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Airway intubation

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https://www.readbyqxmd.com/read/29690950/safety-of-tracheal-intubation-in-the-presence-of-cardiac-disease-in-paediatric-icus
#1
Eleanor A Gradidge, Adnan Bakar, David Tellez, Michael Ruppe, Sarah Tallent, Geoffrey Bird, Natasha Lavin, Anthony Lee, Vinay Nadkarni, Michelle Adu-Darko, Jesse Bain, Katherine Biagas, Aline Branca, Ryan K Breuer, Calvin Brown, Kris Bysani, Guillaume Emeriaud, Sandeep Gangadharan, John S Giuliano, Joy D Howell, Conrad Krawiec, Jan Hau Lee, Simon Li, Keith Meyer, Michael Miksa, Natalie Napolitano, Sholeen Nett, Gabrielle Nuthall, Alberto Orioles, Erin B Owen, Margaret M Parker, Simon Parsons, Lee A Polikoff, Kyle Rehder, Osamu Saito, Ron C Sanders, Asha Shenoi, Dennis W Simon, Peter W Skippen, Keiko Tarquinio, Anne Thompson, Iris Toedt-Pingel, Karen Walson, Akira Nishisaki
IntroductionChildren with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.Materials and methodsWe sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry...
April 25, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29688927/securing-the-airway-in-pretracheal-dermal-metastases-from-oropharyngeal-carcinoma-a-case-report
#2
Angela T Truong, Dam-Thuy Truong, Ann M Gillenwater, Jose M Soliz, Thomas F Rahlfs
Dermal metastases reflect the ominous and aggressive spread of oropharyngeal squamous cell carcinomas. The rampant proliferation of these metastatic tumors to the neck results in respiratory distress and impending airway obstruction. We report a case of a patient with massive neck dermal metastases requiring urgent airway control for intermittent stridor. Awake tracheostomy is generally regarded as the gold standard to manage the compromised airway. However, in this unusual case, after discussion between surgeon and anesthesiologist, because of the anticipated formidable difficulties in performing awake tracheostomy, it was decided that awake fiberoptic intubation would provide the best chance of success...
April 23, 2018: A&A practice
https://www.readbyqxmd.com/read/29688857/less-invasive-treatment-of-sleep-disordered-breathing-in-children-with-syndromic-craniosynostosis
#3
Silvia Müller-Hagedorn, Cornelia Wiechers, Jörg Arand, Wolfgang Buchenau, Margit Bacher, Michael Krimmel, Siegmar Reinert, Christian F Poets
BACKGROUND: Infants and children with syndromic craniosynostosis (SCS), such as Apert-, Crouzon- or Pfeiffer syndrome, are prone to sleep disordered breathing (SDB) including obstructive sleep apnea and upper airway resistance syndrome (OSAS, UARS), potentially leading to tracheostomy. We modified the Tübingen Palatal Plate (TPP), an oral appliance with a velar extension effectively treating airway obstruction in Robin sequence, by attaching a tube to its velar extension to bridge the narrow pharyngeal airway in SCS patients...
April 23, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29687891/videolaryngoscopy-vs-fibreoptic-bronchoscopy-for-awake-tracheal-intubation-a-systematic-review-and-meta-analysis
#4
REVIEW
M Alhomary, E Ramadan, E Curran, S R Walsh
Awake fibreoptic intubation is often considered the technique of choice when a difficult airway is anticipated. However, videolaryngoscopes are being used more commonly. We searched the current literature and performed a meta-analysis to compare the use of videolaryngoscopy and fibreoptic bronchoscopy for awake tracheal intubation. Our primary outcome was the time needed to intubate the patient's trachea. Secondary outcomes included: failed intubation; the rate of successful intubation at the first attempt; patient-reported satisfaction with the technique; and any complications resulting from intubation...
April 17, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29687674/intubation-through-2-supraglottic-airway-device-in-cervical-spine-immobilization-a-randomized-trial-of-residents-use-of-the-intubating-laryngeal-mask-airway-and-the-intubating-laryngeal-tube-in-manikins
#5
Dawid Aleksandrowicz, Tomasz Gaszyński
OBJECTIVES: The aim of this study was to compare the intubating laryngeal mask (iLM) airway and the new intubating laryngeal tube (iLTS-D) in use by residents with minimal previous intubation experience during simulated conditions of reduced cervical spine mobility. MATERIAL AND METHODS: Thirty first-year residents in anesthesiology participated in the study (18 women). All participants had minimal intubation experience (fewer than 10 previously performed intubations) and were novices in the specialty...
