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Advanced airway management

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https://www.readbyqxmd.com/read/29142842/prevention-and-management-of-bleeding-in-thyroid-surgery
#1
REVIEW
Gabriele Materazzi, Carlo Enrico Ambrosini, Lorenzo Fregoli, Luigi De Napoli, Gianluca Frustaci, Valeria Matteucci, Piermarco Papini, Sohail Bakkar, Paolo Miccoli
Post-thyroidectomy neck hematoma represents a major concern for surgeons because it can result in severe and even life-threatening complications. In fact, postoperative hemorrhage may result in airway compression and respiratory distress, and therefore, effective hemostasis is an important goal in thyroid surgery. Postoperative hematoma occurs at a rate of approximately 0.1% to 1.1%. Almost all cases occur in the first 6 h after surgery and can be the result of several surgeon or patient factors. For many years the clamp-and-tie technique has been the most common way to divide the main vascular pedicles of the thyroid gland...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142836/preoperative-intraoperative-and-postoperative-anesthetic-prospective-for-thyroid-surgery-what-s-new
#2
REVIEW
I-Cheng Lu, I-Hua Lin, Che-Wei Wu, Hsiu-Ya Chen, Yi-Chu Lin, Feng-Yu Chiang, Pi-Ying Chang
The aim of this review is to analyze what's new on anesthetic prospective to perioperative management for thyroid surgery. For recent decades intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. For example, the precise position of EMG tube and optimal use of neuromuscular blocking agents (NMBAs) play key roles in successful IONM system. Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29139062/tools-in-asthma-evaluation-and-management-when-and-how-to-use-them
#3
REVIEW
Anna Mulholland, Alana Ainsworth, Naveen Pillarisetti
The goals of asthma management are accurate diagnosis, prompt initiation of treatment and monitoring of disease progression to limit potential morbidity and mortality. While the diagnosis and management is largely based on history taking and clinical examination, there are an increasing number of tools available that could be used to aid diagnosis, define phenotypes, monitor progress and assess response to treatment. Tools such as the Asthma Predictive Index could help in making predictions about the possibility of asthma in childhood based on certain clinical parameters in pre-schoolers...
November 15, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29135617/lessons-to-learn-from-epidemiologic-studies-in-ards
#4
Bairbre A McNicholas, Grainne M Rooney, John G Laffey
PURPOSE OF REVIEW: Recent advances in our understanding of the epidemiology of ARDS has generated key insights into the incidence, risk factors, demographics, management and outcomes from this devastating clinical syndrome. RECENT FINDINGS: ARDS occurs in 10% of all ICU patients, in 23% of all mechanically ventilated patients, with 5.5 cases per ICU bed each year. Although some regional variation exists regarding ARDS incidence, this may be less than previously thought...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29112511/an-anesthesiologist-s-perspective-on-the-history-of-basic-airway-management-the-progressive-era-1904-to-1960
#5
Adrian A Matioc
This third installment of the history of basic airway management discusses the transitional-"progressive"-years of anesthesia from 1904 to 1960. During these 56 yr, airway management was provided primarily by basic techniques with or without the use of a face mask. Airway maneuvers were inherited from the artisanal era: head extension and mandibular advancement. The most common maneuver was head extension, also used in bronchoscopy and laryngoscopy. Basic airway management success was essential for traditional inhalation anesthesia (ether, chloroform) and for the use of the new anesthetic agents (cyclopropane, halothane) and intravenous drugs (thiopental, curare, succinylcholine)...
November 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29106861/laryngotracheal-reconstruction-and-swallowing-a-review
#6
REVIEW
Jennifer F Ha, Lynn Driver, David A Zopf
OBJECTIVES: Significant advances in laryngotracheal reconstruction over the last few decades have revolutionised the management of paediatric patients with complex congenital or acquired airway stenosis. The primary aim of laryngotracheal reconstruction has focused primarily on airway and surgery specific outcomes, often at the expense of voice, as well as swallowing function, which are all intricately related. There is currently a paucity of data on swallowing outcome. The goal of this paper is to review and discuss the existing research on the impact of laryngotracheal on swallowing...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29103835/genioglossus-muscle-advancement-and-simultaneous-sliding-genioplasty-in-the-management-of-sleep-apnoea
#7
R Rojas, R Chateau, C Gaete, C Muñoz
Genioglossus muscle advancement (GMA) was reported in 1993 as an option for the surgical treatment of obstructive sleep apnoea syndrome (OSAS), in the context of phase I of the Stanford University (Powell-Riley) protocol. The rationale for this technique is the placement of tension on the base of the tongue, thus preventing the tongue from falling back into the posterior airway space. However, in retrognathic patients undergoing phase I of the Stanford University protocol, an additional genioplasty will provide a better aesthetic outcome...
