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Complications of intubation

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https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#1
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#2
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27904574/comparison-of-early-period-results-of-blood-use-in-open-heart-surgery
#3
Serhat Huseyin, Volkan Yuksel, Orkut Guclu, Fatma Nesrin Turan, Suat Canbaz, Turan Ege, Hasan Sunar
BACKGROUND: Various adverse effects of homologous blood transfusion detected particularly in open heart surgery, in which it is frequently used, lead researchers to study on autologous blood use and to evaluate the patient's blood better. Due to the complications of homologous blood transfusion, development of techniques that utilize less transfusion has become inevitable. We aimed to evaluate the effects of acute normovolemic hemodilution (ANH) in patients undergoing open heart surgery...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27903075/australian-taipan-oxyuranus-spp-envenoming-clinical-effects-and-potential-benefits-of-early-antivenom-therapy-australian-snakebite-project-asp-25
#4
Christopher I Johnston, Nicole M Ryan, Margaret A O'Leary, Simon G A Brown, Geoffrey K Isbister
CONTEXT: Taipans (Oxyuranus spp.) are medically important venomous snakes from Australia and Papua New Guinea. The objective of this study was to describe taipan envenoming in Australian and its response to antivenom. METHODS: Confirmed taipan bites were recruited from the Australian Snakebite Project. Data were collected prospectively on all snakebites, including patient demographics, bite circumstances, clinical effects, laboratory results, complications and treatment...
November 30, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27902676/dural-sinus-cerebral-venous-thrombosis-in-a-pediatric-trauma-patient-a-rare-complication-after-closed-head-injury
#5
Jonathan Wilcher, Michelle Pannell
OBJECTIVE: Closed head injury rarely predisposes patients, particularly children, to the development of dural sinus thrombosis. In addition, most cases of sinus thrombosis are subacute in nature. The following is a case report of a precipitous course of dural sinus thrombosis after closed head injury in a pediatric trauma patient. DESCRIPTION: A 14-year-old African American girl presented to the emergency department as a trauma activation. She was an unrestrained rear-seat passenger involved in a motor vehicle collision during which she was ejected...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#6
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902612/intubation-without-use-of-stylet-for-mcgrath-videolaryngoscopy-in-patients-with-expected-normal-airway-a-randomized-noninferiority-trial
#7
Hyun Jeong Kwak, Sook Young Lee, Su Youn Lee, Yong Beom Kim, Jong Yeop Kim
BACKGROUND: During McGrath videolaryngoscope (VL) intubation, a styletted endotracheal tube maintaining an upward distal tip angle is recommended by some manufacturers. However, a styletted endotracheal tube can elicit rare but potentially serious complications. The purpose of this study was to demonstrate that a nonstyletted tube with exaggerated curvature would be noninferior to a styletted tube for orotracheal intubation using McGrath VL in patients with expected normal airway, by comparing the time to intubation and ease of intubation...
November 2016: Medicine (Baltimore)
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
#8
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/27894764/thoracoscopic-bilateral-t3-sympathectomy-for-primary-focal-hyperhidrosis-in-children
#9
Pablo Laje, Kali Rhodes, Leanne Magee, Mary Kate Klarich
AIM OF THE STUDY: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients. METHODS: Retrospective chart review of all patients operated between 2013 and 2015. RESULTS: We operated and included in the study 28 patients, 22 females and 6 males. Mean age was 14 (6-21) years. All patients had previously tried at least one form of medical therapy with no success...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#10
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27889843/a-randomized-comparison-of-the-ambu-auragain-versus-the-lma-supreme-in-patients-undergoing-gynaecologic-laparoscopic-surgery
#11
Ana M Lopez, Merce Agusti, Pedro Gambus, Montserrat Pons, Teresa Anglada, Ricard Valero
Second generation supraglottic airway devices providing high seal airway pressures are suitable for patients undergoing gynecologic laparoscopy. We compared the seal pressure achieved by the new Ambu AuraGain™ versus LMA Supreme™ following pneumoperitoneum in the Trendelenburg position. Sixty female patients were randomly allocated to ventilation with either the AuraGain or the Supreme. A target-controlled system was used to administer total intravenous anesthesia. Intracuff pressure was maintained below 60 cm H2O...
November 26, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27887662/the-effects-of-water-lubrication-of-tracheal-tubes-on-post-intubation-airway-complications-study-protocol-for-a-randomized-controlled-trial
#12
Eugene Kim, Seong Mi Yang, So Jeong Yoon, Jae-Hyon Bahk, Jeong-Hwa Seo
BACKGROUND: Water is known to have lubricating properties, thus it is used for lubrication of tracheal tubes to reduce airway injuries caused by intubation. However, there is no definite evidence to substantiate the beneficial effects of lubricating tracheal tubes using water for attenuating airway injuries. Moreover, the lubrication pretreatment may cause contamination of the tube, leading to respiratory infections. Therefore, this trial aims to assess whether no pretreatment of tracheal tubes does not increase post-intubation airway complications as compared with water lubrication of tubes...
