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https://www.readbyqxmd.com/read/29666918/procedure-specific-assessment-tool-for-flexible-pharyngo-laryngoscopy-gathering-validity-evidence-and-setting-pass-fail-standards
#1
Jacob Melchiors, K Petersen, T Todsen, A Bohr, Lars Konge, Christian von Buchwald
OBJECTIVE: The attainment of specific identifiable competencies is the primary measure of progress in the modern medical education system. The system, therefore, requires a method for accurately assessing competence to be feasible. Evidence of validity needs to be gathered before an assessment tool can be implemented in the training and assessment of physicians. This evidence of validity must according to the contemporary theory on validity be gathered from specific sources in a structured and rigorous manner...
April 17, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29666294/laryngeal-responses-to-mechanically-assisted-cough-in-progressing-amyotrophic-lateral-sclerosis
#2
Tiina M Andersen, Astrid Sandnes, Ove Fondenes, Roy M Nilsen, Ole-Bjørn Tysnes, John-Helge Heimdal, Hege H Clemm, Thomas Halvorsen, Maria Vollsœter, Ola D Røksund
BACKGROUND: Respiratory complications represent the major cause of death in amyotrophic lateral sclerosis (ALS). Noninvasive respiratory support is the mainstay therapy, but treatment becomes challenging as the disease progresses, possibly due to a malfunctioning larynx, which is the entrance to the airways. We studied laryngeal response patterns to mechanically assisted cough (mechanical insufflation-exsufflation) as ALS progresses. METHODS: This prospective longitudinal study of 13 consecutively included subjects with ALS were followed up during 2011-2016 with repeated tests of lung function, neurological status, and laryngeal responses to mechanical insufflation-exsufflation using video-recorded flexible transnasal fiberoptic laryngoscopy...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29660807/a-randomised-clinical-trial-comparing-the-sniffing-and-neutral-position-using-channelled-kingvision-%C3%A2-and-non-channelled-c-mac-%C3%A2-videolaryngoscopes
#3
C Mendonca, N Ungureanu, A Nowicka, P Kumar
Head and neck position is one of the factors which can be associated with difficult videolaryngoscopy and tracheal intubation. This prospective randomised clinical trial compared 'sniffing' and neutral positions using a channelled (KingVision® ) and a non-channelled (C-MAC® D-blade) videolaryngoscope in 200 adult patients randomly allocated into four groups (KingVision 'sniffing', KingVision neutral, C-MAC 'sniffing' and C-MAC neutral). The primary outcome was the ease of tracheal intubation using the modified intubation difficulty scale (mIDS) score...
April 16, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29649032/airway-management-practice-in-adults-with-an-unstable-cervical-spine-the-harborview-medical-center-experience
#4
Michael G Holmes, Armagan Dagal, Bryan A Feinstein, Aaron M Joffe
BACKGROUND: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Our aim was to describe the frequency of airway management techniques used in patients with CSI at our level I trauma center and report the incidence of neurological injury attributable to airway management...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29643630/comparison-of-pretreatment-with-dexmedetomidine-with-midazolam-for-prevention-of-etomidate-induced-myoclonus-and-attenuation-of-stress-response-at-intubation-a-randomized-controlled-study
#5
Swarnendu Dey, Meenakshi Kumar
Background and Aims: Myoclonus is a common problem during induction of anesthesia with etomidate. A variety of drugs have been used to decrease the incidence of myoclonus. In this study we compared the effects of dexmedetomidine and midazolam pretreatment on the incidence of etomidate induced myoclonus. We also studied the effects of these drugs on attenuation of stress response at laryngoscopy and intubation on induction with etomidate. Material and Methods: Eighty adult patients (18 to 60 years age) of either sex, American Society of Anestheiologists physical status I and II undergoing elective general surgeries under general anesthesia were randomly allocated into two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643626/ratio-of-height-to-thyromental-distance-and-ratio-of-height-to-sternomental-distance-as-predictors-of-laryngoscopic-grade-in-children
#6
Swarup Ray, Shwethapriya Rao, Jasvinder Kaur, Yogesh K Gaude
Background and Aims: Failure to secure the airway is an important cause of morbidity and mortality in children. Children are often uncooperative for routine examination and pose problems for obtaining external measurements. We aimed to evaluate ratio of height-to-thyromental distance (RHTMD) and ratio of height-to-sternomental distance (RHSMD) as predictors of laryngoscopic grade in children aged 1-12 years. Material and Methods: This study was an observational study conducted in children aged between 1 and 12 years scheduled for elective surgery under general anesthesia...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643623/effect-of-dexmedetomidine-infusion-on-hemodynamic-responses-in-microsurgery-of-larynx
#7
Shakuntala Basantwani, Mayuresh Patil, Balasaheb Govardhane, Jyoti Magar, Bharati Tendolkar
Background and Aims: Microlaryngeal surgery is a frequently performed ear, nose, and throat procedure used to diagnose and treat laryngeal disorders. Suspension laryngoscopy causes prolonged stimulation of the deep pressure receptors of the larynx leading to adverse circulatory responses and consequently cardiac complications. In this study, dexmedetomidine infusion was used to assess its effectiveness for attenuation of this hemodynamic stress response. Material and Methods: Sixty patients undergoing elective microlaryngeal surgery randomly received either dexmedetomidine 1 μg/kg over 10 min followed by continuous infusion of 0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643559/appropriate-angled-tip-front-width-facilitates-tracheal-tube-introducer-placement-in-difficult-to-displace-epiglottis-situations
#8
Amitabh Dutta, Manish Gupta, Prabhat Kumar Choudhary, Jayashree Sood
