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Awake intubation

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https://www.readbyqxmd.com/read/29174197/comparison-of-cardiac-measurements-by-multi-detector-computed-tomography-angiography-and-transthoracic-echocardiography-in-english-bulldogs
#1
E T Hostnik, B A Scansen, A M Habing, G A Chiappone, R R Layman, R D White
INTRODUCTION: Transthoracic echocardiography (TTE) is the primary tool for the assessment of cardiac structure and function in dogs but is challenging in English bulldogs due to dorsoventral compression of the thorax, obesity, and narrow intercostal spaces. Multi-detector computed tomography angiography (CTA) may overcome the conformational obstacles of cardiac imaging in this breed. ANIMALS: Eleven client-owned English bulldogs. MATERIALS AND METHODS: Prospective clinical trial with paired analysis of TTE and CTA studies...
November 22, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29149007/awake-bronchoscopic-intubation-with-a-noninvasive-positive-pressure-support-in-critically-ill-patients
#2
Fu-Shan Xue, Gui-Zhen Yang, Chao Wen
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29119207/anesthesia-in-a%C3%A2-child-with-suspected-peroxisomal-disorder
#3
J S Englbrecht, M Maas
We present the case of an 8‑year-old female child with suspected peroxisomal disorder requiring general anesthesia for adenotomy, paracentesis and brainstem-evoked response audiometry. Peroxisomes are small intracellular organelles that catalyse key metabolic reactions. Peroxisomal disorders are a heterogeneous group of rare genetic diseases. Anesthesia can be challenging as adrenal insufficiency, mental retardation, muscle weakness, risk of pulmonary aspiration, airway complications, seizure disorders and altered pharmacokinetics and pharmacodynamics can occur in these patients but guidelines for anesthesia do not exist due to the heterogeneity and rarity of these diseases and case reports are rare...
November 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29109646/ludwig-s-angina-in-children-anesthesiologist-s-nightmare-case-series-and-review-of-literature
#4
Maitree Pandey, Manpreet Kaur, Manoj Sanwal, Aruna Jain, Sunil K Sinha
Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered during the anesthetic management of six children who required emergency surgical drainage under general anesthesia...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29054944/anaesthesia-and-orphan-disease-airway-and-anaesthetic-management-in-huntington-s-disease
#5
Phuong Thao Nguyen, Daveena Meeks, Despoina Liotiri
We present a case that highlights the issues surrounding the delivery of a safe general anaesthetic to a patient with Huntington's disease (HD) and bulbar dysfunction. In the case of a 46-year-old patient undergoing laparoscopic percutaneous endoscopic gastrostomy tube insertion, we discuss the rationale behind our chosen method and anaesthetic agents as well as airway issues specific to HD. In a patient whose condition would not allow for an awake fibreoptic intubation, we opted for a modified rapid sequence induction...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28990962/two-stage-technique-used-to-manage-severe-upper-airway-obstruction-and-avoid-surgical-tracheostomy-a-case-report
#6
Desire N Onwochei, Kariem El-Boghdadly, Imran Ahmad
Severe upper airway obstruction is commonly managed with surgical tracheostomy under local anesthesia. We present a 49-year-old woman with postradiotherapy laryngeal fixation and transglottic stenosis for dilation of a pharyngeal stricture who refused elective tracheostomy. A 2-stage technique was used, which involved an awake fiberoptic intubation, followed by the transtracheal insertion of a Cricath needle and ventilation using an ejector-based Ventrain device. We discuss management aspects of this clinical scenario and the principles by which the Ventrain works...
