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Airway intubation

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https://www.readbyqxmd.com/read/29910496/feeding-obturator-as-an-airway-adjunct-during-complete-unilateral-cleft-palate-repair
#1
Moustafa Abdelaziz Moustafa, Alaa Abdelrahman Kandeel, Ahmed M A Habib, Shady A Hassan
Background and Aims: The palatal defect and abnormal dentition in cleft palate make mask ventilation and laryngoscopy difficult. This study aimed to assess the effect of feeding obturator on laryngeal view in unilateral complete cleft palate. Methods: Ninety non-syndromic infants scheduled for the first stage correction of complete unilateral cleft palate were randomised to Group A (no feeding obturator) or Group B (obturator used for induction and intubation). The primary objective was to assess effect of the feeding obturator on the Cormack-Lehane grade on laryngoscopy...
May 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29910492/direct-and-indirect-low-skill-fibre-optic-intubation-a-randomised-crossover-manikin-study-of-six-supraglottic-airway-devices
#2
Sau Yee Chow, Yan Ru Tan, Theodore Gar Ling Wong, Vui Kian Ho, Abey Matthew Matthews, Hui Hua Li, Patrick Wong
Background and Aims: Fibre-optic intubation (FOI) through supraglottic airway devices (SADs) is useful in the management of the difficult airway. We compared two methods of FOI through seven SADs in a randomised crossover manikin study to assess each device's performance and discuss implications on SAD selection. Methods: Thirty anaesthetsiologists, 15 seniors and 15 juniors, each performed low skill FOI (LSFOI) with seven SADs using both 'direct' and 'indirect' methods...
May 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29910491/a-randomised-comparative-study-on-customised-versus-fixed-sized-pillow-for-tracheal-intubation-in-the-sniffing-position-by-macintosh-laryngoscopy
#3
Mridul Dhar, Habib Md Reazaul Karim, Narayanan Rajaram, Avinash Prakash, Sarasa K Sahoo, Anilkumar Narayan
Background and Aims: The sniffing position has been most commonly used for positioning of the head and neck to facilitate tracheal intubation. However, the optimum degree of head elevation for the optimal laryngeal view is not well studied, especially in non-Western countries. The present study was aimed to compare the use of a fixed height pillow versus a customised pillow (CP) height for head elevation, in terms of glottis visualisation and time required for tracheal intubation. Methods: With research and ethics committee approval from the institute, this randomised study was conducted among patients of both sexes aged 16 years or more and American Society of Anesthesiologists physical Status I to IV...
May 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29907469/management-of-the-airway-in-maxillofacial-surgery-part-1
#4
REVIEW
S W Evans, R A McCahon
In part 1 of this review of management of the airway in maxillofacial surgery we discuss preoperative assessment of the airway, and the practical means to deal with difficulties. We review the evidence for videolaryngoscopy and flexible indirect laryngoscopy, together with surgical access to the airway including tracheostomy, cricothyroidotomy, and submental intubation.
June 12, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29907267/critical-care-airway-management
#5
REVIEW
Etieno U Umobong, Paul H Mayo
Critical care airway management is associated with a variety of complications, including severe oxygen desaturation, life-threatening hypotension, and death. This article reviews aspects of airway management that are relevant to intensivists and emergency medicine clinicians tasked with improving the quality of urgent endotracheal intubation in the critically ill patient.
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29904428/flexible-bronchoscopy-in-pulmonary-diseases-in-children-with-congenital-cardiovascular-abnormalities
#6
Ting Chen, Li Qiu, Lin Zhong, Qingfen Tao, Hanmin Liu, Lina Chen
There is a lack of data describing the role of flexible bronchoscopy (FB) in evaluating pulmonary diseases in children with congenital cardiovascular abnormalities in China. Determining whether those children suffer from respiratory complications may be useful for future preoperative planning and family counseling. The present study aimed to investigate the features and FB-associated findings with respect to pulmonary diseases in children with congenital cardiovascular abnormalities. The role of FB in guiding the treatment and safety of procedures was also evaluated...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29898436/endotracheal-intubation-and-in-hospital-mortality-after-intracerebral-hemorrhage
#7
Vasileios-Arsenios Lioutas, Sarah Marchina, Louis R Caplan, Magdy Selim, Joseph Tarsia, Luciana Catanese, Jonathan Edlow, Sandeep Kumar
BACKGROUND: Many patients with acute intracerebral hemorrhages (ICHs) undergo endotracheal intubation with subsequent mechanical ventilation (MV) for "airway protection" with the intent to prevent aspiration, pneumonias, and its related mortality. Conversely, these procedures may independently promote pneumonia, laryngeal trauma, dysphagia, and adversely affect patient outcomes. The net benefit of intubation and MV in this patient cohort has not been systematically investigated...
