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https://www.readbyqxmd.com/read/29031240/colonization-of-oropharynx-and-lower-respiratory-tract-in-critical-patients-risk-of-ventilator-associated-pneumonia
#1
Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
OBJECTIVE: To investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied...
October 2, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/29028928/effectiveness-of-tip-rotation-in-fibreoptic-bronchoscopy-under-different-experimental-conditions-an-in-vitro-crossover-study
#2
T Piegeler, N G Clausen, M Weiss
Background: Proper manipulation of fibreoptic bronchoscopes is essential for successful tracheal intubation or diagnostic bronchoscopy. Failure of proper navigation and rotation of the fibrescope may lead to difficulties in advancing the fibrescope and might also be responsible for (unnecessary) difficulties and delays in fibreoptic tracheal intubation, with subsequent hypoxaemia. The present study, therefore, aimed to assess the effectiveness of tip rotation in flexible bronchoscopes in different experimental conditions...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29027772/supraglottic-airway-devices-indications-contraindications-and-management
#3
Joanna Gordon, Richard M Cooper, Matteo Parotto
Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an alternative to face mask ventilation and/or endotracheal intubation. The range of proposed uses and features have increased significantly. They are used in pre- and in-hospital settings, elective and emergency anesthesia, in spontaneously breathing and ventilated patients, as conduits for intubation, as a bridge to extubation and for airway rescue...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29019723/accidental-hanging-injuries-in-children-recognition-and-management
#4
Siba P Paul, Ruby Paul, Paul A Heaton
Accidental hanging is rare in childhood but is often fatal. Window blind cords pose a particular and unique risk to young children in the UK, accounting for one to two deaths annually. These accidents are frequently associated with non-adherence to the safety instructions provided by the manufacturers. Early discovery of the child and initiation of effective cardiopulmonary resuscitation at the site of the incident are likely to improve the outcome. Prolonged suspension, children who are pulseless at first contact by the emergency paramedic responder, and patients with prolonged periods of remaining in asystole before return of spontaneous circulation after starting cardiopulmonary resuscitation are unlikely to have intact neurological survival...
October 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29017739/pulmonary-and-laryngeal-tuberculosis-in-a-25-weeks-gestation-parturient-diagnosed-after-failed-tracheal-intubation
#5
J Geier, B Orlando
A pregnant woman at 25weeks of gestation was diagnosed with laryngeal tuberculosis following a failed intubation for upper gastro-intestinal endoscopy. Laryngeal tuberculosis represents approximately 1% of all cases of tuberculosis in the United States and presents a unique diagnostic challenge, because accompanying laryngeal changes are both varied and nonspecific. This report highlights both the challenges of the pregnant airway and the diagnosis and treatment of laryngeal tuberculosis.
August 19, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28994676/does-bilevel-positive-airway-pressure-improve-outcome-of-acute-respiratory-failure-after-open-heart-surgery
#6
Ahmed Said Elgebaly
BACKGROUND: Respiratory failure is of concern in the postoperative period after cardiac surgeries. Invasive ventilation (intermittent positive pressure ventilation [IPPV]) carries the risks and complications of intubation and mechanical ventilation (MV). AIMS: Noninvasive positive pressure ventilation (NIPPV) is an alternative method and as effective as IPPV in treating insufficiency of respiration with less complications and minimal effects on respiratory and hemodynamic parameters next to open-heart surgery...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28993038/capnography-in-the-emergency-department-a-review-of-uses-waveforms-and-limitations
#7
Brit Long, Alex Koyfman, Michael A Vivirito
BACKGROUND: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. OBJECTIVE OF THE REVIEW: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. DISCUSSION: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients...
October 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28990962/two-stage-technique-used-to-manage-severe-upper-airway-obstruction-and-avoid-surgical-tracheostomy-a-case-report
#8
Desire N Onwochei, Kariem El-Boghdadly, Imran Ahmad
Severe upper airway obstruction is commonly managed with surgical tracheostomy under local anesthesia. We present a 49-year-old woman with postradiotherapy laryngeal fixation and transglottic stenosis for dilation of a pharyngeal stricture who refused elective tracheostomy. A 2-stage technique was used, which involved an awake fiberoptic intubation, followed by the transtracheal insertion of a Cricath needle and ventilation using an ejector-based Ventrain device. We discuss management aspects of this clinical scenario and the principles by which the Ventrain works...
