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https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#1
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28422820/comparison-of-the-etview-single-lumen-and-macintosh-laryngoscopes-for-endotracheal-intubation-in-an-airway-manikin-with-immobilized-cervical-spine-by-novice-paramedics-a-randomized-crossover-manikin-trial
#2
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Barak Cohen, Kurt Ruetzler, Lukasz Szarpak
CONTEXT: Management of the airway of a trauma victim is considered challenging. Various approaches have been described to achieve airway control in this setup; many of them include video-assited viewing of the larynx during intubation. ETView Single Lumen (SL) is a novice single-use endotracheal tube equiped with a video camera and a light source at its distal tip. Its use was previously described in seeral clinical and training setups. OBJECTIVE: The aim was to evaluate the efficacy of the VivaSight SL compared with classic direct laryngoscopy performed with a Macintosh blade in a manikin-simulated trauma setup presenting various degrees of airway challenge when performed by inexperienced physicians...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421631/subclinical-lower-airways-correlates-of-chronic-allergic-and-non-allergic-rhinitis
#3
Ricardo J Saranz, Alejandro Lozano, Natalia A Lozano, Marina F Ponzio, Álvaro A Cruz
The upper and lower airways behave as a physiological and pathophysiological unit. Subclinical lower airways abnormalities have been described in patients with rhinitis without asthma. These are expressed as bronchial hyperreactivity, abnormalities in lung function and bronchial inflammation, likely as a result of the same phenomenon with systemic inflammatory impact that reaches both the nose and the lungs, which for unknown reasons does not always have a full clinical expression. Patients with rhinitis are at increased risk of developing asthma; therefore most authors suggest a careful clinical evaluation and monitoring of these patients, especially if symptoms related to inflammation in the lower airways are observed...
April 19, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28413970/optimizing-the-management-of-uncontrolled-resistant-hypertension-the-importance-of-sleep-apnoea-syndrome
#4
Jacek Wolf, Krzysztof Narkiewicz
Obstructive sleep apnoea (OSA) constitutes the most prevalent form of abnormal respiratory control during sleep in adults. Evidence linked OSA to cardiovascular disease, and the role of OSA in abnormal blood pressure (BP) control has been extensively studied. Although longitudinal trials suggest a causative role of OSA in the development of hypertension, the evidence is not fully consistent. Nasal continuous positive airway pressure (nCPAP) applied during sleep is well documented and a highly efficient therapeutic aid to eliminate OSA...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413282/comparison-of-success-of-tracheal-intubation-using-macintosh-laryngoscope-assisted-bonfils-fiberscope-and-truview-video-laryngoscope-in-simulated-difficult-airway
#5
Bangaru Vivek, R Sripriya, Gayatri Mishra, M Ravishankar, S Parthasarathy
BACKGROUND AND AIMS: Restriction of head and neck movements prevents the alignment of the oral, pharyngeal, and laryngeal axes and increases the incidence of difficult tracheal intubation in patients with cervical spine fractures. Video laryngoscopes have gained an important role in the management of difficult intubation, especially in situations with limited head and neck movements. This study compares the success of intubation using Macintosh laryngoscope assisted Bonfils(®) fiberscope (ML-BF) with Truview(PCD) video laryngoscope (TV) in patients with simulated restricted head and neck movements...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28408096/local-treatment-of-a-pharyngocutaneous-fistula-secondary-to-osteoradionecrosis
#6
Olga González-Antolín
Radionecrosis is a late, and difficult to treat,complication of radiotherapy performed on head and neck tumours, and it is difficult to treat. This process causes significant damage, not only in the skin, but also in muscular, nervous, vascular, and bone structures. This, in turn, leads to airway and digestive tract involvement, as well as a functional loss and a cosmetic defect that usually requires reconstructive surgery. Therefore, this process is associated with a significant loss in the quality of life of patients and involves a long hospital stay for treatment, as well as the necessary support measures...
April 10, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28405043/anaesthetic-management-of-a-child-with-stone-man-syndrome-look-before-you-leap
#7
Geeta Kamal, Anju Gupta, Sapna Batla, Nishkarsh Gupta
Stone Man syndrome or fibrodysplasia ossificans progressiva (FOP) is an extremely rare (1 in 2 million) genetic disorder characterised by ectopic ossification of the skeletal and connective tissues leading to progressive fusion of axial and appendicular skeleton. Surgery and anaesthesia-induced trauma can lead to disease flare-up if due precautions are not taken and disable the patient further. However, rarity of the disease may lead to its common misdiagnosis and anaesthesiologist may be caught unaware. There is relative paucity of literature regarding anaesthetic management of children with FOP...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28404553/airway-emergencies-presenting-to-the-paediatric-emergency-department-requiring-advanced-management-techniques
#8
Leopold Simma, Domenic Cincotta, Stefan Sabato, Elliot Long
BACKGROUND: Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. AIMS: This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. METHODS: A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia...
