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difficult airway management

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https://www.readbyqxmd.com/read/28619016/clinical-application-of-a-novel-endoscopic-mask-a-randomized-controlled-multi-center-trial-in-patients-undergoing-awake-fiberoptic-bronchoscopic-intubation
#1
Tianxiao Zou, Zhenling Huang, Xiaoxue Hu, Guangyu Cai, Miao He, Shanjuan Wang, Ping Huang, Bin Yu
BACKGROUND: Awake fiberoptic bronchoscopic tracheal intubation is usually regarded as an effective method in the management of predicted difficult airway. Hypoxia during awake nasal fiberoptic bronchoscopic intubation leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. The main aim of the study was to test whether the novel endoscopic mask is helpful for hypoxia during the intubation. METHODS: This was a randomized, controlled, multi-center study...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#2
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28611887/derivation-and-validation-of-the-prehospital-difficult-airway-identificationtool-predait-a-predictive-model-for-difficult-intubation
#3
Jestin N Carlson, David Hostler, Francis X Guyette, Mark Pinchalk, Christian Martin-Gill
INTRODUCTION: Endotracheal intubation (ETI) in the prehospital setting poses unique challenges where multiple ETI attempts are associated with adverse patient outcomes. Early identification of difficult ETI cases will allow providers to tailor airway-management efforts to minimize complications associated with ETI. We sought to derive and validate a prehospital difficult airway identification tool based on predictors of difficult ETI in other settings. METHODS: We prospectively collected patient and airway data on all airway attempts from 16 Advanced Life Support (ALS) ground emergency medical services (EMS) agencies from January 2011 to October 2014...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28606617/management-of-patients-with-predicted-difficult-airways-in-an-academic-emergency-department
#4
John C Sakles, Matthew J K Douglas, Cameron D Hypes, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management. OBJECTIVES: To determine the incidence, management, and outcomes of patients with predicted difficult airways in the ED. METHODS: Over the 1-year period from July 1, 2015 to June 30, 2016, data were prospectively collected on all patients intubated in an academic ED. After each intubation, the operator completed an airway management data form...
June 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28601212/awake-cricothyrotomy-a-novel-approach-to-the-surgical-airway-in-the-tactical-setting
#5
REVIEW
Robert L Mabry, Chetan U Kharod, Brad L Bennett
Airway obstruction on the battlefield is most often due to maxillofacial trauma, which may include bleeding and disrupted airway anatomy. In many of these cases, surgical cricothyrotomy (SC) is the preferred airway management procedure. SC is an emergency airway procedure performed when attempts to open an airway using nasal devices, oral devices, or tracheal intubation have failed, or when the risks from intubation are unacceptably high. The aim of this overview is to describe a novel approach to the inevitably surgical airway in which SC is the first and best procedure to manage the difficult or failed airway...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601203/the-care-of-thermally-injured-patients-in-operational-austere-and-mass-casualty-situations
#6
REVIEW
Booker T King, Wylan C Peterson
Burn injury affects a half million people in the United States annually. The severe thermal injury can have long-term debilitating effects. The management of burn patients in austere and operational environments is more complex. Mass casualty incidents can result in a large number of patients with multiple traumatic injuries, which often include burn injury. Appropriate triage of casualties is essential. Severely burned patients should be evacuated to a burn center if possible. Airway management and fluid resuscitation of burn patients present unique challenges...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28595790/trace-metals-in-fluids-lining-the-respiratory-system-of-patients-with-idiopathic-pulmonary-fibrosis-and-diffuse-lung-diseases
#7
REVIEW
Elena Bargagli, Federico Lavorini, Massimo Pistolesi, Elisabetta Rosi, Antje Prasse, Emilia Rota, Luca Voltolini
Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with a poor prognosis and an undefined etiopathogenesis. Oxidative stress contributes to alveolar injury and fibrosis development and, because transition metals are essential to the functioning of most proteins involved in redox reactions, a better knowledge of metal concentrations and metabolism in the respiratory system of IPF patients may provide a valuable complementary approach to prevent and manage a disease which is often misdiagnosed or diagnosed in later stages...
July 2017: Journal of Trace Elements in Medicine and Biology
https://www.readbyqxmd.com/read/28594858/factors-associated-with-delayed-defibrillation-in-cardiopulmonary-resuscitation-a-prospective-simulation-study
#8
Christoph Castan, Alexander Münch, Moritz Mahling, Leopold Haffner, Jan Griewatz, Anne Hermann-Werner, Reimer Riessen, Jörg Reutershan, Nora Celebi
INTRODUCTION: Early defibrillation is an important factor of survival in cardiac arrest. However, novice resuscitators often struggle with cardiac arrest patients. We investigated factors leading to delayed defibrillation performed by final-year medical students within a simulated bystander cardiac arrest situation. METHODS: Final-year medical students received a refresher lecture and basic life support training before being confronted with a simulated cardiac arrest situation in a simulation ambulance...
2017: PloS One
https://www.readbyqxmd.com/read/28574957/-attention-everyone-time-out-safety-attitudes-and-checklist-practices-in-anesthesiology-in-germany-a-cross-sectional-study
#9
Christopher Neuhaus, Aline Spies, Henryk Wilk, Markus A Weigand, Christoph Lichtenstern
BACKGROUND: The use of perioperative checklists has generated a growing body of evidence pointing toward reduction of mortality and morbidity, improved compliance with guidelines, reduction of adverse events, and improvements in human factor-related areas. Usual quality management metrics generally fall short in assessing compliance with their perioperative application. Our study assessed application attitudes and compliance with safety measures centered around the World Health Organization (WHO) "Safe Surgery Saves Lives" campaign as perceived by anesthesia professionals in Germany...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28556897/claims-for-compensation-after-injuries-related-to-airway-management-a-nationwide-study-covering-15-years
#10
I Fornebo, K A Simonsen, I R K Bukholm, U E Kongsgaard
BACKGROUND: Securing the airway is one of the most important responsibilities in anaesthesia. Injuries related to airway management can occur. Analysis from closed claims can help to identify patterns of injury, risk factors and areas for improvement. METHODS: All claims to The Norwegian System of Compensation to Patients from 1 January 2001 to 31 December 2015 within the medical specialty of anaesthesiology were studied. Data were extracted from this database for patients and coded by airway management procedures...