October 5, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28990960/anesthesia-simulator-based-functional-capacity-evaluation-of-an-anesthesiologist-after-radial-fracture-a-case-report
#9
Ceferina Suarez, Jesús Maxide, Demian Szyld, Jose M Maestre
We used simulation as a job-specific functional capacity evaluation method after a distal radius fracture in an anesthesiologist. Treatment included open reduction followed by an internal fixation with an arthrodesis plate. The patient performed simulated anesthesia inductions to assess her response to endotracheal intubation, bag-mask ventilation, and the manual opening of the airway. Data collected helped to guide the rehabilitation protocol, and to assess pain and the time to safely return to work. The patient began her clinical duties after 7 weeks of therapy and was able to fully perform her daily tasks with confidence, and full functional capacity...
October 5, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28987399/review-of-difficult-airway-management-in-thoracic-surgery
#10
M Granell, M J Parra, M J Jiménez, L Gallart, A Villalonga, O Valencia, M C Unzueta, A Planas, J M Calvo
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers...
October 4, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28984107/video-assisted-intubating-laryngeal-mask-airway-needs-evaluation-in-unstable-cervical-spine-patients
#11
Kamath Sriganesh
No abstract text is available yet for this article.
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28984089/airway-management-with-fastrach-laryngeal-mask-versus-spritztube-a-prospective-randomised-manikin-based-study
#12
Silvia DE Rosa, Fiorenza Ferrari, Stefano Carboni Checcacci, Alessandro Rigobello, Paolo Gennaro, Daniele DE Luca, Mirco Primadei, Federico Politi, Adriano Pellizzari, Raffaele Bonato
BACKGROUND: A new promising device, the Spritztube (ST), was developed combining the ability to perform both supraglottic ventilation and orotracheal fibreoptic intubation using the same device, allowing an easy passage from supraglottic ventilation to tracheal ventilation avoiding apnea. The present study aims to compare the speed and the subjective ease of in- sertion of the novel tracheal tube (Spritztube ®) compared to the intubating laryngeal mask airway FastrachTM [FT-LMA] in a simulation environment...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28981579/comparison-of-the-paediatric-blade-of-the-pentax-aws-and-ovassapian-airway-in-fibreoptic-tracheal-intubation-in-patients-with-limited-mouth-opening-and-cervical-spine-immobilization-by-a-semi-rigid-neck-collar-a-randomized-controlled-trial
#13
D H Kim, J Y Yoo, S Y Ha, Y J Chae
Background: We compared the performances of the paediatric blade of a Pentax Airway Scope and an Ovassapian airway in fibreoptic tracheal intubation in patients whose necks were stabilized by semi-rigid neck collars. Methods: Ninety patients were enrolled in this prospective, open-label, randomized controlled trial. Patients were randomly allocated to one of two groups (Group OVA-FOB and Group AWS-FOB). The time to tracheal intubation, success rate of tracheal intubation, number of optimization manoeuvres (jaw thrust), and difficulty of manipulation of the fibreoptic bronchoscope were compared between the groups...
September 14, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28976458/evaluation-of-the-c-mac-miller-video-laryngoscope-sizes-0-and-1-during-tracheal-intubation-of-infants-less-than-10-kg
#14
Florian J Raimann, Colleen E Cuca, Detlev Kern, Kai Zacharowski, Udo Rolle, Dirk Meininger, Christian F Weber, Christian Byhahn, Haitham Mutlak
STUDY OBJECTIVE: Video laryngoscopy has primarily been developed to assist in difficult airways. Using video laryngoscopy in pediatric airway management is an up-and-coming topic. The aim of the presented study was to compare the intubation conditions obtained when using the C-MAC video laryngoscope with Miller blades sizes 0 and 1 for standard direct laryngoscopy and indirect laryngoscopy in children weighing less than 10 kg. DESIGN: This was a prospective study...
