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https://www.readbyqxmd.com/read/30291405/-management-of-the-difficult-airway-overview-of-the-current-guidelines
#1
REVIEW
J C Schäuble, T Heidegger
Several national airway task forces have recently updated their recommendations for the management of the difficult airway in adults. Routinely responding to airway difficulties with an algorithm-based strategy is consistently supported. The focus is increasingly not on tools and devices but more on good planning, preparation and communication. In the case of anticipated airway difficulties the airway should be secured when the patient is awake with maintenance of spontaneous ventilation. Unaltered a flexible bronchoscopic intubation technique is advised as a standard of care in such patients...
October 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/30283189/efficiency-and-efficacy-of-two-techniques-of-preoxygenation-during-modified-rapid-sequence-intubation
#2
Rajesh Kesavan, Sindhu Balakrishnan, Sunil Rajan, Shyam S Purushothaman, Rekha Varghese, Lakshmi Kumar
Background: Apneic mass movement of oxygen by applying continuous positive airway pressure (CPAP) is possible only when the airway is kept patent which helps to reduce the rate of desaturation. Aims: The aim of this study was to check the efficiency of preoxygenation and apneic oxygenation by assessing the drop in partial pressure of arterial oxygen (PaO2 ) during apnea with and without keeping an oropharyngeal airway to maintain the patency of airway. Settings and Design: This prospective observational study was conducted at a tertiary care center...
July 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/30263860/propofol-versus-thiopental-for-rapid-sequence-induction-in-isolated-systolic-hypertensive-patients-a-factorial-randomized-double-blind-clinical-trial
#3
Nesrin Ahu Aslan, Çağıl Vural, Ali Abbas Yılmaz, Zekeriyya Alanoğlu
Objective: We investigated the effects of four different anaesthesia induction protocols on the haemodynamic response to laryngoscopy and tracheal intubation during rapid-sequence induction (RSI) in systolic hypertensive patients. Methods: One hundred and twenty hypertensive adult patients (systolic pressure >140 mmHg and diastolic pressure <90 mmHg), classified according to the American Association of Anesthesiologists as Class II and III were randomized into four groups...
September 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/30227319/preoxygenation-during-induction-of-anesthesia-in-non-critically-ill-patients-a-systematic-review
#4
REVIEW
Elena Bignami, Francesco Saglietti, Alessandro Girombelli, Andrea Briolini, Tiziana Bove, Luigi Vetrugno
We conducted a systematic review of the literature to better understand whether preoxygenation in non-critically ill patients (i.e. elective surgery patients) should be recommended, as it lengthens safe apnea time (the time required to reach oxygen saturation < 90% in an apneic patient). Furthermore, we looked for the most efficient technique amongst those currently employed in clinical practice. We searched Scopus, CINAHL, the Cochrane Library, PubMed and MeSH using various combinations of the words "preoxygenation", "general anesthesia", "induction", "operating room" and "oxygen"...
September 15, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/30226779/photothermoelectric-detection-of-gold-oxide-nonthermal-decomposition
#5
Xifan Wang, Charlotte I Evans, Douglas Natelson
A thin coating of gold oxide, metastable at room temperature, can be formed by placing gold in a strongly oxidizing environment such as an oxygen plasma. We report scanning photovoltage measurements of lithographically defined gold nanowires subsequent to oxygen plasma exposure. Photovoltages are detected during the first optical scan of the devices that are several times larger than those mapped on subsequent scans. The first-scan enhanced photovoltage correlates with a reduction of the electrical resistance of the nanostructure back to preoxygen-exposure levels...
September 24, 2018: Nano Letters
https://www.readbyqxmd.com/read/30170488/oxidation-of-reduced-peat-particulate-organic-matter-by-dissolved-oxygen-quantification-of-apparent-rate-constants-in-the-field
#6
Nicolas Walpen, Maximilian P Lau, Annika Fiskal, Gordon J Getzinger, Stefan A Meyer, Taylor F Nelson, Mark A Lever, Martin H Schroth, Michael Sander
Peat particulate organic matter (POM) is an important terminal electron acceptor for anaerobic respiration in northern peatlands provided that the electron-accepting capacity of POM is periodically restored by oxidation with O2 during peat oxygenation events. We employed push-pull tests with dissolved O2 as reactant to determine pseudo-first-order rate constants of O2 consumption ( kobs ) in anoxic peat soil of an unperturbed Swedish ombrotrophic bog. Dissolved O2 was rapidly consumed in anoxic peat with a mean kobs of 2...