October 5, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28975073/usefulness-of-ultrasound-view-of-larynx-in-pre-anesthetic-airway-assessment-a-comparison-with-cormack-lehane-classification-during-direct-laryngoscopy
#7
Sussan Soltani Mohammadi, Alireza Saliminia, Nasim Nejatifard, Roxana Azma
BACKGROUND: One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28962712/nonintubated-awake-anesthesia-for-uniportal-video-assisted-thoracic-surgery-procedures
#8
REVIEW
Hui Zheng, Xue-Fei Hu, Ge-Ning Jiang, Jia-An Ding, Yu-Ming Zhu
Nonintubated video-assisted thoracic surgery (VATS) strategies are gaining popularity. This review focuses on noninutbated VATS, and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. Advances in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. The nonintubated thoracoscopic approach has been adapted for use with major lung resections. The need for general anesthesia and endotracheal intubation has been reexamined, such that regional or epidural analgesia may be sufficient for cases where lung collapse can be accomplished with spontaneous ventilation and an open hemithorax...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28928590/arteriovenous-malformation-of-face-a-challenge-to-anesthesiologists
#9
S Neeta, Rammoorthi Rao, Madhusudan Upadya, P Keerthi
Arteriovenous (AV) malformations of the face are rare presentations. Endovascular coiling is one of the treatment modalities. We report a case of a 65-year-old lady who presented with a large AV malformation of the face located around the nasal bride and alae nasae posted for coiling under general anesthesia. Anesthetic management of the case was a challenge as it was an anticipated difficult airway situation. Furthermore, any pressure on the swelling can lead to rupture and hemorrhage as the skin above swelling was unhealthy...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28895500/anesthetic-management-of-a-patient-with-tracheal-dehiscence-post-tracheal-resection-surgery
#10
Sang Kim, Maryna Khromava, Jeron Zerillo, George Silvay, Adam I Levine
We present a case of a patient with complete tracheal dehiscence and multiple false passages after recent tracheal resection and anastomosis. Loss of tracheal continuity after disruption of anastomosis with distal stump retraction presents a unique anesthetic challenge given lack of access to the trachea and the need for adequate anesthesia and analgesia for surgical neck dissection. Traditional airway management, including awake fiberoptic intubation, intubation via direct laryngoscopy, needle cricothyrotomy, and awake tracheostomy are not viable options...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#11
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890562/efficacy-of-atomised-local-anaesthetic-versus-transtracheal-topical-anaesthesia-for-awake-fibreoptic-intubation
#12
Bindu K Vasu, Sunil Rajan, Jerry Paul, Lakshmi Kumar
BACKGROUND AND AIMS: Successful awake fibreoptic intubation (AFOI) depends on adequate topical anaesthesia of the airway. We aimed to compare efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for AFOI. METHODS: It was a prospective, randomised controlled study of 33 patients with the American Society of Anesthesiologists' physical status 1-3 with anticipated difficult airway requiring AFOI. The primary objective was to compare the patient comfort after topical anaesthesia of the airway using atomiser with transtracheal injection of the local anaesthetic agent for AFOI in patients with anticipated difficult airway...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28882637/successful-retrograde-intubation-after-failed-fiberoptic-intubation-and-percutaneous-cricothyrotomy
#13
Stephanie Brenman, Sachin Gupta, Stephanie Tseeng
BACKGROUND: An obstructive neck lesion presents an airway challenge for any emergency physician. Retrograde intubation is an infrequently used airway alternative that can be employed in the difficult airway algorithm that requires little training and is less invasive than surgical cricothyrotomy. CASE REPORT: We report a case of a 31-year-old male patient who presented with respiratory distress progressing to respiratory failure from upper airway obstruction. The patient had significant tracheal thickening at the level of the thyroid gland based on a computed tomography report from 3 weeks prior to his presentation...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#14
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#15
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28808576/-awake-ecco2r-superseded-intubation-in-a-near-fatal-asthma-attack
#16
Thomas-Michael Schneider, Tibor Bence, Franz Brettner
BACKGROUND: Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. CASE PRESENTATION: A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28774673/can-videolaryngoscopy-be-a-first-option-in-a-patient-with-laryngeal-amyloidosis
#17
L España Fuente, G Mella Pérez, B Laserna Cocina, J L González González
Amyloidosis is a term that involves a group of diseases characterised by deposition of extracellular monoclonal light-chain fibrillar immunoglobulin aggregates in the body, including many organs, with the larynx among them. A case is presented of a 78 year-old man who was referred to our institution for strangulated umbilical hernia treatment. He suffered from progressive hoarseness and dysphagia for 5months. He had a history of primary laryngeal amyloidosis. Awake intubation was performed successful with the King Vision(®) video-laryngoscopy...
July 31, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28757856/transverse-approach-for-ultrasound-guided-superior-laryngeal-nerve-block-for-awake-fiberoptic-intubation
#18
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Umesh Kumar Bhadani
No abstract text is available yet for this article.
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28723308/percutaneous-trans-tracheal-endoscopic-approach-a-novel-technique-for-the-excision-of-benign-lesions-of-thoracic-trachea
#19
Suresh C Sharma, K Devaraja, Arvind Kairo, Rakesh Kumar
INTRODUCTION: Currently, neoplasms of the trachea and lower airway demand open transcervical approach with or without thoracotomy. We describe here a novel, minimally invasive approach for an intraluminal lesion of the thoracic trachea, called percutaneous trans-tracheal endoscopic approach (PTEA). Apart from obvious advantages over potentially morbid open procedures, this technique has certain peculiar benefits over rigid or flexible bronchoscopic approach. MATERIALS AND METHODS: A 43-year-old male patient had glomus tumor of thoracic trachea...
July 19, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28701607/anesthetic-challenges-of-extrinsic-trachea-bronchial-compression-due-to-posterior-mediastinal-mass-our-experience-with-a-large-esophageal-mucocele
#20
Saipriya Tewari, Puneet Goyal, Amit Rastogi, Aarti Agarwal, P K Singh
Large posterior mediastinal masses may lead threatening complications such as critical tracheobronchial compression. Airway management in these individuals is a challenge and being a lower airway obstruction; rescue strategies are limited. We encountered one such case of a large esophageal mucocele causing extrinsic tracheobronchial compression. We have described the anesthetic management of this case using awake fiber-optic assessment followed by intubation. Close communication with the surgical team, meticulous planning of airway management, and early drainage of the mucocele are the cornerstones of management in such patients...
July 2017: Annals of Cardiac Anaesthesia
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