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Complications of intubation

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https://www.readbyqxmd.com/read/28634749/the-king-laryngeal-tube-a-mimic-of-esophageal-intubation-in-the-emergency-department
#1
Daniel B Green, Christopher W Root, Ian R Drexler, Alan C Legasto, Jonathan St George
The King Airway is a temporary airway device used primarily in the pre-hospital setting and typically exchanged for an endotracheal tube upon arrival to the emergency department. Since this usually occurs before imaging, many radiologists are unfamiliar with the King Airway. This lack of familiarity can have important consequences for the patient and treating team. The purpose of this article is to raise awareness of the King Airway among radiologists, emphasize appropriate positioning, and review the imaging complications of incorrect positioning...
June 20, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28631763/-noninvasive-ventilation-general-characteristics-indications-and-review-of-the-literature
#2
Fabio Vagnarelli, Marco Marini, Giorgio Caretta, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Daniela Pini, Alessandro Navazio, Renata De Maria, Serafina Valente, Michele Massimo Gulizia
Noninvasive ventilation (NIV), including both continuous and bilevel positive airway pressure, plays a pivotal role in the treatment of acute respiratory failure secondary to acute heart failure. For an appropriate use of NIV, it is essential to consider the underlying pathophysiological principles, the differences between the different modes of ventilation, the main indications, contraindications and complications. The aim of this review is also to give practical guidance on how and when to start NIV at the bedside, how to monitor the response and how to choose the most appropriate interface...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28629915/video-laryngoscopy-for-endotracheal-intubation-of-critically-ill-adults-a-systemic-review-and-meta-analysis
#3
Hui-Bin Huang, Jin-Min Peng, Biao Xu, Guang-Yun Liu, Bin Du
BACKGROUND: Endotracheal intubation (EI) in intensive care unit (ICU) patients is associated with an increased risk of life-threatening adverse events due to unstable conditions, rapid deterioration, limited preparation time, and variability in expertise of operators. We aimed to compare the effect of video laryngoscopy (VL) and direct laryngoscopy (DL) in ICU patients requiring EI. METHODS: We searched for relevant studies in PubMed, Embase, and the Cochrane database from inception up to Jan 30, 2017...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28627964/comparison-of-the-success-rate-between-monocanalicular-and-bicanalicular-intubations-in-incomplete-complex-congenital-nasolacrimal-duct-obstruction
#4
Bahram Eshraghi, Mansooreh Jamshidian-Tehrani, Arash Mirmohammadsadeghi
This article compares the success rate between monocanalicular (MCI) and bicanalicular intubations (BCI) in incomplete complex congenital nasolacrimal duct obstruction (CNLDO) and evaluate the factors responsible for the success of intubation. First, 99 patients with incomplete complex CNLDO underwent MCI (Monoka) or BCI (Crawford). Therapeutic success was defined as dye disappearance test grade 0-1 and complete resolution of previous symptoms at 12 months' follow-up. The success rates were compared between two groups...
June 19, 2017: Orbit
https://www.readbyqxmd.com/read/28624030/emergency-department-length-of-stay-in-critical-nonoperative-trauma
#5
Anaar Siletz, Kexin Jin, Marilyn Cohen, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
BACKGROUND: Prolonged emergency department (ED) stays correlate with negative outcomes in critically ill nontrauma patients. This study sought to determine the effect of ED length of stay (LOS) on trauma patients. MATERIALS AND METHODS: Two hundred forty-one trauma patients requiring direct intensive care unit (ICU) admission were identified. Patients requiring immediate operative intervention were excluded. Odds ratios (ORs) of outcomes for patients transferred to ICU in ≤90 min were compared with patients transferred in >90 min, adjusting for Injury Severity Score (ISS)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622177/postoperative-respiratory-complications-in-patients-at-risk-for-obstructive-sleep-apnea-a-single-institution-cohort-study
#6
Satya Krishna Ramachandran, Jaideep Pandit, Scott Devine, Aleda Thompson, Amy Shanks
BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent condition that is associated with early postoperative respiratory complications (PRCs). As the majority of patients with OSA are undiagnosed, preoperative screening remains the most efficient method to identify suspected OSA. METHODS: This retrospective study was performed on patients undergoing anesthesia in a single academic medical center. We assigned OSA risk class retrospectively to all patients in the study by using the Perioperative Sleep Apnea Prediction (PSAP) score...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28620499/intrauterine-death-following-intraamniotic-triiodothyronine-and-thyroxine-therapy-for-fetal-goitrous-hypothyroidism-associated-with-polyhydramnios-and-caused-by-a-thyroglobulin-mutation
#7
Pradeep Vasudevan, Corrina Powell, Adeline K Nicholas, Ian Scudamore, James Greening, Soo-Mi Park, Nadia Schoenmakers
In the absence of maternal thyroid disease or iodine deficiency, fetal goitre is rare and usually attributable to dyshormonogenesis, for which genetic ascertainment is not always undertaken in the UK. Mechanical complications include tracheal and oesophageal compression with resultant polyhydramnios, malpresentation at delivery and neonatal respiratory distress. We report an Indian kindred in which the proband (first-born son) had congenital hypothyroidism (CH) without obvious neonatal goitre. His mother's second pregnancy was complicated by fetal hypothyroid goitre and polyhydramnios, prompting amniotic fluid drainage and intraamniotic therapy (with liothyronine, T3 and levothyroxine, T4)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28620491/pseudo-thrombotic-thrombocytopenic-purpura-presenting-as-multi-organ-dysfunction-syndrome-a-rare-complication-of-pernicious-anemia
#8
Saroj Kandel, Nibash Budhathoki, Shanta Pandey, Bikash Bhattarai, Aam Baqui, Ramesh Pandey, Divya Salhan, Danilo Enriquez, Joseph Quist, Frances M Schmidt
