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Advanced airway management

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https://www.readbyqxmd.com/read/28219331/a-comparison-of-videolaryngoscopes-for-tracheal-intubation-in-predicted-difficult-airway-a-feasibility-study
#1
Maria Vargas, Antonio Pastore, Fulvio Aloj, John G Laffey, Giuseppe Servillo
BACKGROUND: Videolaryngoscopy has become increasingly attractive for the routine management of the difficult airway. Glidescope® is well studied in the literature while imago V-Blade® is a recent videolaryngoscope. This is a feasibility study with 1:1 case-control sequential allocation comparing Imago V-Blade ® and Glidescope® in predicted difficult airway settings. METHODS: Two senior anesthesiologists with no clinical experience in video assisted intubation but previously trained in a simulated scenario, performed the endotracheal intubations with Imago V-Blade® and Glidescope®...
February 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28194479/-airway-management-in-intensive-care-units-in-rhineland-palatinate-evolution-over-five-years
#2
T Piepho, T Härer, L Ellermann, R R Noppens
BACKGROUND: Securing the airway in severely ill patients is associated with a high rate of complications. So far, no information exists about the equipment readily available for airway management in German intensive care units (ICUs). It is also unknown if the range of material has improved over time. OBJECTIVES: In the present trial the availability of equipment for airway management in ICUs in Rhineland-Palatinate was evaluated at two different times. MATERIALS AND METHODS: Using a structured questionnaire, all ICUs in the state were contacted in the years 2010 and 2015...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28187808/diagnosis-and-management-of-acute-encephalitis
#3
J J Halperin
Encephalitis is typically viral (approximately half of diagnosed cases) or autoimmune (about a quarter) with the remainder remaining undiagnosable at this time. All require general supportive care but only a minority requires intensive care admission - in these intubation, to protect the airway or to treat status epilepticus with anesthetic drugs, may be needed. In some dysautonomia with wide blood pressure fluctuations is the principal concern. Remarkably, in addition to supportive care, specific treatment options are available for the majority - immune-modulating therapy for those with autoimmune disorders, antiviral therapy for herpes simplex 1 and 2, and varicella-zoster encephalitis...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28176512/respiratory-adverse-events-during-upper-digestive-endoscopies-in-children-under-ketamine-sedation
#4
Jose C Flores-González, Alfonso M Lechuga Sancho, Mónica Saldaña Valderas, Gema Jimenez Gonzalez, Maria D Cruzado Garcia, Cristina Perez Aragon, Jose A Blanca Garcia
BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations. METHODS: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#5
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
January 31, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#6
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28149583/the-role-of-bronchoscopy-in-the-diagnosis-of-airway-disease
#7
REVIEW
Tyler J Paradis, Jennifer Dixon, Brandon H Tieu
Endoscopy of the airway is a valuable tool for the evaluation and management of airway disease. It can be used to evaluate many different bronchopulmonary diseases including airway foreign bodies, tumors, infectious and inflammatory conditions, airway stenosis, and bronchopulmonary hemorrhage. Traditionally, options for evaluation were limited to flexible and rigid bronchoscopy. Recently, more sophisticated technology has led to the development of endobronchial ultrasound (EBUS) and electromagnetic navigational bronchoscopy (ENB)...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28127145/an-approach-for-safe-conversion-of-an-oral-endotracheal-tube-to-a-nasal-endotracheal-tube
#8
Michael Hofkamp, Zhiying Diao
We present an approach for safe management of a patient with an oral endotracheal tube who required conversion to a nasal endotracheal tube. A 35-year-old man presented for mandibular fracture repair after multiple injuries sustained in a motor vehicle accident. The patient already had an oral endotracheal tube, and the surgical team requested a nasal endotracheal tube to facilitate surgical exposure and postoperative airway management in anticipation of a wired jaw. A nasal endotracheal tube was inserted through the naris and a video laryngoscope was used to visualize the glottis...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28096585/comparison-of-three-insertion-techniques-of-proseal-laryngeal-mask-airway-a-randomized-clinical-trial
#9
Kadirehally Bheemanna Nalini, Shivanna Shivakumar, Shivashankar Archana, Doddagavanahalli Channaiah Sandhya Rani, Chadalavada Venkata Rama Mohan
BACKGROUND AND AIMS: We aimed to compare three techniques for insertion of ProSeal laryngeal mask airway (PLMA). MATERIAL AND METHODS: Two hundred ten patients (American Society of Anaethesiologists I-II, aged 18-60 years) undergoing general anesthesia using the PLMA as an airway management device were randomly allocated to digital (D), rotational (R), or pharyngoscopic (P) techniques. In the D group (n = 70), the PLMA insertion was performed by using digital manipulation...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#10
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28079564/an-anesthesiologist-s-perspective-on-the-history-of-basic-airway-management-the-artisanal-anesthetic-era-1846-to-1904
#11
Adrian A Matioc
This second installment of the history of basic airway management covers the early-artisanal-years of anesthesia from 1846 to 1904. Anesthesia was invented and practiced as a supporting specialty in the context of great surgical and medical advances. The current-day anesthesia provider tends to equate the history of airway management with the history of intubation, but for the first 58 yr after the introduction of ether anesthesia, airway management was provided by basic airway techniques with or without the use of a face mask...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28077503/european-association-for-cardio-thoracic-surgery-expert-consensus-statement-on-the-prevention-and-management-of-mediastinitis
