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pediatric airway

Ashley Gionfriddo, Mika L Nonoyama, Peter C Laussen, Peter N Cox, Megan Clarke, Alejandro A Floh
OBJECTIVES: To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. DESIGN: Retrospective cohort study...
March 15, 2018: Pediatric Critical Care Medicine
Mihir Sarkar, Rajasree Sinha, Satyabrata Roychowdhoury, Sobhanman Mukhopadhyay, Pramit Ghosh, Kalpana Dutta, Shibarjun Ghosh
Background: Early initiation of appropriate noninvasive respiratory support is utmost important intervention to avoid mechanical ventilation in severe bronchiolitis. Aim: This study aims to compare noninvasive continuous positive airway pressure (nCPAP) and hot humidified high-flow nasal cannulae (HHHFNC) as modes of respiratory support in infants with severe bronchiolitis. Methods: Prospective, randomized, open-label pilot study done in a tertiary-care hospital Pediatric Intensive Care Unit (PICU)...
February 2018: Indian Journal of Critical Care Medicine
Ryan H Belcher, David W Molter, Steven L Goudy
Despite humanitarian otolaryngology groups traveling in record numbers to resource-limited areas treating pediatric otolaryngology disease processes and training local providers, there remains a large burden of unmet needs. There is a meager amount of published information that comes from the developing world from an otolaryngology standpoint. As would be expected, the little information that does comes involves some of the most common pediatric otolaryngology diseases and surgical burdens including childhood hearing loss, otitis media, adenotonsillectomies, airway obstructions requiring tracheostomies, foreign body aspirations, and craniomaxillofacial surgeries, including cleft lip and palate...
March 7, 2018: Otolaryngologic Clinics of North America
Andrew J Lautz, Kelly C Martin, Akira Nishisaki, Christopher P Bonafide, Roberta L Hales, Elizabeth A Hunt, Vinay M Nadkarni, Robert M Sutton, Donald L Boyer
OBJECTIVES: Miscommunication has been implicated as a leading cause of medical errors, and standardized handover programs have been associated with improved patient outcomes. However, the role of structured handovers in pediatric emergencies remains unclear. We sought to determine if training with an airway, breathing, circulation, situation, background, assessment, recommendation handover tool could improve the transmission of essential patient information during multidisciplinary simulations of critically ill children...
March 7, 2018: Hospital Pediatrics
Eric B Jelin, Elizabeth M O'Hare, Tim Jancelewicz, Isam Nasr, Emily Boss, Daniel S Rhee
PURPOSE: We sought to determine optimal timing for CPAM resection within the first year of life. METHODS: We queried the National Surgical Quality Improvement Program pediatric database from 2012 to 2015 for elective CPAM resections on patients less than 1year of age. Patients were divided by age in months: 1-3 (n=57), 4-6 (n=135), and 6-12 (n=214). Patient operative variables and 30-day postoperative outcomes were compared. RESULTS: A total of 406 patients were included with no differences in demographics or comorbidities...
February 10, 2018: Journal of Pediatric Surgery
Paula Colvara de Souza, Vanessa Souza Gigoski, Camila Lúcia Etges, Lisiane da Rosa Barbosa
PURPOSE: Describe the findings of postoperative clinical evaluation of swallowing in infants with congenital heart disease (CHD) in a reference hospital in southern Brazil. METHODS: This is a cross-sectional study conducted postoperatively with infants with medical diagnosis of CHD aged 0-6 months in a Pediatric Intensive Care Unit. Exclusion criteria comprised infants with neurological and respiratory impairments, craniofacial malformation, structural alteration in the upper airways, and suspicion or diagnosis of genetic syndromes...