OBJECTIVE: We present a rare case of pernicious anemia presented as multi-organ dysfunction syndrome, later found to have pseudo-thrombotic thrombocytopenic purpura. METHODS: An 86-year-old female presented with respiratory distress, altered mental status, acute renal failure and was intubated in emergency room. She was found to have severe anemia, thrombocytopenia, high lactate, high lactate dehydrogenase and low haptoglobin. Peripheral smear revealed multilobulated neutrophils with schistocytes, poikilocytes and anisocytes...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28619544/changes-in-tracheostomy-and-intubation-related-tracheal-stenosis-implications-for-surgery
#9
Samuel S Kim, Zain Khalpey, Charles Hsu, Alex G Little
BACKGROUND: This study sought to identify the changing characteristic patterns and locations of stenosis after tracheostomy or intubation and to assess the risk factors associated with perioperative complication and restenosis after primary resection and reconstruction. METHODS: A retrospective review was performed (January /2012 to March 2015) on patients treated at the University of Arizona Medical Center (Tucson, Arizona) who had symptomatic tracheal stenosis secondary to prolonged intubation or tracheostomy...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28619016/clinical-application-of-a-novel-endoscopic-mask-a-randomized-controlled-multi-center-trial-in-patients-undergoing-awake-fiberoptic-bronchoscopic-intubation
#10
Tianxiao Zou, Zhenling Huang, Xiaoxue Hu, Guangyu Cai, Miao He, Shanjuan Wang, Ping Huang, Bin Yu
BACKGROUND: Awake fiberoptic bronchoscopic tracheal intubation is usually regarded as an effective method in the management of predicted difficult airway. Hypoxia during awake nasal fiberoptic bronchoscopic intubation leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. The main aim of the study was to test whether the novel endoscopic mask is helpful for hypoxia during the intubation. METHODS: This was a randomized, controlled, multi-center study...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28614081/spontaneous-fungal-peritonitis-a-rare-but-severe-complication-of-liver-cirrhosis
#11
Marta Gravito-Soares, Elisa Gravito-Soares, Sandra Lopes, Graça Ribeiro, Pedro Figueiredo
INTRODUCTION AND AIM: Spontaneous bacterial peritonitis is the most common infectious complication in cirrhosis. Spontaneous fungal peritonitis is rare and remains unknown. In this work, spontaneous fungal peritonitis as well as risk factors and prognosis are characterized. PATIENTS AND METHODS: A retrospective case-control study of 253 consecutive admissions by peritonitis in cirrhotic patients was carried out between 2006 and 2015. Comparison of patients with spontaneous fungal peritonitis (cases) and spontaneous bacterial peritonitis with positive microbiologic ascitic fluid culture (controls) was performed...
June 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28611887/derivation-and-validation-of-the-prehospital-difficult-airway-identificationtool-predait-a-predictive-model-for-difficult-intubation
#12
Jestin N Carlson, David Hostler, Francis X Guyette, Mark Pinchalk, Christian Martin-Gill
INTRODUCTION: Endotracheal intubation (ETI) in the prehospital setting poses unique challenges where multiple ETI attempts are associated with adverse patient outcomes. Early identification of difficult ETI cases will allow providers to tailor airway-management efforts to minimize complications associated with ETI. We sought to derive and validate a prehospital difficult airway identification tool based on predictors of difficult ETI in other settings. METHODS: We prospectively collected patient and airway data on all airway attempts from 16 Advanced Life Support (ALS) ground emergency medical services (EMS) agencies from January 2011 to October 2014...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611429/streptococcus-sp-in-neonatal-endotracheal-tube-biofilms-is-associated-with-ventilator-associated-pneumonia-and-enhanced-biofilm-formation-of-pseudomonas-aeruginosa-pao1
#13
Yun Pan, Sijie Song, Xiaoli Tang, Qing Ai, Danping Zhu, Zhenqiu Liu, Jialin Yu
Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation leading to high morbidity and mortality among intubated neonates in neonatal intensive care units (NICUs). Endotracheal tube (ETT) biofilm flora were considered to be responsible for the occurrence of VAP as a reservoir of pathogens. However, regarding neonates with VAP, little is known about the complex microbial signatures in ETT biofilms. In the present study, a culture-independent approach based on next generation sequencing was performed as an initial survey to investigate the microbial communities in ETT biofilms of 49 intubated neonates with and without VAP...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28611138/cardiac-arrest-following-arteriovenous-fistula-manipulation-a-cautionary-note
#14
Miles Gandolfi, Bimbi S Fernando
Arteriovenous fistulas can lead to a number of different chronic complications. We describe a case where a patient developed a thrombosis within her brachiobasilic arteriovenous fistula, which was manually manipulated in order to restore fistula flow. This resulted in a pulseless electrical activity cardiac arrest within a few minutes. After ten minutes of chest compressions and intubation, there was return of spontaneous circulation. No epinephrine was given nor shocks administered. Patient was extubated within minutes and was alert, orientated and haemodynamically stable...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28607332/massive-ischemic-stroke-due-to-pulmonary-barotrauma-and-cerebral-artery-air-embolism-during-commercial-air-travel
#15
Sara Farshchi Zarabi, Matteo Parotto, Rita Katznelson, James Downar
BACKGROUND Air embolism into the systemic arterial circulation secondary to pulmonary barotrauma has rarely been reported. Herein, we report the clinical course of an extremely rare presentation of cerebral air embolism likely due to ruptured pulmonary bullae during commercial air travel. CASE REPORT A 65-year-old man suddenly became unconscious during an airplane descent. Upon landing, he was immediately transferred to the nearest emergency department where he was intubated for airway protection. His head CT angiogram showed multiple air pockets in the right parietal lobe suspicious for multiple air emboli...
