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https://www.readbyqxmd.com/read/29331616/paediatric-video-laryngoscopy-and-airway-management-what-s-the-clinical-evidence
#1
Xue Fu-Shan, Liu Ya-Yang, Li Hui-Xian, Yang Gui-Zhen
The major complications of paediatric airway management are uncommon, but the outcomes are often severe. Over the last decade, additions and advancements in the devices and technology have significantly improved our ability to manage difficult paediatric airways safely. Videolaryngoscopy involves the use of video and optical technology to facilitate indirect visualisation of the larynx during intubation and has been seen as an evolutionary step in intubation technology. Over the past few years, video laryngoscopes have been receiving plenty of attention as new airway devices for use in paediatric patients...
January 10, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29331580/local-delivery-of-mometasone-furoate-from-an-eluting-endotracheal-tube
#2
Abu Ammar Aiman, Maayan Gruber, Patrick Martin, Ohad Stern, Forsan Jahshan, Offir Ertracht, Eyal Sela, Samer Srouji, Eyal Zussman
Laryngeal and tracheal morbidity is a common complication of endotracheal tube (ETT)-based airway management, and manifests as local irritation, inflammation, and edema. Systemic corticosteroids are commonly administered to manage these conditions; however, their efficacy is inadequate and limited by potential severe side effects. In the present study, a steroid delivery system for local therapy was developed to generate relatively high local drug concentrations and to improve drug efficacy. ETTs were coated with electrospun poly (lactic-co-glycolic acid) (PLGA) nanofibers loaded with mometasone furoate (MF), creating a microscale thick layer...
January 10, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29325063/epidemiology-and-outcomes-of-hematopoietic-stem-cell-transplant-in-hiv-patients-from-1998-to-2012-a-nationwide-analysis
#3
Kathan Mehta, Annie Im, Farah Rahman, Hong Wang, Peter Veldkamp
Background: Prior studies have shown that outcomes of hematopoietic stem cell transplantation (HSCT) in HIV (+) patients are similar to HIV (-) patients since effective implementation of HAART by 1998; but they are limited by small sample size or non-inclusion of recent data. Methods: We queried National Inpatient Sample, a large inpatient dataset in the US, from 1998 to 2012 for HSCT using ICD9 procedure code 41.0. HIV patients were identified by ICD9 diagnostic code of 042, 043, 044, V08 and 079...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29324651/incidence-microbiological-profile-and-risk-factors-of-healthcare-associated-infections-in-intensive-care-units-a-10-year-observation-in-a-provincial-hospital-in-southern-poland
#4
Małgorzata Kołpa, Marta Wałaszek, Agnieszka Gniadek, Zdzisław Wolak, Wiesław Dobroś
Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016...
January 11, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29319632/extracorporeal-membrane-oxygenation-for-pertussis-predictors-of-outcome-including-pulmonary-hypertension-and-leukodepletion
#5
Michele Domico, Deborah Ridout, Graeme MacLaren, Ryan Barbaro, Gail Annich, Luregn J Schlapbach, Katherine L Brown
OBJECTIVE: The recent increase of pertussis cases worldwide has generated questions regarding the utility of extracorporeal membrane oxygenation for children with pertussis. We aimed to evaluate factors associated with extracorporeal membrane oxygenation outcome. DESIGN: The study was designed in two parts: a retrospective analysis of the Extracorporeal Life Support Organization Registry to identify factors independently linked to outcome, and an expanded dataset from individual institutions to examine the association of WBC count, pulmonary hypertension, and leukodepletion with survival...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#6
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29316779/double-balloon-endoscopy-after-incomplete-colonoscopy-and-its-comparison-with-computed-tomography-colonography
#7
Carlijn Hermans, Dennis van der Zee, Lennard Gilissen
Background/Aims: Because of the national screening program for colorectal carcinoma in The Netherlands, the number of colonoscopies has increased. In case of incomplete colonoscopy, computed tomography colonography (CTC) and double-balloon colonoscopy (DBc) are alternative options. This study evaluated cecal intubation rate and pathology detection rate in the previously unexplored part of the colon, complication rate of DBc, and CTC results after incomplete colonoscopy. Methods: Retrospective observational study in a tertiary referral hospital regarding DBc and CTC reports from cases with incomplete colonoscopy...