Tracheal tube introducers (TTIs) are a useful aid to a conventional laryngoscopy-intubation method of upper airway access in adults. However, even when TTIs are used, successful tracheal intubation is not guaranteed. Apart from suboptimal practice proficiency and unavailability of the complete repertoire of TTI, the physical attributes of the TTI have a role to play. Our report on the management of two cases highlights the importance of selecting a TTI with appropriate angled tip characteristics to facilitate successful guided intubation...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29643554/effectiveness-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-traditional-preoxygenation-followed-by-apnoeic-oxygenation-in-delaying-desaturation-during-apnoea-a-preliminary-study
#9
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Dilesh Kadapamannil, Jerry Paul, Lakshmi Kumar
Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to <90% during apnoea with THRIVE versus traditional preoxygenation followed by apnoeic oxygenation. Methods: This prospective, randomised, single-blinded study was conducted in 10 adult patients presenting for direct laryngoscopy under general anaesthesia without endotracheal intubation...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628843/point-of-care-ultrasound-in-the-airway-assessment-a-correlation-of-ultrasonography-guided-parameters-to-the-cormack-lehane-classification
#10
Shelly Rana, Versha Verma, Shyam Bhandari, Shalini Sharma, Vishal Koundal, Sudarshan Kumar Chaudhary
Background and Aim: The sonographic assessment of airway in the preoperative period has encouraging results in predicting difficult laryngoscopy. Materials and Methods: The prospective, observational study was conducted on 120 patients scheduled for elective surgery requiring general anesthesia and tracheal intubation. The depth of the pre-epiglottic space (Pre-E), the distance from the epiglottis to the midpoint of the distance between the vocal cords (E-VC) was measured sonographically...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628593/comparison-of-esmolol-and-dexmedetomidine-for-suppression-of-hemodynamic-response-to-laryngoscopy-and-endotracheal-intubation-in-adult-patients-undergoing-elective-general-surgery-a-prospective-randomized-controlled-double-blinded-study
#11
Sandeep Sharma, Om Prakash Suthar, M L Tak, Abhilasha Thanvi, Naveen Paliwal, Rakesh Karnawat
Context: Laryngoscopy and endotracheal intubation lead to strong sympathetic response which may precipitate arrhythmias, myocardial ischemia and cerebrovascular accidents in patients with preexisting cardiovascular disease. Aims: This study was aimed to compare the effect of dexmedetomidine and esmolol on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective surgery under general anesthesia. Settings and Design: This was a prospective, randomized controlled double-blinded study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628581/ease-of-intubation-with-c-mac-videolaryngoscope-use-of-60%C3%A2-angled-styletted-endotracheal-tube-versus-intubation-over-bougie
#12
Pulak Tosh, Sunil Rajan, Lakshmi Kumar
Background: Although videolaryngoscopes improve glottic visualization, their actual usefulness in intubation is not yet established. Aims: The primary objective was to compare the ease of oral intubation with the use of 60° angled styletted endotracheal tube versus that performed over bougie inserted under videolaryngoscopic guidance. The secondary objectives were assessment of incidence of airway loss, hemodynamic changes, and time and number of attempts at intubation...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628570/effect-of-c-mac-video-laryngoscope-aided-intubations-using-d-blade-on-incidence-and-severity-of-postoperative-sore-throat
#13
Pulak Tosh, Dilesh Kadapamannil, Sunil Rajan, Naina Narayani, Lakshmi Kumar
Background: Video laryngoscope-aided intubations require less force to align oral, pharyngeal, and laryngeal planes to visualize the glottis opening during intubation. Aim: The primary objective of the study was to assess the incidence and severity of postoperative sore throat (POST) in patients who were intubated with C-MAC video laryngoscope using D-blade versus traditional Macintosh laryngoscope. Settings and Design: This prospective, randomized, open label study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628567/comparison-of-upper-lip-bite-test-and-ratio-of-height-to-thyromental-distance-with-other-airway-assessment-tests-for-predicting-difficult-endotracheal-intubation
#14
D Shobha, Maitri Adiga, D Devika Rani, Sudheesh Kannan, S S Nethra
Background and Aims: Unanticipated difficult intubation or the failed intubation in operating room and in emergency department is an imperative source of anesthesia-related patient's mortality. The aim of this study is to compare the predictive value of upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) with other commonly used preoperative airway assessment tests for predicting difficult intubation in Indian population. Materials and Methods: In this prospective, single-blinded observational study, 260 adult patients of either sex, belonging to American Society of Anesthesiologists physical Status I and II undergoing elective surgical procedure under general anesthesia were included in the study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29621014/laryngoscopy-and-bronchoscopy-in-an-infant-with-a-congenital-laryngeal-web-complicated-by-bilateral-pneumothoraces-a-case-report
#15
Michelle M LeRiger, Marcellene H Franzen, Ryan K Sewell, Greta L Duncan-Wiebe
Neonates with laryngeal webs pose unique challenges to the anesthesiologist. We present a 2-day-old neonate with aphonia and stridor who underwent microdirect laryngoscopy. Intraoperatively, a Cohen type 4 laryngeal web was diagnosed not immediately amenable to resection. Therefore, the decision was made for endotracheal intubation and subsequent tracheostomy. After endotracheal intubation, there was acute respiratory compromise and oxygen desaturation that improved moderately after urgent tracheostomy. A chest radiograph revealed a large pneumothorax...