June 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28599040/intubation-of-the-right-atrium-during-an-attempted-modified-surgical-airway-in-a-pig
#16
Jason Bowman, Andrew Juergens, Matthew McClure, Dave Spear
In modern medicine, the surgical cricothyrotomy is an airway procedure of last resort. In austere environments, however, its simplicity may make it a more feasible option than carrying a full complement of laryngoscopes. To create a Transportation Security Agency-compliant compact first-response bag, we attempted to establish a surgical cricothyrotomy in a pig, using trauma shears, basic medical scissors, a pocket bougie, and an endotracheal tube. Bougies can provide tactile feedback via the "tracheal ring sign" and "stop sign" to indicate positive tracheal placement during orotracheal intubation...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#17
Gráinne Patricia Garvey, Vibhangini S Wasade, Kellie E Murphy, Mrinalini Balki
BACKGROUND: Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. METHODS: A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28597413/late-onset-ornithine-transcarbamylase-deficiency-associated-with-hyperammonemia
#18
Kana Daijo, Tomokazu Kawaoka, Takashi Nakahara, Yuko Nagaoki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Hiroshi Aikata, Keiichi Hara, Go Tajima, Masao Kobayashi, Kazuaki Chayama
The urea cycle converts ammonia and produces urea. One form of urea cycle abnormality is ornithine transcarbamylase (OTC) deficiency. This hereditary disorder is associated with hyperammonemia. OTC deficiency commonly appears during neonatal and early childhood life and is rare in adults. We report a 69-year-old man who presented at the local hospital with 3-day loss of appetite, early morning vomiting, and state of confusion. Blood ammonia was 293 μg/dl. At 2-3 h after admission, the patient went into a deep coma...
June 9, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28590308/perioperative-factors-related-to-the-severity-of-vocal-cord-paralysis-after-thoracic-cardiovascular-surgery-a-retrospective-review
#19
Hiroki Taenaka, Sho Carl Shibata, Kenta Okitsu, Takeshi Iritakenishi, Tatsuyuki Imada, Akinori Uchiyama, Yuji Fujino
BACKGROUND: Vocal cord paralysis (VCP) is a rare complication of thoracic cardiovascular surgery. In severe cases, life-threatening airway obstruction may occur. OBJECTIVE: To evaluate the incidence and severity of VCP among patients who underwent thoracic cardiovascular surgery and to identify possible risk factors. DESIGN: Single-centre retrospective review of adult patients. SETTING: Osaka University Hospital, Suita, Japan, from January 2013 to August 2015...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28590232/anesthesia-for-patients-with-mucopolysaccharidoses-comprehensive-review-of-the-literature-with-emphasis-on-airway-management
#20
REVIEW
Brittney M Clark, Juraj Sprung, Toby N Weingarten, Mary E Warner
Mucopolysaccharidoses (MPS) are rare, inherited, lysosomal storage diseases that cause accumulation of glycosaminoglycans, resulting in anatomic abnormalities and organ dysfunction that can increase the risk of anesthesia complications. We conducted a systematic review of the literature in order to describe the anesthetic management and perioperative outcomes in patients with MPS. We reviewed English-language literature search using an OVID-based search strategy of the following databases: 1) PubMed (1946-present), 2) Medline (1946-present), 3) EMBASE (1946-present), and 4) Web of Science (1946-present) using the following search terms: mucopolysaccharidosis, Hurler, Scheie, Sanfilippo, Morquio, Maroteaux, anesthesia, perioperative, intubation, respiratory insufficiency, and airway...
June 6, 2017: Bosnian Journal of Basic Medical Sciences
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