January 10, 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29316004/comparison-of-intubation-conditions-with-cmac-miller-videolaryngoscope-and-conventional-miller-laryngoscope-in-lateral-position-in-infants-a-prospective-randomized-trial
#8
Divya Jain, Swati Mehta, Komal Gandhi, Suman Arora, Badal Parikh, Muneer Abas
BACKGROUND: Endotracheal intubation in lateral position in infants is a challenge. This difficulty may be surmounted to some extent by using videolaryngoscopes but the routine use of these devices as a tool to secure the airway in lateral position remains unevaluated. Therefore, we conducted a prospective, randomized controlled trial to compare the intubation conditions achieved with the CMAC videolaryngoscope and the Miller Laryngoscope in lateral position in infants. We hypothesized that CMAC videolaryngoscope would provide a better laryngoscopic view and reduce the time to intubation compared to the Miller blade...
January 9, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29315046/supraglottic-airway-devices-current-and-future-uses
#9
Lloyd E Kwanten, Pradeep Madhivathanan
Supraglottic airway devices have increasingly been used in anaesthesia since their invention in 1982. Now over half of general anaesthetic cases in the UK use them, and they have vital roles in difficult airway algorithms, pre-hospital use and emergency medicine. This article presents the current evidence regarding the complications of these devices, and compares these devices and endotracheal intubation. The technology of the newer generation devices has improved the safety profile, and they may be considered a better choice than endotracheal tubes in some cases...
January 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#10
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29310701/severe-thoracic-trauma-still-an-independent-predictor-for-death-in-multiple-injured-patients
#11
Michael Grubmüller, Maximilian Kerschbaum, Eva Diepold, Katharina Angerpointner, Michael Nerlich, Antonio Ernstberger
BACKGROUND: Over the past, the severe thoracic trauma has had decisive influence on the outcome of multiple injured patients. Today, new therapies (e.g. extracorporeal membrane oxygenation (ECMO), protective ventilation methods and new forms of patient positioning) are available and applied regularly. What impact on the patient's outcome does the thoracic trauma have today? METHODS: Prospective data collection of multiple injured patients in a level-I trauma center was performed between 2008 and 2014...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29310390/takotsubo-cardiomyopathy-caused-by-acute-respiratory-stress-from-extubation-a-case-report
#12
Kohei Taniguchi, Syogo Takashima, Ryo Iida, Koshi Ota, Masahiko Nitta, Kazushi Sakane, Tomohiro Fujisaka, Nobukazu Ishizaka, Osamu Umegaki, Kazuhisa Uchiyama, Akira Takasu
RATIONAL: Takotsubo cardiomyopathy (TCM) is a transient systolic dysfunction of the left ventricular apex without stenosis of coronary arteries and is induced by various psychological and physical factors. TCM sometimes causes lethal complications such as arrhythmia, thrombogenesis, and even cardiac rupture, and thus it should be diagnosed appropriately and managed carefully. Intensive care unit (ICU) patients are exposed to overstress during the treatment process and therefore can are at potential risk for TCM...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29306264/management-of-right-main-bronchial-rupture-with-a-double-lumen-endotracheal-tube-in-a-patient-with-blunt-chest-trauma
#13
Seung Hwan Seol, Woon Jeong Lee, Seon Hee Woo, Dae Hui Kim, Jong Hui Suh
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29301800/catamenial-anaphylaxis-a-woman-under-monthly-progesterone-curse
#14
Kyawzaw Lin, Ameer Rasheed, Sithu Lin, Louis Gerolemou