April 12, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#9
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10 - 17% in the general population. Its prevalence in the surgical population seems to be higher. However, a proportion of up to 60% of patients may not have a formal diagnosis at the moment of preoperative visit. OSA is associated with a number of comorbidities and increased perioperative risks. However, most interventions for the perioperative management of OSA patients lack high quality evidence...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#10
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28394084/personalised-asthma-action-plans-for-adults-with-asthma
#11
REVIEW
Timothy L Gatheral, Alison Rushton, David Jw Evans, Caroline A Mulvaney, Nathan R Halcovitch, Gemma Whiteley, Fiona Jr Eccles, Sally Spencer
BACKGROUND: A key aim of asthma care is to empower each person to take control of his or her own condition. A personalised asthma action plan (PAAP), also known as a written action plan, an individualised action plan, or a self-management action plan, contributes to this endeavour. A PAAP includes individualised self-management instructions devised collaboratively with the patient to help maintain asthma control and regain control in the event of an exacerbation. A PAAP includes baseline characteristics (such as lung function), maintenance medication and instructions on how to respond to increasing symptoms and when to seek medical help...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28379868/double-dilemma-management-of-a-pregnant-patient-with-a-difficult-airway-presenting-with-undiagnosed-placenta-percreta-a-case-report
#12
Yewande A Omowanile, Luke N Weiler, Jill M Mhyre, Faiza A Khan
Patients with abnormal placentation should undergo planned cesarean delivery with the option for hysterectomy based on severity. We report a case of a multigravida with a known difficult airway presenting for cesarean delivery. She was found to have an undiagnosed placenta percreta at the start of surgery after the epidural was placed. After team discussion, the procedure was aborted and rescheduled electively 2 days later under general anesthesia with preoperative placement of internal iliac artery balloon catheters...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28376741/neck-circumference-to-inter-incisor-gap-ratio-a-new-predictor-of-difficult-laryngoscopy-in-cervical-spondylosis-patients
#13
Yong-Zheng Han, Yang Tian, Mao Xu, Cheng Ni, Min Li, Jun Wang, Xiang-Yang Guo
BACKGROUND: Preoperative airway assessment help anticipate a difficult airway. We hypothesized that a close association existed between difficult laryngoscopy and the neck circumference/inter-incisor gap ratio (RNIIG). Our aim was to determine its utility in predicting difficult laryngoscopy in cervical spondylosis patients. METHODS: Two hundred thirteen consecutive patients, aged 20-70 years, scheduled to undergo cervical spine surgery under general anesthesia, were recruited...
April 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28366293/procedural-difficulties-during-successful-intubation-in-octogenarians-a-prospective-observational-study
#14
Y F Bryan, K N Johnson
OBJECTIVE: Octogenarians undergo anatomic and physiopathologic degradation, making airway management problematic, specific to intubation, bag mask ventilation, leading to desaturation and aspiration. Our study's aim was to examine the process of airway management regarding the steps involved in intubation and any deviations or delays in the tasks. MATERIALS AND METHODS: An institutional review board-approved difficult airway prospective observational study in older adults was conducted...
March 30, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28362531/comparison-between-simulation-based-training-and-lecture-based-education-in-teaching-situation-awareness-a-randomized-controlled-study
#15
Alfredo Lee Chang, Andrew A Dym, Carla Venegas-Borsellino, Maneesha Bangar, Massoud Kazzi, Dmitry Lisenenkov, Nida Qadir, Adam Keene, Lewis Ari Eisen
RATIONALE: Situation awareness has been defined as the perception of the elements in the environment within volumes of time and space, the comprehension of their meaning, and the projection of their status in the near future. Intensivists often make time-sensitive critical decisions, and loss of situation awareness can lead to errors. It has been shown that simulation-based training is superior to lecture-based training for some critical scenarios. Because the methods of training to improve situation awareness have not been well studied in the medical field, we compared the impact of simulation vs...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28358178/time-to-intubation-in-obese-patients-a-randomized-study-comparing-direct-laryngoscopy-and-videolaryngoscopy-in-experienced-anaesthetists
#16
Fredrik Ander, Anders Magnuson, Lars Berggren, Rebecca Ahlstrand, Alex de Leon
BACKGROUND: Airway management may be difficult in obese patients. Moreover, during prolonged intubation, oxygen desaturation develops rapidly. Videolaryngoscopy improves the view of the larynx, and the Storz® C-MACTM has been shown to be superior to other videolaryngoscopes in terms of intubation time in obese patients. However, no effort has been made to compare the Storz® C-MACTM with direct laryngoscopy. The aim of the study was to evaluate if the use of Storz® C-MACTM may reduce intubation time when compared to direct laryngoscopy (classic Macintosh® blade)...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#17
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28325523/total-management-of-chronic-obstructive-pulmonary-disease-copd-as-an-independent-risk-factor-for-cardiovascular-disease
#18
REVIEW
Katsuya Onishi
Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28323237/comparison-of-the-mcgrath-%C3%A2-mac-video-laryngoscope-with-direct-macintosh-laryngoscopy-for-novice-laryngoscopists-in-children-without-difficult-intubation-a-randomized-controlled-trial
#19
Antoine Giraudon, Maryline Bordes-Demolis, Barbara Blondeau, Nadia Sibai de Panthou, Nathan Ferrand, Maeva Bello, Victoria Dahlet, François Semjen, Matthieu Biais, Karine Nouette-Gaulain
INTRODUCTION: Airway management and tracheal intubation are routinely performed in paediatric anaesthesia and yet are associated with preventable adverse events. The McGrath(®) MAC is a video laryngoscope with a curved blade similar to the Macintosh blade, which has not been previously described in first intention paediatric tracheal intubation. We aimed to compare direct laryngoscopy to the McGrath(®) MAC video laryngoscope among novice laryngoscopists. METHODS: Six paediatric anaesthesia residents with novice skills in paediatric laryngoscopy were randomly assigned to perform tracheal intubation using either direct Macintosh laryngoscopy (DL) or the McGrath(®) MAC video laryngoscope (MM) as the first attempted device in children weighing between 10 and 20kg without difficult intubation...
March 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#20
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
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