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https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#1
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28797305/improved-success-rates-using-videolaryngoscopy-in-unexperienced-users-a-randomized-crossover-study-in-airway-manikins
#2
Hendrik Eismann, Lion Sieg, Nicola Etti, Lars Friedrich, Christian Schröter, Philipp Mommsen, Christian Krettek, Christian Zeckey
BACKGROUND: Videolaryngoscopy has been proven to be a safe procedure managing difficult airways in the hands of airway specialists. Information about the success rates in unexperienced users of videolaryngoscopy compared to conventional laryngoscopy is sparse. Therefore, we aimed to evaluate if there might be more success in securing an airway if the unexperienced provider is using a videolaryngoscope in simulated airways in a randomized manikin study. Differences between commonly used videolaryngoscopes were elucidated...
August 10, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#3
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
https://www.readbyqxmd.com/read/28781848/successful-difficult-airway-management-of-a-child-with-coffin-siris-syndrome
#4
Ahmet Selim Ozkan, Sedat Akbas, Mehmet Ridvan Yalin, Emine Ozdemir, Zeynep Koylu
Management of airway in patients who have Coffin-Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C-MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28781841/perioperative-airway-management-of-a-16-year-old-boy-with-progressive-airway-obstruction-due-to-juvenile-nasopharyngeal-angiofibroma
#5
Kei Kamiyama, Maiko Satomoto, Kotaro Minami, Yukiko Baba, Koshi Makita
Juvenile nasopharyngeal angiofibroma (JNA) involves difficult anesthetic management because of the risk of massive bleeding, while airway management is rarely a problem in JNA. This report presents an unusual case of JNA causing airway obstruction.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28780895/the-use-of-pulmonary-clearance-medications-in-the-acutely-ill-patient
#6
Michael F Papacostas, Peter Luckett, Susan Hupp
Retention of airway secretions occurs in disease, leading to airway plugging, atelectasis, and worsened respiratory mechanics, making airway clearance an important therapeutic target. Areas Covered: Many medications designed to enhance clearance of airway secretions are available. We will review the medications available to enhance airway clearance, their mechanisms of action, and the evidence available for their use in acutely ill patients. Expert Commentary: In the cystic fibrosis (CF) population, beneficial effects have been shown in pulmonary function with the use of some of these agents...
August 7, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28776555/induction-of-anesthesia-with-dexmedetomidine-and-sevoflurane-for-a-pediatric-difficult-airway
#7
Ling-Xin Wei, Xiao-Ming Deng, Jing-Hu Sui, Lei Wang
No abstract text is available yet for this article.
August 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28775071/the-acute-effects-of-long-acting-bronchodilators-on-small-airways-detected-in-copd-patients-by-single-breath-n2-test-and-lung-p-v-curve
#8
Matteo M Pecchiari, Pierachille Santus, Dejan Radovanovic, Edgardo Giacomo D'Angelo
Small airways represent the key factor of chronic obstructive pulmonary disease (COPD) pathophysiology. The effect of different classes of bronchodilators on small airways is still poorly understood and difficult to assess. Hence, the acute effects of tiotropium (18 µg) and indacaterol (150 µg) on closing volume (CV) and ventilation inhomogeneity were investigated and compared in 51 stable patients (mean age (SD): 70±7 years; 82% males) with moderate to very severe COPD. Patients underwent body-plethysmography, arterial blood gas-analysis, tidal expiratory flow limitation (EFL), dyspnea assessment, and simultaneous recording of single breath nitrogen test (SBN) and transpulmonary pressure-volume curve (PL-V), before and one hour after drug administration...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28771680/safety-and-efficacy-of-rescue-flexible-bronchoscopic-intubation-using-the-bentson-floppy-tip-guidewire-via-a-supraglottic-airway-in-critically-ill-children
#9
D Cross, A Nyman, P James, A Durward
Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation...
August 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28767471/high-flow-nasal-oxygen-in-patient-with-obstructive-sleep-apnea-undergoing-awake-craniotomy-a-case-report
#10
Jaclyn W M Wong, Amy H S Kong, Sau Yee Lam, Peter Y M Woo
Patients with obstructive sleep apnea are frequently considered unsuitable candidates for awake craniotomy due to anticipated problems with oxygenation, ventilation, and a potentially difficult airway. At present, only a handful of such accounts exist in the literature. Our report describes the novel use of high-flow nasal oxygen therapy for a patient with moderate obstructive sleep apnea who underwent an awake craniotomy under deep sedation. The intraoperative application of high-flow nasal oxygen therapy achieved satisfactory oxygenation, maintained the partial carbon dioxide pressure within a reasonable range even during periods of deep sedation, permitted responsive patient monitoring during mapping, and provided excellent patient and surgeon satisfaction...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28766039/fungal-and-bacterial-diversity-of-airway-microbiota-in-adults-with-cystic-fibrosis-concordance-between-conventional-methods-and-ultra-deep-sequencing-and-their-practical-use-in-the-clinical-laboratory
#11
Françoise Botterel, Cécile Angebault, Odile Cabaret, Franziska A Stressmann, Jean-Marc Costa, Frédéric Wallet, Benoit Wallaert, Kenneth Bruce, Laurence Delhaes
Given the complexity of the airway microbiota in the respiratory tract of cystic fibrosis (CF) patients, it seems crucial to compile the most exhaustive and exact list of the microbial communities inhabiting CF airways. The aim of the present study was to compare the bacterial and fungal diversity of sputa from adult CF patients during non-exacerbation period by culture-based and molecular methods, and ultra-deep-sequencing (UDS). Sputum samples from four CF patients were cultured and analysed by DNA extractions followed by terminal restriction fragment length polymorphism analysis through resolution of bacterial ribosomal gene (rDNA) fragments, and cloning plus sequencing of part of fungal rRNA genes...