June 13, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29894918/c-mac-videolaryngoscope-versus-macintosh-laryngoscope-for-tracheal-intubation-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#8
Hiroshi Hoshijima, Takahiro Mihara, Koichi Maruyama, Yohei Denawa, Kentaro Mizuta, Toshiya Shiga, Hiroshi Nagasaka
STUDY OBJECTIVE: The C-MAC laryngoscope (C-MAC) is a videolaryngoscope that uses a modified Macintosh blade. Although several anecdotal reports exist, it remains unclear whether the C-MAC is superior to the Macintosh laryngoscope for tracheal intubation in the adult population. DESIGN: Systematic review, meta-analysis. SETTING: Operating room, intensive care unit. MEASUREMENTS: For inclusion in our analysis, studies had to be prospective randomised trials which compared the C-MAC with the Macintosh laryngoscope for tracheal intubation in the adult population...
June 9, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29894346/airway-management-of-near-complete-tracheal-transection-by-through-the-wound-intubation-a-case-report
#9
Yuel-Kai Jean, Paul Potnuru, Christian Diez
We present an approach to airway management in a patient with machete injuries culminating in near-complete cricotracheal transection, in addition to a gunshot wound to the neck. Initial airway was established by direct intubation through the cricotracheal wound. Once the airway was secured, a bronchoscopy-guided orotracheal intubation was performed with simultaneous retraction of the cricotracheal airway to optimize the surgical field. This case offers insight into a rarely performed approach to airway management...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29891124/retention-of-cricothyrotomy-skills-by-paramedics-using-a-wire-guided-technique
#10
J A March, M J Kiemeney, J De Guzman, J D Ferguson
INTRODUCTION: Cricothyrotomy may be necessary for airway management when a patient's airway cannot be maintained through standard techniques such as oral airway placement, blind insertion airway device, or endotracheal intubation. Wire-guided cricothyrotomy is one of many techniques used to perform a cricothyrotomy. Although there is some controversy over which cricothyrotomy technique is superior, there is no published data regarding long term retention rates. The purpose of this study is to determine whether ground based paramedics can be taught and are able to retain the skills necessary to successfully perform a wire-guided cricothyrotomy...
May 31, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29889744/safety-of-deep-sedation-without-intubation-for-second-trimester-dilation-and-evacuation
#11
Sarp Aksel, Laura Lang, Jody E Steinauer, Eleanor A Drey, Lauren Lederle, Abby Sokoloff, A Sue Carlisle
OBJECTIVE: To estimate the incidence of pulmonary aspiration and other anesthesia-related adverse events in women undergoing dilation and evacuation (D&E) under intravenous deep sedation without tracheal intubation in an outpatient setting. METHODS: We reviewed all D&Es done under anesthesiologist-administered intravenous deep sedation without tracheal intubation between February 2009 and April 2013. The study's primary outcome was pulmonary aspiration; secondary outcomes included other anesthesia-related complications...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29889726/evolution-of-delivery-room-management-for-meconium-stained-infants-recent-updates
#12
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29889671/evaluation-of-two-neck-ultrasound-measurements-as-predictors-of-difficult-direct-laryngoscopy-a-prospective-study
#13
Stefano Falcetta, Simona Cavallo, Vincenzo Gabbanelli, Paolo Pelaia, Massimiliano Sorbello, Ivana Zdravkovic, Abele Donati
BACKGROUND: Unpredictable difficult laryngoscopy remains a challenge for anaesthesiologists, especially if difficult ventilation occurs during standard laryngoscopy. Accurate airway assessment should always be performed, but the common clinical screening tests have shown low sensitivity and specificity with a limited predictive value. Ultrasound-based airway assessment has been proposed recently as a useful, simple, noninvasive bedside tool as an adjunct to clinical methods, but to date, few studies are available about the potential role of ultrasound in difficult airway evaluation, and these are mostly limited to specific groups of patients...
June 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29888875/ketamine-use-for-rapid-sequence-intubation-in-australian-and-new-zealand-emergency-departments-from-2010-to-2015-a-registry-study
#14
Ian Ferguson, Hatem Alkhouri, Toby Fogg, Anders Aneman
OBJECTIVE: This study aimed to quantify the proportion of patients undergoing rapid sequence intubation using ketamine in Australian and New Zealand EDs between 2010 and 2015. METHODS: The Australian and New Zealand Emergency Department Airway Registry is a multicentre airway registry prospectively capturing data from 43 sites. Data on demographics and physiology, the attending staff and indication for intubation were recorded. The primary outcome was the annual percentage of patients intubated with ketamine...
