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Advanced airway management

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https://www.readbyqxmd.com/read/28732224/three-dimensional-changes-in-the-upper-airway-of-skeletal-class-iii-patients-after-different-orthognathic-surgical-procedures
#1
Yuxue Yang, Kai Yang, Ying Zhao
PURPOSE: We hypothesized that 3-dimensional changes in the upper airway of patients with skeletal Class III malocclusion are different after mandibular setback and maxillary advancement (MSMA) compared with mandibular setback (MS) and that upper airway changes and the amount of jaw movement are correlated. PATIENTS AND METHODS: Skeletal Class III patients who underwent MS surgery or MSMA surgery were included in this retrospective cohort study. Cone beam computed tomography scans were acquired before and 3 months after surgery...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#2
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28698134/effects-of-advanced-life-support-on-patients-who-suffered-cardiac-arrest-outside-of-hospital-and-were-defibrillated
#3
Akihito Hagihara, Daisuke Onozuka, Takashi Nagata, Manabu Hasegawa
BACKGROUND: The effects and relative benefits of advanced airway management and epinephrine on patients with out-of-hospital cardiac arrest (OHCA) who were defibrillated are not well understood. METHODS: This was a prospective observational study. Using data of all out-of-hospital cardiac arrest cases occurring between 2005 and 2013 in Japan, hierarchical logistic regression and conditional logistic regression along with time-dependent propensity matching were performed...
July 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28665848/change-in-posterior-pharyngeal-space-after-counterclockwise-rotational-orthognathic-surgery-for-class-ii-dentofacial-deformity-diagnosed-with-obstructive-sleep-apnea-based-on-cephalometric-analysis
#4
Woo Shik Jeong, Young Chul Kim, Yoo Sam Chung, Chang Yeol Lee, Jong Woo Choi
Although maxillomandibular advancement (MMA) is an orthognathic surgical procedure used to manage obstructive sleep apnea (OSA) in individuals who are noncompliant with continuous positive airway pressure therapy, simple MMA encounters problems in terms of aesthetic outcomes in Asian populations with preexisting dentoalveolar protrusion. Our current prospective investigation describes changes in posterior pharyngeal space and aesthetic outcomes after counterclockwise rotational orthognathic surgery, which is known to be quite difficult in terms of the maintenance of the skeletal stability in skeletal class II patients with OSA...
June 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28661698/the-role-of-chest-computed-tomography-in-the-evaluation-and-management-of-the-patient-with-copd
#5
Wassim W Labaki, Carlos H Martinez, Fernando J Martinez, Craig J Galbán, Brian D Ross, George R Washko, R Graham Barr, Elizabeth A Regan, Harvey O Coxson, Eric A Hoffman, John D Newell, Douglas Curran-Everett, James C Hogg, James D Crapo, David A Lynch, Ella A Kazerooni, MeiLan K Han
Chronic obstructive pulmonary disease (COPD) exhibits significant heterogeneity in clinical presentation and rate of disease progression, owing at least in part to differing underlying morphologic abnormalities. Symptom assessment and spirometry have traditionally been used to determine disease severity and guide management. However, chest computed tomography (CT) is a widely available and increasingly used imaging modality that can provide additional insight into structural and pathophysiologic pulmonary parameters...
June 29, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28657971/laryngeal-mask-airway-as-a-rescue-device-for-failed-endotracheal-intubation-during-scene-to-hospital-air-transport-of-combat-casualties
#6
Itai Shavit, Eliad Aviram, Yoav Hoffmann, Oded Biton, Elon Glassberg
BACKGROUND: Advanced airway management of combat casualties during scene-to-hospital air transport is challenging. Because of the short transport time, flight physicians of the Israeli military airborne combat evacuation unit are approved for the use of a laryngeal mask airway (LMA) in the event of failed endotracheal intubation (ETI). The aim of this study was to assess the effectiveness of LMA use during scene-to-hospital transport of combat casualties in Israel. PATIENTS AND METHODS: A retrospective cohort analysis of all combat casualties treated with ETI during scene-to-hospital transport over a 3-year period was carried out...
June 27, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28654610/what-s-new-in-syndromic-craniosynostosis-surgery
#7
Jesse A Taylor, Scott P Bartlett
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand the role of prenatal screening and counseling of parents of unborn children with syndromic craniosynostosis. 2. Recognize the genetic abnormalities, craniofacial phenotype, associated anomalies, and challenges associated with each of the five major forms of syndromic craniosynostosis. 3. Identify the pros and cons associated with timing and types of cranial vault remodeling techniques in this patient population...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28651011/indications-of-airway-stenting-for-severe-central-airway-obstruction-due-to-advanced-cancer
#8
Hiroaki Nagano, Tomoo Kishaba, Yuichirou Nei, Shin Yamashiro, Hiroaki Takara
BACKGROUND: Management of severe central airway obstruction due to advanced cancer is a medical and technical challenge. The impact of airway stenting on the clinical outcome of such patients is unclear. METHOD: This single-center, retrospective study evaluated 21 patients who underwent airway stenting for advanced cancer. We examined predictors of the post-stenting mortality, including age, serum albumin, tracheal diameter, smoking, opioid use, respiratory failure, and performance status (PS)...