June 2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29687523/safety-of-anesthesia-for-children-with-mucopolysaccharidoses-a-retrospective-analysis-of-54-patients
#6
Vittorio Scaravilli, Alberto Zanella, Valentina Ciceri, Mariagrazia Bosatra, Claudia Flandoli, Alessia La Bruna, Simone Sosio, Rossella Parini, Serena Gasperini, Antonio Pesenti, Alessandra Moretto
BACKGROUND: Complications are common during anesthesia for patients with mucopolysaccharidoses. San Gerardo Hospital (Italy) is a reference center for mucopolysaccharidoses with a dedicated pediatric anesthesia service. AIMS: This study aims to evaluate the safety of anesthesia for mucopolysaccharidoses patients, describe their anesthetic management at our institution, and assess risk factors for complications. METHODS: The anesthetic charts of mucopolysaccharidoses patients admitted from January 1999 to December 2014 were retrospectively analyzed...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29687359/does-apneic-oxygenation-prevent-desaturation-during-emergency-airway-management-a-systematic-review-and-meta-analysis
#7
Edmund Tan, Osama Loubani, Nelofar Kureshi, Robert S Green
RéSUMé: OBJECTIF: L'oxygénation apnéique (OA) par lunettes nasales est une méthode de prévention de la désaturation en oxygène au cours des intubations en urgence. L'objectif de cette revue systématique était de déterminer l'efficacité de l'OA sur la prévention de la désaturation en oxygène au cours des intubations en urgence. SOURCE: Des recherches systématiques ont été effectuées dans trois bases de données électroniques (MEDLINE, EMBASE et CINAHL) pour identifier les études portant sur la prévention de la désaturation en oxygène au moyen de l'OA par lunettes nasales...
April 23, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29686594/analysis-of-the-risk-factors-associated-with-prolonged-intubation-or-reintubation-after-anterior-cervical-spine-surgery
#8
Moinay Kim, Seung Chul Rhim, Sung Woo Roh, Sang Ryong Jeon
Background: Standardized postoperative airway management is essential for patients undergoing anterior cervical spine surgery (ACSS). The paucity of clinical series evaluating these airway complications after ACSS has been resulted in a significant limitation in statistical analyses. Methods: A retrospective cohort study was performed regarding airway distress (intubation for more than 24 hours or unplanned reintubation within 7 days of operation) developed after ACSS...
April 23, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29684995/successful-airway-management-with-combined-use-of-mcgrath%C3%A2-mac-video-laryngoscope-and-fiberoptic-bronchoscope-in-a-severe-obese-patient-with-huge-goiter-a-case-report
#9
Mee Young Chung, Byunghoon Park, Jaeho Seo, Chang Jae Kim
Huge goitor can lead to tracheal compression and hence difficulty in intubation. This is compounded by severe obesity. Failed tracheal intubation in difficult intubation is a serious event that may lead to increased patient morbidity and mortality. Current intubation rescue techniques and combination of different rescue techniques may increase the success rate of difficult intubation. In a 47-year-old female patient, with severe obesity and a huge goiter, our attempts at intubation using direct laryngoscope, video laryngoscope, and awake fiberoptic bronchoscope had failed...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29678147/protocol-based-evaluation-for-feasibility-of-extubation-compared-to-clinical-scoring-systems-after-major-oral-cancer-surgery-safely-reduces-the-need-for-tracheostomy-a-retrospective-cohort-study
#10
Axel Schmutz, Rolf Dieterich, Johannes Kalbhenn, Pit Voss, Torsten Loop, Sebastian Heinrich
BACKGROUND: Despite risks, complications and negative impact to quality of life, tracheostomy is widely used to bypass upper airway obstruction after major oral cancer surgery (MOCS). Decision to tracheostomy is frequently based on clinical scoring systems which mainly have not been validated by different cohorts. Delayed extubation in the Intensive Care Unit (ICU) may be a suitable alternative in selected cases. We hypothesize that delayed routine ICU extubation after MOCS instead of scoring system based tracheostomy is safe, feasible and leads to lower tracheostomy rates...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29677067/reflections-on-combining-the-bonfils-intubation-endoscope-the-macintosh-videolaryngocope-and-the-difficult-airway
#11
Sinead E McCarthy, Richard M Cooper
No abstract text is available yet for this article.
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29674403/unexpected-case-of-pneumomediastinum-and-subcutaneous-emphysema-primary-or-secondary-aetiology
#12
Amanda J L Cheng, Timothy J Sadler
A 77-year-old man was admitted with a relapse of antineutrophil cytoplasmic antibody-positive vasculitis with pulmonary involvement and acute kidney injury. There was a background of pulmonary fibrosis (non-specific interstitial pneumonia type pattern) and superadded pulmonary haemorrhage, acute pulmonary oedema and sepsis. The patient was intubated for 4 days and remained dependent on high flow oxygen and continuous positive airway pressure after extubation. A chest radiograph performed 2 weeks after extubation demonstrated unexpected, extensive pneumomediastinum and subcutaneous emphysema...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29672600/associations-of-obesity-with-tracheal-intubation-success-on-first-attempt-and-adverse-events-in-the-emergency-department-an-analysis-of-the-multicenter-prospective-observational-study-in-japan
#13
Hiromasa Yakushiji, Tadahiro Goto, Wataru Shirasaka, Yusuke Hagiwara, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa
Obesity is deemed to increase the risk of difficult tracheal intubation. However, there is a dearth of research that examines the relationship of obesity with intubation success and adverse events in the emergency department (ED). We analyzed the data from a prospective, observational, multicenter study-the Japanese Emergency Airway Network (JEAN) 2 study from 2012 through 2016. We included all adults (aged ≥18 years) who underwent tracheal intubation in the ED. Patients were categorized into three groups according to their body mass index (BMI): lean (<25...