October 2, 2018: Environmental Science & Technology
https://www.readbyqxmd.com/read/30123510/difficult-tracheal-intubation-in-critically-ill
#7
REVIEW
Armin Ahmed, Afzal Azim
Background: Endotracheal intubation in critically ill is a high-risk procedure requiring significant expertise in airway handling as well as understanding of pathophysiology of the disease process. Main body: Critically ill patients are prone for hypotension and hypoxemia in the immediate post-intubation phase due to blunting of compensatory sympathetic response. Preoxygenation without NIV is frequently suboptimal, as alveolar flooding cause loss of alveolar capillary interface in many of these patients...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/30056844/development-and-testing-of-a-novel-anaesthesia-induction-ventilation-protocol-for-patients-with-cardiogenic-shock-complicating-acute-myocardial-infarction
#8
Athanasios Chalkias, Fotios Pavlopoulos, Effie Papageorgiou, Christos Tountas, Artemis Anania, Maria Panteli, Apostolos Beloukas, Theodoros Xanthos
BACKGROUND: Cardiogenic shock is a life-threatening condition and patients might require rapid sequence induction (RSI) and mechanical ventilation. In this study, we evaluated a new RSI/mechanical ventilation protocol in patients with acute myocardial infarction complicated by cardiogenic shock. METHODS: We included consecutive adult patients who were transferred to the emergency department. The RSI protocol included 5 phases: preoxygenation, pretreatment, induction/paralysis, intubation, and mechanical ventilation (PPIIM)...
August 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30048366/oxygenator-impact-on-ceftaroline-in-extracorporeal-membrane-oxygenation-circuits
#9
Jeffrey J Cies, Wayne S Moore, Nadji Giliam, Tracy Low, Adela Enache, Arun Chopra
OBJECTIVES: To determine the oxygenator impact on alterations of ceftaroline in a contemporary neonatal/pediatric (1/4-inch) and adolescent/adult (3/8-inch) extracorporeal membrane oxygenation circuit including the Quadrox-i oxygenator (Maquet, Wayne, NJ). DESIGN: Quarter-inch and 3/8-inch, simulated closed-loop extracorporeal membrane oxygenation circuits were prepared with a Quadrox-i pediatric and Quadrox-i adult oxygenator and blood primed. Additionally, 1/4-inch and 3/8-inch circuits were also prepared without an oxygenator in series...
July 25, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30037519/end-tidal-oxygen-saturation-with-nasal-cannula-during-noninvasive-positive-pressure-ventilation-a-randomized-crossover-trial
#10
Derek J Brown, Jessica Carmichael, Stephen M Carroll, Michael D April
BACKGROUND: Simultaneous use of nasal cannula (NC) with noninvasive positive pressure ventilation (NIPPV) may help streamline the transition from preoxygenation to intubation with apneic oxygenation in patients with deteriorating respiratory status, but may also compromise preoxygenation by impairing NIPPV mask seal. OBJECTIVES: To demonstrate that end-tidal oxygen (EtO2 ) after NIPPV with NC is noninferior to that of NIPPV without NC. METHODS: We conducted a randomized cross-over noninferiority study using healthy volunteers...
October 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30036274/what-every-anesthesiologist-should-know-about-the-manual-resuscitation-bag
#11
Carolyn S Sivco, Verghese T Cherian
The bag-valve-mask or the manual resuscitation bag is life-saving equipment. This article explains its construction, functioning, and limitations. This article also attempts to clarify some common misconceptions such as whether a resuscitation bag can be used to preoxygenate or provide continuous positive airway pressure or positive end-expiratory pressure and the highest percentage of oxygen that it can deliver.
July 20, 2018: A&A practice
https://www.readbyqxmd.com/read/30020104/novel-preoxygenation-technique-to-deliver-high-flow-oxygen-in-a-patient-with-facial-trauma-a-case-report
#12
Verna M Aykanat, Desmond P McGlade
This case demonstrates a novel preoxygenation technique in a patient with difficult access to the airway after a traumatic facial injury. To find a solution, a fusion of oxygenation equipment was trialed by altering and combining a tracheostomy mask and the tubing of an Optiflow circuit from which the nasal cannula component had been removed. This novel combination delivered high-flow humidified oxygen (60 L/min) orally, avoided further facial injury, and was well tolerated by the patient. Effective preoxygenation was confirmed by arterial gas measurements...
July 16, 2018: A&A practice
https://www.readbyqxmd.com/read/29966108/the-use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-for-pre-oxygenation-in-neurosurgical-patients-a-randomised-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
I Ng, R Krieser, P Mezzavia, K Lee, C Tseng, Nwr Douglas, R Segal
This study explored the use of high-flow nasal oxygen (HFNO) in both pre-oxygenation and apnoeic oxygenation in adults who were intubated following a non-rapid sequence induction. Fifty patients were randomised to receive pre-oxygenation via a standard facemask or the Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) device. After five minutes of pre-oxygenation, induction and muscle relaxant agents were given. While waiting for complete paralysis, patients in the standard facemask group received bag-mask ventilation (BMV), whereas patients in the HFNO group received apnoeic oxygenation via the THRIVE device...