2017: PloS One
https://www.readbyqxmd.com/read/28649564/primary-ciliary-dyskinesia-an-update-on-clinical-aspects-genetics-diagnosis-and-future-treatment-strategies
#9
REVIEW
Virginia Mirra, Claudius Werner, Francesca Santamaria
Primary ciliary dyskinesia (PCD) is an orphan disease (MIM 244400), autosomal recessive inherited, characterized by motile ciliary dysfunction. The estimated prevalence of PCD is 1:10,000 to 1:20,000 live-born children, but true prevalence could be even higher. PCD is characterized by chronic upper and lower respiratory tract disease, infertility/ectopic pregnancy, and situs anomalies, that occur in ≈50% of PCD patients (Kartagener syndrome), and these may be associated with congenital heart abnormalities...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28635202/palliative-treatment-of-life-threatening-hemoptysis-with-silicone-stent-insertion-in-advanced-lung-cancer
#10
Emanuela Barisione, Carlo Genova, Marco Grosso, Mercedes Pasquali, Alessandro Blanco, Raffaella Felletti, Mario Salio
Massive hemoptysis is a stressful and life-threatening event that can occur in lung cancer patients. The management of this event is usually challenging, and can involve surgery, embolization, and bronchoscopy. Unfortunately, while surgery can offer a definitive solution to hemoptysis, lung cancer patients are often excluded from this approach. On the other hand, bronchial arterial embolization rarely results in long-term control of bleeding. Endoscopy allows a skilled physician to perform mechanical tamponade or laser photocoagulation of bleeding lesions and preserve the main airways...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28629917/personalized-management-approach-for-osa
#11
REVIEW
Jayne C Carberry, Jason Amatoury, Danny J Eckert
OSA is a heterogeneous disorder. If left untreated, it has major health, safety, and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), nonanatomical "phenotypic traits" are also important contributors to OSA for most patients. However, the majority of existing therapies (eg, CPAP, oral appliances, weight loss, positional therapy, upper airway surgery) target only the anatomical cause. These are typically administered as monotherapy according to a trial and error management approach in which the majority of patients are first prescribed CPAP...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28621155/the-role-of-telemedicine-in-obstructive-sleep-apnea-management
#12
Vera Lugo, Jair Asir Villanueva, Onintza Garmendia, Josep M Montserrat
Obstructive sleep apnea (OSA) is a common disease that leads in notorious symptoms and comorbidities. Although general measures are important, continuous positive airway pressure (CPAP) is the best treatment option. However, compliance can be suboptimal and telemedicine may play a role to improve it. Areas covered: Review authors searched EMBASE, PubMed and Cochrane data bases using the following keywords: continuous positive airway pressure, Obstructive sleep apnea, telemedicine, respiratory telemedicine, information and communication technology...
June 29, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28611887/derivation-and-validation-of-the-prehospital-difficult-airway-identificationtool-predait-a-predictive-model-for-difficult-intubation
#13
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/28603907/a-randomised-controlled-trial-evaluating-a-low-cost-3d-printed-bronchoscopy-simulator
#14
T H Pedersen, J Gysin, A Wegmann, M Osswald, S R Ott, L Theiler, R Greif
Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering complex procedural skills. We developed a cost-effective bronchial tree simulator based on a human thorax computed tomography scan using rapid-prototyping (3D-print) technology. This randomised, single-blind study evaluated how realistic our 3D-printed simulator would mimic human anatomy compared with commercially available bronchial tree simulators (Laerdal(®) Airway Management Trainer with Bronchial Tree and AirSim Advance Bronchi, Stavanger, Norway)...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#15
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28590232/anesthesia-for-patients-with-mucopolysaccharidoses-comprehensive-review-of-the-literature-with-emphasis-on-airway-management
#16
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
https://www.readbyqxmd.com/read/28578372/mandibular-advancement-devices-vs-nasal-continuous-positive-airway-pressure-in-the-treatment-of-obstructive-sleep-apnoea-systematic-review-and-meta-analysis
#17
G Cammaroto, C Galletti, F Galletti, B Galletti, C Galletti, C Gay-Escoda
BACKGROUND: Obstructive sleep apnoea (OSA) is a common disorder that may affect at least 2 to 4% of the adult population. Nasal-Continuous Positive Airway Pressure (N-CPAP) is today considered the gold standard for the treatment of OSA. The development of oral appliances (OAs) represents a new approach for the management of this pathology. The aim of this systematic review is to compare the efficacy of OAs and N-CPAP in the treatment of patients with mild to severe OSA. MATERIAL AND METHODS: A PubMed-MEDLINE and Cochrane databases search of articles published between 1982 and 2016 comparing the effect of N-CPAP and OAs in OSA patients was conducted during July 2016...
July 1, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28511807/does-the-novel-lateral-trauma-position-cause-more-motion-in-an-unstable-cervical-spine-injury-than-the-logroll-maneuver
#18
Per Kristian Hyldmo, MaryBeth Horodyski, Bryan P Conrad, Sindre Aslaksen, Jo Røislien, Mark Prasarn, Glenn R Rechtine, Eldar Søreide
OBJECTIVE: Prehospital personnel who lack advanced airway management training must rely on basic techniques when transporting unconscious trauma patients. The supine position is associated with a loss of airway patency when compared to lateral recumbent positions. Thus, an inherent conflict exists between securing an open airway using the recovery position and maintaining spinal immobilization in the supine position. The lateral trauma position is a novel technique that aims to combine airway management with spinal precautions...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#19
Stephen J M Sollid, Marius Rehn
PURPOSE OF REVIEW: The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. RECENT FINDINGS: Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28506358/-research-advances-in-noninvasive-high-frequency-oscillatory-ventilation-in-neonates
#20
Jia Huang, Lin Yuan, Chao Chen
Noninvasive ventilation is an important respiratory management technique for the treatment of mild or moderate respiratory failure in the neonatal intensive care unit. Its reasonable application can effectively avoid the use of invasive ventilation and related complications. Recent studies have found that noninvasive high-frequency oscillatory ventilation has the advantages of both nasal continuous positive airway pressure and high-frequency ventilation and can rapidly improve oxygenation, effectively remove carbon dioxide, and improve respiratory failure...
May 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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