November 25, 2016: Trials
https://www.readbyqxmd.com/read/27886977/can-submandibular-tracheal-intubation-be-an-alternative-to-tracheotomy-during-surgery-for-major-maxillofacial-fractures
#13
Ahmed Gaber Hassanein, Ahmed M A Abdel Mabood
PURPOSE: During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. MATERIALS AND METHODS: This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27880060/neurogenic-pulmonary-oedema-complicating-traumatic-posterior-fossa-extradural-haematoma-case-report-and-review
#14
Ajay Hegde, G Lakshmi Prasad, Priyanka Kini
INTRODUCTION: Pulmonary oedema is accumulation of fluid in the lung air spaces and interstitia. Neurogenic pulmonary oedema (NPE) is a potentially life-threatening condition which has been noted in head injury, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and others. Timely management is crucial to achieve good outcome; however, no specific guidelines have been defined. METHODS: A 33-year female involved in a motor vehicular accident had a GCS of 14/15 and CT scan showed a moderate-sized unilateral posterior fossa extradural haematoma (PFEDH)...
November 23, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27876355/lung-protective-ventilatory-strategies-in-intubated-preterm-neonates-with-rds
#15
REVIEW
F Reiterer, B Schwaberger, T Freidl, G Schmölzer, G Pichler, B Urlesberger
This article provides a narrative review of lung-protective ventilatory strategies (LPVS) in intubated preterm infants with RDS. A description of strategies is followed by results on short-and long-term respiratory and neurodevelopmental outcomes. Strategies will include patient-triggered or synchronized ventilation, volume targeted ventilation, the technique of intubation, surfactant administration and rapid extubation to NCPAP (INSURE), the open lung concept, strategies of high-frequency ventilation, and permissive hypercapnia...
October 26, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27876071/bilateral-single-port-thoracoscopic-extended-thymectomy-for-management-of-thymoma-and-myasthenia-gravis-case-report
#16
Francesco Paolo Caronia, Alfonso Fiorelli, Ettore Arrigo, Sebastiano Trovato, Mario Santini, Attilio Ignazio Lo Monte
BACKGROUND: Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, and length of hospitalization. Herein, we reported an extended resection of thymoma in a patient with myasthenia gravis through an uniportal bilateral thoracoscopic approach. CASE PRESENTATION: A 74 years old woman with myasthenia gravis was referred to our attention for management of a 3...
November 22, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27875775/bronchoscopic-intubation-is-an-effective-airway-strategy-in-critically-ill-patients
#17
Kevin C Ma, Augustine Chung, Kerri I Aronson, Jamuna K Krishnan, Igor Z Barjaktarevic, David A Berlin, Edward J Schenck
PURPOSE: American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients. METHODS: We performed a retrospective cohort study of patients who underwent endotracheal intubation in the medical intensive care unit of a tertiary urban referral center over 1 academic year...
November 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27874166/-massive-cerebral-air-embolism-following-endoscopic-retrograde-cholangiopancreatography-a-case-report-and-review-of-the-literature
#18
J Fernandez-Fernandez, H Real-Noval, E Rodriguez-Rodriguez
INTRODUCTION: Cerebral air embolism following endoscopic processes is an infrequent complication, but can have catastrophic consequences. CASE REPORT: An 85-year-old male diagnosed with distal cholangiocarcinoma with criteria for unresectability who was submitted to placement of a biliary drainage prosthesis. Endoscopic retrograde cholangiopancreatography was performed to change the prosthesis. After the procedure, the patient's vital signs and level of consciousness underwent a decline, and orotracheal intubation was required...
December 1, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27873326/complications-of-turbinate-reduction-surgery-in-combination-with-tonsillectomy-in-pediatric-patients
#19
Sonia N Yuen, Peggy P Leung, Jamie Funamura, Kosuke Kawai, David W Roberson, Eelam A Adil
OBJECTIVES/HYPOTHESIS: To examine whether the addition of turbinoplasty to tonsillectomy and adenoidectomy (T&A) increases the risk of postoperative complications. STUDY DESIGN: Retrospective cohort study of children (18 years old and younger) who underwent tonsillectomy and/or turbinoplasty between July 1, 2013 and June 30, 2015 using the 2016 Pediatric Health Information System administrative database METHODS: Patients were divided into three groups: 1) T&A and turbinoplasty, 2) T&A alone, and 3) turbinoplasty alone...
November 22, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27871595/a-comparison-of-king-vision-video-laryngoscopy-and-direct-laryngoscopy-as-performed-by-residents-a-randomized-controlled-trial
#20
Jose A Valencia, Katherine Pimienta, Darwin Cohen, Daniel Benitez, David Romero, Oswaldo Amaya, Enrique Arango
STUDY OBJECTIVE: For more than 40 years, direct laryngoscopy (DL) has been used to assure the airway during endotracheal intubation. The King Vision video laryngoscope is one of the latest devices introduced for endotracheal intubation. We hypothesize that, relative to direct laryngoscopy, it improves the intubation success rate with fewer intubation attempts and no difference in intubation time or complications. DESIGN: This randomized controlled clinical trial included...
December 2016: Journal of Clinical Anesthesia
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