#12
Yasir Abu-Omar, Gregor J Kocher, Paolo Bosco, Cristina Barbero, David Waller, Tomas Gudbjartsson, Miguel Sousa-Uva, Peter B Licht, Joel Dunning, Ralph A Schmid, Giuseppe Cardillo
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28066624/practical-anesthetic-considerations-in-patients-undergoing-tracheobronchial-surgeries-a-clinical-review-of-current-literature
#13
REVIEW
Sanchit Ahuja, Barak Cohen, Jochen Hinkelbein, Pierre Diemunsch, Kurt Ruetzler
Tracheobronchial surgeries require close cooperation and extensive communication between the anesthesia providers and the surgeons. Anesthetic management of tracheal and bronchial pathologies differ basically from regular upper airways management, due access to the patients airway is limited, mostly even practically impossible for the anesthesia providers. As a consequence, the surgeon overtakes responsibility for the airway access from the anesthesia provider in the variety of the cases. Preoperative recognition of a difficult airway, detailed planning and being aware of plan B and plan C are the elementary keys to success...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28066616/techniques-of-endoscopic-airway-tumor-treatment
#14
REVIEW
Nicolas Guibert, Laurent Mhanna, Sylvain Droneau, Gavin Plat, Alain Didier, Julien Mazieres, Christophe Hermant
Interventional bronchoscopy has a predominant role in the management of both early and advanced-stage airway tumors. Given the very poor prognosis of lung cancer, there is a need for new tools to improve early detection and bronchoscopic treatment of endo-bronchial precancerous lesions. In more advanced stages, interventional bronchoscopy plays an important role, as nearly a third of lung cancers lead to proximal airway obstruction. This will cause great discomfort or even life-threatening symptoms related to local extension, such as dyspnea, post-obstructive pneumonia, and hemoptysis...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28063275/a-survey-of-sleep-medicine-physician-perceptions-on-the-surgical-treatment-of-obstructive-sleep-apnea
#15
Jonathan J Swope, Marcus A Couey, James W Wilson, Jonathon S Jundt
PURPOSE: Surgical treatment for obstructive sleep apnea (OSA) varies by specialty. Our survey sought to answer 3 principal questions: 1) To which surgical specialists are sleep physicians referring patients for upper airway surgery? 2) Which surgical treatment do sleep specialists find to be most effective in treating OSA? 3) Do sleep medicine physicians believe that maxillomandibular advancement (MMA) is worthwhile to patients who are surgical candidates? MATERIALS AND METHODS: We formulated a cross-sectional survey...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28053912/management-of-obstructive-sleep-apnea-in-a-treacher-collins-syndrome-patient-using-distraction-osteogenesis-of-the-mandible
#16
İbrahim Damlar, Ahmet Altan, Berk Turgay, Soydan Kiliç
In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors...
December 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28039246/safety-of-sedation-for-gastrointestinal-endoscopy-in-a-group-of-university-affiliated-hospitals-a-prospective-cohort-study
#17
K Leslie, M L Allen, E C Hessian, P J Peyton, J Kasza, A Courtney, P A Dhar, J Briedis, S Lee, A R Beeton, D Sayakkarage, S Palanivel, J K Taylor, A J Haughton, C X O'Kane
BACKGROUND: Service models for gastrointestinal endoscopy sedation must be safe, as endoscopy is the most common procedure performed under sedation in many countries. The aim of this prospective cohort study was to determine the patient risk profile, and incidence of and risk factors for significant unplanned events, in adult patients presenting for gastrointestinal endoscopy in a group of university-affiliated hospitals where most sedation is managed by anaesthetists. METHODS: Patients aged ≥18 yr presenting for elective and emergency gastrointestinal endoscopy under anaesthetist-managed sedation at nine hospitals affiliated with the University of Melbourne, Australia, were included...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27995120/tonsillectomy-as-prevention-and-treatment-of-sleep-disordered-breathing-a-report-of-23-cases
#18
Jae-Man Woo, Jin-Young Choi
BACKGROUND: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27964793/lung-involvement-in-inflammatory-rheumatic-diseases
#19
REVIEW
Clive Kelly, Kundan Iqbal, La'ali Iman-Gutierrez, Phil Evans, Kanchan Manchegowda
This chapter describes the involvement of the lung in systemic inflammatory joint disease (IJD) with a particular focus on rheumatoid arthritis, although the topics of pulmonary involvement in ankylosing spondylitis and psoriatic arthritis are also addressed. Interstitial lung disease is the most lethal pulmonary complication of IJD and the chapter describes recent advances in both our understanding of this complication and the therapeutic options that offer real hope for improved outcomes. Although less well recognised, airways disease is just as common and its association with IJD is described in some detail, with a section devoted to the recent surge in interest in bronchiectasis...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27943254/minimally-invasive-surgery-versus-radiotherapy-chemoradiotherapy-for-small-volume-primary-oropharyngeal-carcinoma
#20
REVIEW
James Howard, Liam Masterson, Raghav C Dwivedi, Faruque Riffat, Richard Benson, Sarah Jefferies, Piyush Jani, James R Tysome, Chris Nutting
BACKGROUND: More than 400,000 cases of oropharyngeal squamous cell carcinoma (OPSCC) are diagnosed each year worldwide and the incidence is rising, partly as a result of human papillomavirus. Human papillomavirus-associated OPSCC affects younger patients and often presents at a higher stage; however, it is associated with a better prognosis.Until recently, first-line management of OPSCC involved chemoradiotherapy, as research had demonstrated comparable survival outcomes when compared with open surgery, with significantly decreased morbidity...
11, 2016: Cochrane Database of Systematic Reviews
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