March 31, 2018: A&A practice
https://www.readbyqxmd.com/read/29611788/c-mac-%C3%A2-videolaryngoscopy-the-anaesthetic-assistant-s-view
#16
Lydia Jones, Kathleen Mulcahy, Jeremy Fox, Tim M Cook, Fiona E Kelly
Although videolaryngoscopy plays a major role in the 2015 Difficult Airway Society guidelines, the impact on anaesthetic assistant working practices and training has not previously been reported. We surveyed anaesthetic assistants in our hospital to document their experience with using the C-MAC© videolaryngoscope (48 practitioners, 100% response rate). Improvements in the following were reported: patient safety 100%; ability to see whether laryngoscopy is difficult 98%; ability to anticipate the 'next step' 98%; team-working and human factors 96%; ability to call a senior anaesthetist more quickly 94%; assessment or adjustment of cricoid force application 92%, understanding of laryngeal anatomy 92%; training in intubation 98%; training in cricoid force application 87%...
April 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29611119/benefits-of-recording-images-during-video-laryngoscopy-for-early-detection-of-oropharyngeal-and-laryngeal-lesions-implications-for-inattentional-blindness
#17
André A J Van Zundert, Kerstin H Wyssusek, Keith B Greenland
No abstract text is available yet for this article.
April 2, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29605361/combined-nd-yag-laser-and-bleomycin-sclerotherapy-under-the-same-anesthesia-for-cervicofacial-venous-malformations-a-safe-and-effective-treatment-option
#18
Stacie Gregory, Patricia E Burrows, Herodotos Ellinas, Michael Stadler, Robert H Chun
INTRODUCTION: Extensive cervicofacial venous malformations (VM) pose significant challenges to a patient's quality of life (altered breathing, dysphagia, dysarthria). Treatment options include: 1) Surgical debulking; 2) Sclerotherapy; 3) laser therapy; or 4) Combined modalities. Recent studies have demonstrated the importance of multimodality and multidisciplinary management of these patients. However, no studies have described combined single anesthetic laser and sclerotherapy treatment...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29605340/endoscopic-percutaneous-suture-lateralization-for-neonatal-bilateral-vocal-fold-immobility
#19
Glenda Lois Montague, Randall A Bly, Garani S Nadaraja, David E Conrad, Sanjay R Parikh, Dylan K Chan
OBJECTIVE: Bilateral vocal-fold immobility (BFVI) is a rare but significant cause of severe respiratory distress in neonates. The primary aim of treatment is to provide an adequate airway while minimizing adverse effects such as aspiration and dysphonia. Our objective here is to describe the outcomes of a series of neonates undergoing percutaneous endoscopic suture lateralization for BVFI using a novel technique. METHODS: In this retrospective case series, we present 6 neonates (mean age: 18 days) with BVFI from three tertiary academic medical centers...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29587754/retrograde-intubation-in-a-dog-with-severe-temporomandibular-joint-ankylosis-case-report
#20
Verónica Vieitez, Luis Javier Ezquerra, Víctor López Rámis, Massimo Santella, Ignacio Álvarez Gómez de Segura
BACKGROUND: Orotracheal intubation in dogs is a common and easily-performed procedure that provides a patent airway during anaesthesia. In dogs with temporomandibular joint ankylosis or pseudo-ankylosis, airway management can be a challenging procedure since these dogs have a limited ability to open their mouth. Methods to provide safe, uneventful intubation in such patients may include minimally invasive techniques such as retrograde intubation using a guide wire and fibre-optic-aided laryngoscopy...
March 27, 2018: BMC Veterinary Research
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