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Advanced airway management

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https://www.readbyqxmd.com/read/28932570/the-technique-of-endoscopic-airway-tumor-treatment
#1
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
https://www.readbyqxmd.com/read/28929061/drug-induced-sleep-endoscopy-as-a-selection-tool-for-surgical-management-of-obstructive-sleep-apnoea-syndrome-our-personal-experience
#2
M B Bharathi, J Rajendra Prasad, K Satish
The role of Drug-induced sleep endoscopy as a selection tool for surgical management of obstructive sleep apnoea syndrome. SOURCE OF DATA: Polysomnography proved OSA patients, who are planned for surgery in dept. of ENT AND HEAD& NECK, JSS Hospital, Mysore. STUDY DESIGN: A prospective clinical study. METHOD: 30 Polysomnography proved OSA patients, age between 20 and 60 years have been selected for Drug Induced Sleep Endoscopy (DISE) after taking informed consent for proposed surgery...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28915135/otolaryngologic-management-of-down-syndrome-patients-what-is-new
#3
Ethan C Bassett, Mary F Musso
PURPOSE OF REVIEW: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. RECENT FINDINGS: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA...
September 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#4
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28879332/anesthetic-management-for-simultaneous-drug-induced-sleep-endoscopy-and-maxillomandibular-advancement-in-a-patient-with-obstructive-sleep-apnea
#5
Tae Seong Kuk, Eunsun So, Myong-Hwan Karm, Jimin Kim, Seong In Chi, Hyun Jeong Kim, Kwang-Suk Seo, Sung Woon On, Jin-Young Choi
Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28862414/asthma-copd-overlap-syndrome-recent-advances-in-diagnostic-criteria-and-prognostic-significance
#6
Claudio Sorino, Nicola Scichilone, Maria D'Amato, Vincenzo Patella, Fabiano DI Marco
The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide...
June 2017: Minerva Medica
https://www.readbyqxmd.com/read/28858969/obstructive-sleep-apnoea-of-mild-severity-should-it-be-treated
#7
Walter T McNicholas
PURPOSE OF REVIEW: To provide guidance in the management of mild obstructive sleep apnoea syndrome (OSAS) in the context of a very high prevalence, poor correlation with symptom profile, and lack of evidence that mild OSAS significantly contributes to comorbidity or early mortality. RECENT FINDINGS: Mild obstructive sleep apnoea defined by hourly frequency of apnoeas or hypopnoeas (AHI) between 5 and 15 affects up to 35% of the general adult population but is much less prevalent when associated daytime symptoms are included...
August 30, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28850156/fosterkirurgi-%C3%A3-r-en-v%C3%A3-xande-multidisciplin%C3%A3-r-subspecialitet-etablerad-behandling-vid-ryggm%C3%A3-rgsbr%C3%A3-ck-%C3%A2-i-framtiden-skymtar-artificiell-placenta-och-stamcellsterapi
#8
Carmen Mesas Burgos, Peter Conner, Georgios Papatziamos, Eleonor Tiblad
Advances in fetal surgery Fetal surgery is a subspeciality that is evolving rapidly with focus on improving the natural history of congenital malformations and conditions that are either life threatening or cause severe disability. Fetal surgery for myelomeningocele has been shown to improve neurologic outcome, motor function and to reduce the need of ventriculo-peritoneal shunting after birth compared to postnatal care. However, it conveys an increased risk of preterm birth and maternal morbidity. The role of prenatal intervention with endoscopic tracheal occlusion in congenital diaphragmatic hernia is currently the focus of an ongoing multicenter randomized controlled trial...
August 29, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28817401/challenges-in-the-anesthetic-management-of-ambulatory-patients-in-the-mri-suites
#9
Jasper Deen, Yzabel Vandevivere, Peter Van de Putte
PURPOSE OF REVIEW: MRI is becoming an indispensable diagnostic tool. The need for prolonged motion-free periods has substantially increased the need for deep sedation or anesthesia in a challenging environment. This review summarises recent literature with respect to pharmacological sedative strategies, nonpharmacological alternative approaches, airway management and safety issues in the ambulatory setting. RECENT FINDINGS: Most literature researches the pediatric patient population...
August 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28800865/anaphylaxis
#10
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life-threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or nonallergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal, and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest, resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting; however, these conditions can be severe enough to warrant evaluation of the patient in the ED and in some cases, hospitalization, and management in an ICU...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28780982/validation-of-the-criteria-for-early-critical-care-resource-use-in-assessing-the-effectiveness-of-field-triage
#11
Ki Ok Ahn, Sang Chul Kim, Ju Ok Park, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong
BACKGROUND: This study aimed to validate the criteria for early critical care resource (CCR) use as an outcome predictor for seriously injured patients triaged in the field by comparing the effectiveness of the criteria for early CCR use with that of criteria defined by an Injury Severity Score (ISS) >15. METHODS: We analysed data from seriously injured trauma patients who were triaged using a field triage protocol by emergency medical service providers (EMS-ST patients)...
July 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28750882/unrecognized-failed-airway-management-using-a-supraglottic-airway-device
#12
Veer D Vithalani, Sabrina Vlk, Steven Q Davis, Neal J Richmond
BACKGROUND: 911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. METHODS: Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28740999/advanced-cardiac-life-support-2016-singapore-guidelines
#13
Chi Keong Ching, Siew Hon Benjamin Leong, Siang Jin Terrance Chua, Swee Han Lim, Kenneth Heng, Sohil Pothiawala, Venkataraman Anantharaman
The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defibrillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740687/infections-causing-central-airway-obstruction-role-of-bronchoscopy-in-diagnosis-and-management
#14
REVIEW
Sevak Keshishyan, Lawrence DeLorenzo, Kassem Hammoud, Arpine Avagyan, Hussein Assallum, Kassem Harris
Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28732224/three-dimensional-changes-in-the-upper-airway-of-skeletal-class-iii-patients-after-different-orthognathic-surgical-procedures
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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