler, Philip Robinson, David Launay, Laurence Bouillet
Angio-oedema is a transitory, localized, noninflammatory oedema of subcutaneous tissue or mucous. When the oedema affects the mouth, lips, tongue or larynx, it can result in fatal asphyxiation in the absence of specific treatment. Oedema secondary to plasma extravasation is usually mediated by either histamine or bradykinin. As laboratory tests are not available in an emergency setting, the implicated mediator cannot be readily determined. The challenge for the emergency physician is to determine the aetiological type, evaluate severity and initiate adapted treatment by means of a structured approach...
January 4, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#18
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
February 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#19
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27865221/-massive-upper-airway-bleeding-a-rare-case-of-aortobronchial-fistula
#20
Paola Gudiel Arriaza, Amparo Sánchez Serrano, Jorge Marques do Vale, Isabel Gil Pereira, António Simões Torres, Maria José Martín Sánchez
Clinical presentation of haemoptysis and haematemesis often generates confusion, becoming a difficult task to determine the source of upper airway bleeding. Aortobronchial fistula is a rare entity, but has been a reported complication in patients that have undergone aortic vascular surgery. A high clinical suspicion is fundamental to making this diagnosis. A 69 year old male, with a previous diagnosis of chronic gastritis, is admitted to the emergency room for vomiting blood. In the first 24 hours after admission, the patient develops respiratory insufficiency after an episode of massive bleeding from his mouth...
June 2016: Acta Médica Portuguesa
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