October 2, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28975073/usefulness-of-ultrasound-view-of-larynx-in-pre-anesthetic-airway-assessment-a-comparison-with-cormack-lehane-classification-during-direct-laryngoscopy
#15
Sussan Soltani Mohammadi, Alireza Saliminia, Nasim Nejatifard, Roxana Azma
BACKGROUND: One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28974913/successful-endotracheal-intubation-with-trachway-after-failed-fiber-optic-manipulations-in-a-patient-with-retropharyngeal-cervical-chordoma
#16
Yi-Ting Chen, Chun-Ning Ho, Kuo-Chuan Hung
A retropharyngeal mass may distort the airway anatomy and reduce the space available for manipulation of intubation devices. We encountered a patient with a cervical chordoma occupying the retropharyngeal space. Fiber-optic orotracheal intubation was attempted to secure the airway. Although the fiber-optic bronchoscope (FOB) was successfully placed into the trachea, the tracheal tube could not be passed through the glottis. An airway was then successfully established with the Trachway device, a video-assisted system with a rigid but malleable intubating stylet...
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28974162/antenatal-assessment-and-postnatal-outcome-of-fetal-echogenic-lung-lesions-a-decade-s-experience-at-a-tertiary-referral-hospital
#17
Stefan C Kane, Fabrício D A Silva Costa, Joseph A Crameri, Karen L Reidy, Helen Kaganov, Ricardo Palma-Dias
INTRODUCTION: Fetal echogenic lung lesions (ELL) are the commonest pulmonary pathology diagnosed on antenatal sonography, and include congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations. This study aimed to evaluate the predictive utility of the CPAM volume ratio (CVR) at presentation in a series of fetuses with ELLs at a tertiary Australian referral hospital. MATERIAL AND METHODS: Retrospective cohort study of all pregnancies with a prenatal diagnosis of an isolated fetal echogenic lung lesion managed at the Royal Women's Hospital, Victoria, Australia, between 2005 and 2015...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28971804/a-randomised-trial-to-compare-truview-pcd-%C3%A2-c-mac-%C3%A2-and-macintosh-laryngoscopes-in-paediatric-airway-management
#18
Ranju Singh, Nishant Kumar, Aruna Jain
AIM: To evaluate and compare the Truview PCD and C-MAC laryngoscopes to the standard Macintosh laryngoscope in paediatric patients. METHODS: One hundred and fifty ASA I-II patients in the age group of 1-6 years (10-20 kg) scheduled for elective surgery were randomised into three equal groups for laryngoscopy and intubation with either Truview PCD (Group T), C-MAC (Group C) or Macintosh (Group M) laryngoscopes under general anaesthesia. Percentage of glottic opening (POGO) score, application of external laryngeal manoeuvre, time to intubation, number of attempts at intubation, failed intubations, episodes of desaturation and trauma caused were recorded and statistically analysed...
June 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28970665/two-different-endoscopic-procedures-made-feasible-by-the-janus-mask-in-a-high-risk-patient
#19
Paolo Beccaria, Carmine Domenico Votta, Luca Lucchetta, Simona Silvetti, Massimo Agostoni, Alberto Zangrillo
The Janus mask is a full face mask designed for providing noninvasive ventilation (NIV) during any kind of upper endoscopies (e.g., fiber-optic bronchoscopy, gastrointestinal endoscopy, and transesophageal echocardiography). Due to its unique conformation, its use can be considered for both elective and urgent endoscopic procedures in high-risk patients. In this case report, we present a patient with acute respiratory failure who underwent two consecutive different endoscopic procedures (fiber-optic bronchoscopy and gastrointestinal endoscopy) during continuous positive airway pressure support by means of this novel NIV mask, thus avoiding tracheal intubation and at the same time, improving his respiratory condition...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28970662/dual-oxygen-therapy-in-patient-on-bilevel-positive-airway-pressure-prevented-invasive-mechanical-ventilation
#20
Amarjeet Kumar, Lalit Kumar, Chandni Sinha, Neeraj Kumar, Umesh Kumar Bhadani
During noninvasive bilevel positive airway pressure (BiPAP) ventilation it is found that several times patients are unable to maintain oxygen saturation and develop breathing difficulty despite its high setting and high oxygen flow, further management requires invasive positive pressure mechanical ventilation. Increasing oxygen concentration inside the BiPAP mask using nasal cannula with addition of another flow meter not only increase oxygen saturation but also make the patient more comfortable and prevent intubation and its complications...
September 2017: Indian Journal of Critical Care Medicine
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