2018: PloS One
https://www.readbyqxmd.com/read/29672533/protection-afforded-by-respirators-when-performing-endotracheal-intubation-using-a-direct-laryngoscope-glidescope%C3%A2-and-i-gel%C3%A2-device-a-randomized-trial
#14
Hyunggoo Kang, Yoonje Lee, Sanghyun Lee, Yeongtak Song, Tae Ho Lim, Jaehoon Oh, Juncheol Lee, Hyungoo Shin
Emergency physicians are at risk of infection during invasive procedures, and wearing a respirator can reduce this risk. The aim of this study was to determine whether the protection afforded by a respirator during intubation is affected by the type of airway device used. In this randomized crossover study, 26 emergency physicians underwent quantitative fit tests for a N95 respirator (cup-type or fold-type) before and during intubation with a direct laryngoscope, GlideScope®, or i-gel® airway device. The primary outcome was the fit factor value of the respirator and the secondary outcome was the level of acceptable protection provided (percentage of fit factor scores above 100)...
2018: PloS One
https://www.readbyqxmd.com/read/29666093/bougie-associated-bronchial-injury-complicated-by-a-nephropleural-fistula-after-percutaneous-nephrolithotomy-a-tale-of-two-complications
#15
Aparna Pande, Rashmi Ramachandran, Vimi Rewari
We present a case of bronchial injury following bougie-assisted endotracheal intubation in a patient with difficult airway scheduled to undergo right percutaneous nephrolithotomy under general anaesthesia. The patient developed pleuritic pain along with right pleural effusion on the third postoperative day which was diagnosed by the anaesthesiologist who was following up the patient for airway trauma-associated complications. However, the patient was diagnosed to have a nephropleural fistula, a rare complication of supracostal access to percutaneous nephrolithotomy, which was managed successfully...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29664213/a-patient-centred-multi-domain-instrument-for-improving-the-clarity-of-outcomes-reporting-and-documentation-in-complex-airway-surgery
#16
S A R Nouraei, K J Heathcote
Laryngotracheal stenosis refers to abnormal narrowing of the central airways from larynx to carina. It is caused by an eclectic group of conditions that include intubation-related airway stenosis, granulomatosis with polyangiitis, tracheal compression or malignancy, and congenital laryngotracheal malformations. A significant proportion of patients with this condition can be satisfactorily treated using a combination of endoscopic and open surgical techniques and when definitive treatment is not possible, most of the remaining patients can be managed with a combination of endoscopic airway maintenance, stents, T-tubes, and/or tracheostomies...
April 17, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29661388/degree-of-obesity-is-not-associated-with-more-than-one-intubation-attempt-a-large-centre-experience
#17
W Saasouh, K Laffey, A Turan, R Avitsian, A Zura, J You, N M Zimmerman, L Szarpak, D I Sessler, K Ruetzler
BACKGROUND: The role of obesity as a risk factor for difficult intubation remains controversial. We primarily assessed the association between body mass index (BMI) and difficult tracheal intubation. METHODS: We analysed electronic records of more than 67 000 adults having elective non-cardiac surgery requiring tracheal intubation at the Cleveland Clinic between 2011 and 2015. The association between BMI and difficult intubation, defined as more than one intubation attempt, was assessed using multivariable logistic regression adjusting for pre-specified confounders...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661387/pre-hospital-advanced-airway-management-by-anaesthetist-and-nurse-anaesthetist-critical-care-teams-a-prospective-observational-study-of-2028-pre-hospital-tracheal-intubations
#18
M Gellerfors, E Fevang, A Bäckman, A Krüger, S Mikkelsen, J Nurmi, L Rognås, E Sandström, G Skallsjö, C Svensén, D Gryth, H M Lossius
BACKGROUND: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams. METHODS: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661380/relationship-between-severe-obesity-and-depth-to-the-cricothyroid-membrane-in-third-trimester-non-labouring-parturients-a-prospective-observational-study
#19
K Gadd, K Wills, R Harle, N Terblanche
BACKGROUND: Severely obese parturients have increased 'cannot intubate, cannot oxygenate' risk during Caesarean section under general anaesthesia. Front-of-neck access (FONA) at the cricothyroid membrane (CTM) is definitive management; however, attempted FONA can fail. Point-of-care ultrasonography may provide useful information about CTM depth to aid FONA in obesity. This study determined the difference in CTM depth between severely obese and non-obese parturients, utilising ultrasonography...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#20
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
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