July 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29959498/-rapid-sequence-induction-and-intubation-in-patients-with-risk-of-aspiration-recommendations-for-action-for-practical-management-of-anesthesia
#14
C Eichelsbacher, H Ilper, R Noppens, J Hinkelbein, T Loop
BACKGROUND: Induction of general anesthesia in patients with risk for aspiration needs special considerations to avoid the incidence and severity of complications. Since no evidence-based guidelines support the challenge for anesthesiologists various practical recommendations exist in clinical practice for rapid sequence induction and intubation (RSI). The aim of this systematic review is, to summarize the evidence and recommend a decision making process. MATERIAL AND METHODS: Multilevel RAND-delphi-method (RAND: Research and Development) combined with systematic literature research, individual assessment and evaluation, consensus conferences and final common sequence...
August 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29866144/standardised-data-reporting-from-pre-hospital-advanced-airway-management-a-nominal-group-technique-update-of-the-utstein-style-airway-template
#15
G A Sunde, A Kottmann, J K Heltne, M Sandberg, M Gellerfors, A Krüger, D Lockey, S J M Sollid
BACKGROUND: Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. We aimed to identify which airway data were most important to report today and to revise and update a previously reported Utstein-style airway management dataset. METHODS: We recruited sixteen international experts in pre-hospital airway management from Australia, United States of America, and Europe...
June 4, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29802903/difficult-intubation-and-extubation-in-adult-anaesthesia
#16
O Langeron, J-L Bourgain, D Francon, J Amour, C Baillard, G Bouroche, M Chollet Rivier, F Lenfant, B Plaud, P Schoettker, D Fletcher, L Velly, K Nouette-Gaulain
OBJECTIVE: To provide an update to French guidelines about "Difficult intubation and extubation in adult anaesthesia 2006". DESIGN: A consensus committee of 13 experts was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independent of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence...
May 23, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29739649/desaturation-times-between-dogs-preoxygenated-via-face-mask-or-flow-by-technique-before-induction-of-anesthesia
#17
Barbara Ambros, Maria Valentina Carrozzo, Teela Jones
OBJECTIVE: To compare time to desaturation after induction of anesthesia following administration of oxygen via face mask or flow-by for 3 minutes. STUDY DESIGN: Randomized crossover study. ANIMALS: A group of six healthy adult dogs weighing 15.0 ± 3.4 kg. METHODS: Dogs were anesthetized twice separated by 14 days. Intramuscular administration of dexmedetomidine (4 μg kg-1 ), acepromazine (0.01 mg kg-1 ) and butorphanol (0...
July 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29720758/ultra-modified-rapid-sequence-induction-with-transnasal-humidified-rapid-insufflation-ventilatory-exchange-challenging-convention
#18
Ketan Sakharam Kulkarni, Nandini Dave, Shriyam Saran, Madhu Garasia, Sandesh Parelkar
During positive pressure ventilation, gastric inflation and subsequent pulmonary aspiration can occur. Rapid sequence induction (RSI) technique is an age-old formula to prevent this. We adopted a novel approach of RSI for patients with high risk of aspiration and evaluated it further in patients undergoing laparoscopic surgeries. We believe that, in patients with risk of gastric insufflation and pulmonary aspiration, transnasal humidified rapid-insufflation ventilatory exchange can be useful in facilitating pre- and apnoeic oxygenation till tracheal isolation is achieved...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29665981/endotracheal-suction-in-intensive-care-a-point-prevalence-study-of-current-practice-in-new-zealand-and-australia
#19
Eileen Gilder, Rachael L Parke, Andrew Jull
BACKGROUND: Despite the evidence and available guidelines about endotracheal suction (ETS), a discrepancy between published guidelines and clinical practice persists. To date, ETS practice in the adult intensive care unit (ICU) population across New Zealand and Australia has not been described. OBJECTIVE: To describe ICU nurses' ETS practice in New Zealand and Australia including the triggers for performing endotracheal suction. METHODS: A single day, prospective observational, binational, multicentre point prevalence study in New Zealand and Australian ICUs...
April 14, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29643554/effectiveness-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-traditional-preoxygenation-followed-by-apnoeic-oxygenation-in-delaying-desaturation-during-apnoea-a-preliminary-study
#20
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Dilesh Kadapamannil, Jerry Paul, Lakshmi Kumar
Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to <90% during apnoea with THRIVE versus traditional preoxygenation followed by apnoeic oxygenation. Methods: This prospective, randomised, single-blinded study was conducted in 10 adult patients presenting for direct laryngoscopy under general anaesthesia without endotracheal intubation...
March 2018: Indian Journal of Anaesthesia
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