November 2, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29101956/anesthesia-for-routine-and-advanced-upper-gastrointestinal-endoscopic-procedures
#8
REVIEW
Christopher D Sharp, Ezekiel Tayler, Gregory G Ginsberg
This article aims to detail the breadth and depth of advanced upper gastrointestinal endoscopic procedures. It will focus on sedation and airway management concerns pertaining to this emerged and emerging class of minimally invasive interventions. The article will also cover endoscopic hemostasis, endoscopic resection, stenting and Barrett eradication therapy plus endoscopic ultrasound. It additionally will address the nuances of endoscopic retrograde cholangiopancreatography and new natural orifice transluminal endoscopic surgery procedures including endoscopic cystgastrostomy and the per-oral endoscopic myotomy procedure...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29100739/selected-highlights-in-clinical-anesthesia-research
#9
REVIEW
Mark C Kendall, Zachary M Robbins, Alexander Cohen, Mary Minn, Scott E Benzuly, Andrew S Triebwasser, Zachary L McCormick, Michelle Gorgone
STUDY OBJECTIVE: To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. DESIGN: Narrative review. SETTING: N/A. MATERIALS: The major themes address broad categories of general anesthesia including airway management, abdominal surgery, and obstetrical and gynaecological anesthesia. In addition, recent advancements in specialties of anesthesiology including regional anesthesia are reviewed...
October 31, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29080708/classification-of-cough-as-a-symptom-in-adults-and-management-algorithms-chest-guideline-and-expert-panel-report
#10
Richard S Irwin, Cynthia L French, Anne B Chang, Kenneth W Altman
BACKGROUND: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework...
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29072225/bilateral-pediatric-mandibular-distraction-for-micrognathia-with-temporomandibular-joint-ankylosis-and-sleep-apnea
#11
S M Balaji
Mandibular retrognathism is one of the important contributing anatomical factors to the obstructive sleep apnea (OSA). Such patients suffer from number of apneic or hypopneic events during sleep such as snoring, daytime sleepiness, fatigue, inability to concentrate, and irritability. Distraction osteogenesis is a less invasive surgical technique in the management of OSA by correcting the reduced airway space. Apart from correcting functional disturbances due to OSA, it also corrects the facial profile resulting in the substantial improvement in cosmetic appearance...
September 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/29048949/discovering-pediatric-asthma-phenotypes-based-on-response-to-controller-medication-using-machine-learning
#12
Mindy K Ross, Jinsung Yoon, Auke van der Schaar, Mihaela van der Schaar
RATIONALE: Pediatric asthma has variable underlying inflammation and symptom control. Approaches to address this heterogeneity such as clustering methods to find phenotypes and predicting outcomes have been investigated. However, clustering based upon the relationship between treatment and clinical outcome has not been performed. Also, machine learning approaches for long-term outcome prediction in pediatric asthma have not been studied in depth. OBJECTIVES: Our objectives were to use our novel machine learning algorithm, Predictor Pursuit (PP) to discover pediatric asthma phenotypes based on treatment response to different asthma controller medications, to predict outcomes of children with asthma over time, and to identify the most indicative features of asthma control for the discovered pediatric phenotypes...
October 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29017400/minimally-invasive-method-to-activate-the-expiratory-muscles-to-restore-cough
#13
Anthony F DiMarco, Robert T Geertman, Kutaiba Tabbaa, Rebecca R Polito, Krzysztof E Kowalski
CONTEXT: Spinal cord stimulation (SCS) via disc electrodes surgically placed via laminotomy incisions has been shown to restore an effective cough in subjects with spinal cord injury (SCI). The purpose of this study was to evaluate a new method of expiratory muscle activation utilizing spinal cord wire leads, which can be implanted with minimally invasive techniques. METHODS: In a subject with SCI, parallel wire leads with two electrode contacts were inserted percutaneously through a needle, advanced to the T9, T11 spinal levels and connected to an implanted radiofrequency receiver...
October 11, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28989817/medical-and-surgical-advancements-in-the-management-of-cystic-fibrosis-chronic-rhinosinusitis
#14
Kiranya E Tipirneni, Bradford A Woodworth
PURPOSE OF REVIEW: The purpose of this review is to provide otolaryngologists with the most up-to-date advancements in both the medical and surgical management of CF-related sinus disease. RECENT FINDINGS: Recent studies have supported more aggressive CRS management, often with a combination of both medical and surgical therapies. Comprehensive treatment strategies have been shown to reduce hospital admissions secondary to pulmonary exacerbations in addition to improving CRS symptoms...