Catamenial or cyclical anaphylaxis is a complex clinical syndrome with poorly reported incidence and prevalence in the literature review. The underlying mechanism is still a myth although a few proposed hypotheses are stated. Early recognition of these symptoms will bring optimal treatment and prevent unnecessary intubation and complications. Here, we present a 48-year-old woman without significant medical and family history with recurrent angioedema in the setting of catamenial anaphylaxis or cyclical anaphylaxis in the setting of progesterone hypersensitivity...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#15
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29295665/severe-bronchopulmonary-dysplasia-incidence-and-predictive-factors-in-a-prospective-multicenter-study-in-very-preterm-infants-with-respiratory-distress-syndrome
#16
Magdalena Rutkowska, Roman Hożejowski, Ewa Helwich, Maria K Borszewska-Kornacka, Janusz Gadzinowski
BACKGROUND: Severe bronchopulmonary dysplasia (BPD) remains a major complication of prematurity and can have significant impact on long-term pulmonary sequelae and adverse neurodevelopmental outcomes. OBJECTIVE: To assess the incidence and evaluate the predictive factors for severe BPD in very preterm infants with respiratory distress syndrome. METHODS: Of the 846 premature infants born at ≤ 32-week gestation who developed respiratory distress syndrome (RDS), 707 infants with known oxygen dependency at 36 weeks gestational age were included in the analysis of BPD incidence...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#17
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29289367/characterizing-predictors-and-severity-of-vasoplegia-syndrome-after-heart-transplantation
#18
Joshua L Chan, Jon A Kobashigawa, Tamar L Aintablian, Sadia J Dimbil, Paul A Perry, Jignesh K Patel, Michelle M Kittleson, Lawrence S Czer, Parham Zarrini, Angela Velleca, Jenna Rush, Francisco A Arabia, Alfredo Trento, Fardad Esmailian
BACKGROUND: Vasoplegia is characterized as a severe vasodilatory shock after cardiac surgery, and can be associated with substantial morbidity. Increased systemic inflammation and endothelial dysfunction, often related to prolonged cardiopulmonary bypass times, anesthesia, or mechanical circulatory support have been shown to be associated with the development of vasoplegia. We sought to identify risk factors and the impact of various degrees of vasoplegia after heart transplantation. METHODS: A retrospective review was conducted of 244 consecutive patients who underwent heart transplantation over a 3-year period...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29288612/postintubation-tracheoesophageal-fistula-diagnosis-treatment-and-prognosis
#19
Ciprian Bolca, Valerian Păvăloiu, Georgiana Fotache, Mihai Dumitrescu, Andrei Bobocea, Mihai Alexe, Genoveva Cadar, Radu Stoica, Cristian Paleru, Ioan Cordoş
Introduction: Postintubation tracheoesophageal fistula is a severe complication occurring under certain conditions in patients that require prolonged mechanical ventilation. MATERIAL AND METHODS: This article focuses on a sample of 11 patients with postintubation tracheoesophageal fistula, operated in our department between 2005 and 2015. The anterior approach with tracheal resection was performed in 10 of these patients, while an atypical surgical technique was preferred in a case involving a large-sized fistula...
November 2017: Chirurgia
https://www.readbyqxmd.com/read/29288493/jet-ventilation-in-obese-patients-undergoing-airway-surgery-for-subglottic-and-tracheal-stenosis
#20
Ramez Philips, Brad deSilva, Laura Matrka
OBJECTIVES/HYPOTHESIS: To assess the feasibility of jet ventilation in obese patients and to compare complications of jet ventilation in obese and nonobese patients. STUDY DESIGN: Retrospective review of medical records. METHODS: We reviewed 46 patient charts (70 procedures) with the diagnosis of tracheal or subglottic stenosis who underwent endoscopic surgery with jet ventilation between March 2014 and January 2017. Adequacy of jet ventilation was assessed by chest rise, avoidance of endotracheal intubation, and length of case and ventilation...
December 30, 2017: Laryngoscope
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