May 30, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28549421/comparison-of-vividtrac%C3%A2-airtraq%C3%A2-king-vision%C3%A2-macintosh-laryngoscope-and-a-custom-made-videolaryngoscope-for-difficult-and-normal-airways-in-mannequins-by-novices
#11
Szilárd Rendeki, Dóra Keresztes, Gábor Woth, Ákos Mérei, Martin Rozanovic, Mátyás Rendeki, József Farkas, Diána Mühl, Bálint Nagy
BACKGROUND: Direct laryngoscopy remains the gold standard for endotracheal intubation and is preferred by experienced operators. However, an increasing number of reports currently support videolaryngoscopy, particularly for novice users. The widespread use of videolaryngoscopy may be limited due to financial limitations, especially in low-income countries. Therefore, affordable single-use scopes are now becoming increasingly popular. We sought to compare these new scopes with direct laryngoscopes and the previously tested videolaryngoscopes in mannequins by novices...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28527873/comparison-of-xenon-with-led-illuminant-in-difficult-and-inhalation-injury-airway-scenario-a-randomized-crossover-manikin-study
#12
Andreas Moritz, Johannes Prottengeier, Joachim Schmidt
PURPOSE: The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. METHODS: We recruited forty-two anesthetists into a randomized crossover trial. Each performed tracheal intubation (TI) with a Xenon halogen and a LED light handle in the two manikin scenarios...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#13
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Randomised study. PATIENTS: Adults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index)...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28523137/complex-multimodality-central-airway-management-of-aspergillus-pseudomembranous-tracheobronchitis
#14
Samjot Singh Dhillon, Marwan Saoud, Kassem Harris
A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28516246/aspergillus-species-in-bronchiectasis-challenges-in-the-cystic-fibrosis-and-non-cystic-fibrosis-airways
#15
REVIEW
Sanjay H Chotirmall, Maria Teresa Martin-Gomez
Bronchiectasis is a chronic irreversible airway abnormality associated with infectious agents that either cause or superinfect the airways. While the role of bacteria is well studied, much remains to be determined about fungi in both cystic fibrosis- and non-cystic fibrosis-related bronchiectasis. The airway is constantly exposed to inhaled ambient moulds of which Aspergillus represent the most ubiquitous. In a normal healthy host, this situation is of little consequence. The presence of anatomical or immunological abnormalities such as those in bronchiectasis leads to a range of fungal-related pathologies from asymptomatic airway colonization to fungal sensitization, allergic bronchopulmonary aspergillosis or chronic pulmonary aspergillosis...
May 17, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28515525/management-of-an-intraoperatively-damaged-endotracheal-tube-in-a-case-of-difficult-airway-using-fibre-optic-bronchoscope-with-minimal-apnoea-period
#16
Jayachandran Himarani, S Mary Nancy, V B Krishna Kumar Raja, S Shanmuga Sundaram
Damage to the endotracheal tube (ETT) is common in head and neck surgeries, especially in maxillary osteotomy. Airway management in such a crisis is crucial as there is risk of aspiration of blood into lungs, hypoxia and apnoea. This case illustrates a patient with an anticipated difficult airway who had an intraoperative damage to the ETT and was successfully managed by re-intubation with fiberoptic bronchoscope in a minimal apnoea period of <15 s using a new technique.
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28511478/recognition-of-small-airways-obstruction-in-asthma-and-copd-the-road-less-travelled
#17
REVIEW
Desh Deepak, Akhila Prasad, Swapndeep Singh Atwal, Kshitij Agarwal
The small airways, once regarded as the silent zone in the air conducting system of the lungs are now known to be one of the initial sites of involvement in diseases like asthma and Chronic Obstructive Pulmonary Disease (COPD). Identification of the involvement of distal airways in these diseases is often difficult to assess, clinically as well as by conventional pulmonary function tests and therefore, usually remains undiscovered in early stages. Early recognition of their involvement in asthma and COPD and timely management may reduce long term morbidity in these conditions...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#18
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28487824/significance-of-a-clean-tip-catheter-closed-suctioning-system-in-a-high-setting-ventilated-super-morbidly-obese-patient-with-profuse-respiratory-secretions
#19
Mohd Zulfakar Mazlan, Rhendra Hardy Mohd Zaini, Shamsul Kamalrujan Hassan, Saedah Ali, Sanihah Che Omar, Wan Mohd Nazaruddin Wan Hassan
INTRODUCTION: Closed suctioning is commonly used in the context of high-setting mechanical ventilation (MV), given its ability to prevent lung volume loss that otherwise accompanies open suctioning. However, closed suctioning systems (CSS) are not equivalent regarding components and capabilities, and thus this technique may be differentially effective to adequately clear patient secretions from an endotracheal tube (ETT), which is of paramount importance when the tube size makes the ETT particularly vulnerable to block by patient secretions...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28448320/difficult-airway-management-resulting-from-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#20
Courtney L Maxey-Jones, Alec Palmerton, Jocelyn R Farmer, Brian T Bateman
Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.
April 26, 2017: A & A Case Reports
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