March 2017: Current Otorhinolaryngology Reports
https://www.readbyqxmd.com/read/28987230/controversies-in-obstructive-sleep-apnea-surgery
#15
REVIEW
Carolyn C Dicus Brookes, Scott B Boyd
Obstructive sleep apnea (OSA) is a common chronic disease characterized by repetitive pharyngeal collapse during sleep. OSA is associated with cardiovascular disease and increased mortality, among other issues. Continuous positive airway pressure (CPAP) is considered first line therapy for OSA, but is not always tolerated. Both non-surgical and surgical alternative management strategies are available for the CPAP intolerant patient. This article explores controversies surrounding airway evaluation, definition of successful treatment, and surgical management of the CPAP intolerant patient with moderate to severe OSA...
November 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28971654/-surgical-treatment-of-locally-advanced-well-differentiated-thyroid-carcinoma
#16
Shorook Na'ara, Moran Amit, Salem Billan, Jacob Cohen, Ziv Gil
AIMS: We aimed to better define the most appropriate therapeutic protocol for this type of tumor. BACKGROUND: The incidence of well-differentiated thyroid carcinoma is rising and the mortality from the disease remains low for patients with early disease. Nevertheless, the survival of patients with advanced disease has not improved during the last four decades and a controversy still exists in the literature regarding the optimal treatment in patients with locally advanced (T4) differentiated thyroid carcinoma...
September 2017: Harefuah
https://www.readbyqxmd.com/read/28967516/the-effect-of-successful-intubation-on-patient-outcomes-after-out-of-hospital-cardiac-arrest-in%C3%A2-taipei
#17
Wen-Chu Chiang, Ming-Ju Hsieh, Hsin-Lan Chu, Albert Y Chen, Shin-Yi Wen, Wen-Shuo Yang, Yu-Chun Chien, Yao-Cheng Wang, Bin-Chou Lee, Huei-Chih Wang, Edward Pei-Chuan Huang, Chih-Wei Yang, Jen-Tang Sun, Kah-Meng Chong, Hao-Yang Lin, Shu-Hsien Hsu, Shey-Ying Chen, Matthew Huei-Ming Ma
STUDY OBJECTIVE: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. METHODS: We analyzed 6 years of Utstein-based registry data from nontrauma adult patients with out-of-hospital cardiac arrest who underwent out-of-hospital airway management including intubation, laryngeal mask airway, or bag-valve-mask ventilation...
September 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28959487/current-management-of-spontaneous-intracerebral-haemorrhage
#18
REVIEW
Cyrus K Dastur, Wengui Yu
Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. Early airway protection, control of malignant HTN, urgent reversal of coagulopathy and surgical intervention may increase the chance of survival for patients with severe ICH. Intensive lowering of systolic blood pressure to <140 mm Hg is proven safe by two recent randomised trials...
March 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28955672/treatment-of-advanced-carcinoma-of-the-larynx-and-hypopharynx-with-laser-followed-by-external-radiotherapy
#19
Lalee Varghese, John Mathew, Subhashini John, Anand Job
INTRODUCTION: Radical laryngeal surgeries for extensive laryngeal and hypopharyngeal tumors often require a permanent tracheostomy, which has an immense impact on the quality of life of patients. A minimally invasive technique such as transoral laser microresection (TLM) followed by radiotherapy can preserve the functions of the voice and swallowing. The aim of this study is to evaluate the role of laser debulking in the treatment of carcinoma of the larynx and hypopharynx, to evaluate the response of the tumor to subsequent radiotherapy, and also to assess the usefulness of laser in avoiding tracheostomy and functional preservation of the voice and swallowing...
September 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28932570/the-technique-of-endoscopic-airway-tumor-treatment
#20
REVIEW
Simone Scarlata, Lello Fuso, Gabriele Lucantoni, Francesco Varone, Daniele Magnini, Raffaele Antonelli Incalzi, Gianni Galluccio
More than half of primary lung cancers are not resectable at diagnosis and 40% of deaths may be secondary to loco-regional disease. Many of these patients suffer from symptoms related to airways obstruction. Indications for therapeutic endoscopic treatment are palliation of dyspnea and other obstructive symptoms in advanced cancerous lesions and cure of early lung cancer. Bronchoscopic management is also indicated for all those patients suffering from benign or minimally invasive neoplasm who are not suitable for surgery due to their clinical conditions...
August 2017: Journal of Thoracic Disease
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