June 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29887292/dexmedetomidine-in-difficult-airway-management-with-a-fibre-optic-bronchoscope-in-the-awake-patient-with-klippel-feil-syndrome
#15
S Pacreu, S Martínez, E Vilà, L Moltó, J Fernández-Candil
Klippel-Feil Syndrome is a disease characterised by congenital fusion of cervical vertebra, which leads to cervical limitation and instability. In these cases, the best option is the orotracheal intubation with the fibre-optic bronchoscope with the patient awake. The advantage is that cervical movements that could lead to neurological damage are minimised. In these patients, adequate sedation, together with instillation of local anaesthetic in the pharynx and hypopharynx, is the key to reducing patient discomfort and achieving successful orotracheal intubation...
June 7, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29884969/ace-inhibitor-induced-angioedema-a-review
#16
REVIEW
William J Kostis, Mrinali Shetty, Yuvraj Singh Chowdhury, John B Kostis
PURPOSE OF REVIEW: This study aims to examine current knowledge on the occurrence, pathophysiology, and treatment of angioedema among patients who receive angiotensin-converting enzyme inhibitors. RECENT FINDINGS: Angiotensin-converting enzyme inhibitors (ACE-I), a medication class used by an estimated 40 million people worldwide, are associated with angioedema that occurs with incidence ranging from 0.1 to 0.7%. The widespread use of ACE-I resulted in one third of all emergency department visits for angioedema...
June 8, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29877219/endoscopic-and-surgical-treatment-of-benign-tracheal-stenosis-a-multidisciplinary-team-approach
#17
Cengiz Özdemir, Celalettin I Kocatürk, Sinem Nedime Sökücü, Bugra Celal Sezen, Ali Cevat Kutluk, Salih Bilen, Levent Dalar
PURPOSE: Surgical resection and reconstruction are considered the most appropriate approaches to treat post-intubation tracheal stenosis (PITS). Bronchoscopic methods can be utilized as palliative therapy in patients who are ineligible for surgical treatment or who develop post-surgical re-stenosis. We investigated treatment outcomes in patients with benign tracheal stenosis. METHODS: A retrospective review was performed in patients who were diagnosed with PITS...
June 7, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29872865/-successful-prehospital-emergency-thoracotomy-after-blunt-thoracic-trauma-case-report-and-lessons-learned
#18
Janosch Dahmen, Marko Brade, Christian Gerach, Martin Glombitza, Jan Schmitz, Simon Zeitter, Eva Steinhausen
BACKGROUND: The European Resuscitation Council guidelines for resuscitation in patients with traumatic cardiac arrest recommend the immediate treatment of all reversible causes, if necessary even prior to continuous chest compression. In the case of cardiac tamponade immediate emergency thoracotomy should also be considered. OBJECTIVE: The authors report the case of a 23-year-old male patient with multiple injuries including blunt thoracic trauma, which caused a witnessed cardiac arrest...
June 5, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29868457/effect-of-manual-caudal-and-downward-displacement-of-lower-cervical-adipose-tissue-on-laryngoscopic-grade-of-patients-with-morbid-obesity
#19
Sarvin Sanaie, Issa Bilejani, Mirmohammadtaghi Mortazavi, Ata Mahmoodpoor, Sohrab Negargar, Elnaz Faramarzi, Nazanin Hazhir, Qasem Golalizadeh Bibalan, Hassan Soleimanpour
Background: The prevalence of obesity has substantially increased all over the world in the past decades and anesthesiologists more commonly encounter these patients. Excess cervical adipose tissues can result in the narrowing of the pharyngeal opening and affect laryngoscopic grade. Objectives: To evaluate the effect of manual caudal and cervical displacement of cervical adipose tissue on laryngoscopic view of morbid obese patients. Methods: A total of 70 patients with a BMI ≥ 35 were enrolled in this study...
February 2018: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29866716/prevalence-of-a-definitive-airway-in-patients-with-severe-traumatic-brain-injury-received-at-four-urban-public-university-hospitals-in-india-a-cohort-study
#20
Monty Uttam Khajanchi, Vineet Kumar, Ludvig Wärnberg Gerdin, Kapil Dev Soni, Makhan Lal Saha, Nobhojit Roy, Martin Gerdin Wärnberg
AIM: To estimate the proportion of patients arriving with a Glasgow Coma Scale (GCS) less than 9 who had a definitive airway placed prior to arrival. METHODS: We conducted a retrospective analysis of the data from a multicentre, prospective observational research project entitled Towards Improved Trauma Care Outcomes in India. Adults aged ≥18 years with an isolated traumatic brain injury (TBI) who were transferred from another hospital to the emergency department of the participating hospital with a GCS less than 9 were included...
June 4, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
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