August 1, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28763154/best-practices-in-peri-operative-management-of-patients-with-skeletal-dysplasias
#12
Klane K White, Viviana Bompadre, Michael J Goldberg, Michael B Bober, Tae-Joon Cho, Julie E Hoover-Fong, Melita Irving, William G Mackenzie, Shawn E Kamps, Cathleen Raggio, Gregory J Redding, Samantha S Spencer, Ravi Savarirayan, Mary C Theroux
Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia...
August 1, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28757825/sternomental-distance-and-sternomental-displacement-as-predictors-of-difficult-laryngoscopy-and-intubation-in-adult-patients
#13
Smita Prakash, Parul Mullick, Shyam Bhandari, Amitabh Kumar, Anoop Raj Gogia, Rajvir Singh
BACKGROUND: Several morphometric airway measurements have been used to predict difficult laryngoscopy (DL). This study evaluated sternomental distance (SMD) and sternomental displacement (SMDD, difference between SMD measured in neutral and extended head position), as predictors of DL and difficult intubation (DI). MATERIALS AND METHODS: We studied 610 adult patients scheduled to receive general anesthesia with tracheal intubation. SMD, SMDD, physical, and airway characteristics were measured...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28753704/-sleep-apnea-and-mechanical-ventilation-impact-on-clinical-course-and-perioperative-management
#14
S Keymel, S Krüger, S Steiner
There is a high prevalence of sleep related breathing disorders in critical ill patients and in perioperative settings. Nevertheless, less is known about their impact on clinical course and therapeutic strategies in this context. Intensive care physicians should be aware of difficult airway, weaning- and post-extubation failure and negative impact of SRBD on hemodynamics. Sedatives and analgetics might worsen SRBD and their use should be restricted as far as possible, furthermore the use of NIV might be beneficial...
July 28, 2017: Pneumologie
https://www.readbyqxmd.com/read/28748861/current-evidences-for-the-use-of-uescope-in-airway-management
#15
REVIEW
Fu-Shan Xue, Ben-Quan Yang, Ya-Yang Liu, Hui-Xian Li, Gui-Zhen Yang
OBJECTIVE: UEscope is a new angulated videolaryngoscope (VL). This review aimed to describe the features of UEscope and provide clinical evidences regarding the efficacy and safety of this video device in adult tracheal intubation and its roles in airway management teaching. DATA SOURCES: The Wan Fang Data, CNKI, PubMed, Embase, Cochrane Library, and Google Scholar were searched for relevant English and Chinese articles published up to January 15, 2017, using the following keywords: "HC video laryngoscope", "UE videolaryngoscope", "video laryngoscope", and "videolaryngoscopy"...
August 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28743345/-application-of-low-damage-endotracheal-intubation-in-patients-undergoing-extra-long-term-endotracheal-intubation-a-case-report
#16
Hao Wang, Baochun Ding
OBJECTIVE: To approach the effect of low damage endotracheal intubation on reducing the occurrence of cuff-related intubation complication and prolonging the intubation time. METHODS: On January 7th, 2015, 1 patient with respiratory failure after subarachnoid hemorrhage were admitted to Huludao Central Hospital. Immediate endotracheal intubation and ventilator assisted ventilation were performed. When the trachea was difficult to be removed in a short time, and tracheotomy was refused, a low damage endotracheal intubation was used for a long term...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#17
REVIEW
Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu, Gui-Zhen Yang
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28739243/heaven-criteria-derivation-of-a-new-difficult-airway-prediction-tool
#18
Daniel P Davis, David J Olvera
OBJECTIVE: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. METHODS: A retrospective descriptive analysis was performed in a population of air medical rapid sequence intubation patients requiring more than 1 attempt...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28738344/quantitative-low-dose-computed-tomography-of-the-lung-parenchyma-and-airways-for-the-differentiation-between-chronic-obstructive-pulmonary-disease-and-asthma-patients
#19
Huai Chen, Qing-Si Zeng, Min Zhang, Rong-Chang Chen, Ting-Ting Xia, Wei Wang, Xiaoyin Xu, Yubao Guan
BACKGROUND: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD) and asthma in clinics; therefore, for diagnostic purposes, imaging-based measurements could be beneficial to differentiate between the two diseases. OBJECTIVES: We aim to analyze quantitative measurements of the lung and bronchial parameters that are provided by low-dose computed tomography (CT) to differentiate COPD and asthma from an imaging perspective. MATERIALS AND METHODS: 69 COPD patients, 52 asthma patients, and 20 healthy subjects were recruited to participate in CT imaging and pulmonary function tests (PFTs)...
July 25, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28733286/the-regulator-ldhr-and-the-d-lactate-dehydrogenase-ldha-of-burkholderia-multivorans-play-a-role-in-carbon-overflow-and-in-planktonic-cellular-aggregates-formation
#20
Inês N Silva, Marcelo J Ramires, Lisa A Azevedo, Ana R Guerreiro, Andreia C Tavares, Jörg D Becker, Leonilde M Moreira
LysR-type transcriptional regulators (LTTR) are the most commonly found regulators in Burkholderia cepacia complex, comprising opportunistic pathogens causing chronic respiratory infections in cystic fibrosis (CF) patients. Despite LTTRs being global regulators of pathogenicity in several bacteria, few have been characterized in Burkholderia Here, we showed that gene ldhR of B. multivorans encoding a LTTR is co-transcribed with ldhA encoding a d-lactate dehydrogenase, and evaluate their implication in virulence traits like exopolysaccharide (EPS) synthesis and biofilm formation...
July 21, 2017: Applied and Environmental Microbiology
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