March 1, 2018: CoDAS
Ashley Robinson, Rodrigo Romao, Jessica Mills, Dafydd A Davies
PURPOSE: The purpose of this study was to determine practice patterns of Canadian surgeons managing congenital pulmonary airway malformations (CPAMs) and factors influencing practice. METHODS: Pediatric surgeons in Canada were surveyed regarding their experience, evaluation, and management CPAMs, and what factors they feel qualify patients for observation vs resection. Data were summarized, and Fisher's-Exact and Kruskal-Wallis Tests applied where appropriate. RESULTS: Sixty eight percent (n=46) of surgeons responded...
February 10, 2018: Journal of Pediatric Surgery
Christoph Zoeller, Benno M Ure, Jens Dingemann
INTRODUCTION:  Video-assisted thoracoscopic surgery (VATS) has gained broad acceptance among pediatric surgeons. Today, VATS can be regarded as a routine approach for various conditions in neonates and infants. However, there is a lack of information concerning the complications of thoracoscopic pulmonary surgery in neonates and infants. We aimed to review the available data. PATIENTS AND METHODS:  A systematic review of the literature was performed using PubMed...
March 6, 2018: European Journal of Pediatric Surgery
Andrew S Young, Michael W Fischer, Nicholas S Lang, Matthew R Cooke
This study provides trends in the discipline of dental anesthesiology. A questionnaire-based survey was sent to 338 members of the American Society of Dentist Anesthesiologists to evaluate practice patterns. One focus of the study was modality of sedation/anesthesia used for dentistry in North America. Age, gender, years in practice, and geographic region of practice were also obtained. Data gathered from the returned questionnaires were entered into an Excel spreadsheet and then imported into JMP Statistical Discovery Software (v12...
2018: Anesthesia Progress
Masanori Tsukamoto, Jun Hirokawa, Takashi Hitosugi, Takeshi Yokoyama
Tracheal bronchus is an ectopic bronchus almost arising from the right side of the tracheal wall above the carina. The incidence of a tracheal bronchus is reported as 0.1 to 3%. We experienced a patient with tracheal bronchus that was incidentally found at induction of anesthesia. Endotracheal intubation in a patient with tracheal bronchus might cause obstruction of the tracheal bronchus, although in this case, ventilation was not impaired.
2018: Anesthesia Progress
Yuko Shiima, Ting-Chang Hsieh, Andrew Long, Aaron Donoghue
OBJECTIVES: To examine technical aspects of pediatric tracheal intubation using video recording and to determine the association between tracheal intubation technique and procedural outcomes. DESIGN: Prospective observational study. SETTING: Emergency department resuscitation bay in single tertiary pediatric center. PATIENTS: Children undergoing emergent tracheal intubation under videorecorded conditions. INTERVENTIONS: None...
March 2018: Pediatric Critical Care Medicine
Ashley P O'Connell Ferster, Tom Shokri, Michele Carr
IMPORTANCE: Paradoxical vocal fold motion (PVFM) is a disorder often misdiagnosed in children presenting with shortness of breath and stridor. In infants, little is known about the clinical course and best approach for treatment of PVFM. This retrospective study assesses the approach to treatment and outcomes for infants with PVFM. OBJECTIVE: To investigate the clinical course of paradoxical vocal fold motion (PVFM) in infants. DESIGN: Retrospective review...
April 2018: International Journal of Pediatric Otorhinolaryngology
Nickolas Boroda, Monika Malesinska, Michelle S Kars, Lee P Smith
OBJECTIVES: Airway management during adenoidectomy is traditionally performed through endotracheal intubation (ETT). Laryngeal mask airway (LMA) may be less stimulating to the airway and allow for shorter overall operating room time. Previous studies report LMA use during adenotonsillectomy. There has been no prior evaluation of LMA use during adenoidectomy alone. In this study, we attempt to identify the rate and contributing factors of LMA failure during adenoidectomy. METHODS: All pediatric patients undergoing adenoidectomy between January 1, 2016 and June 30, 2017 were reviewed...
April 2018: International Journal of Pediatric Otorhinolaryngology
Amy L Dimachkieh, Allison Dobbie, Damon R Olson, Mark A Lovell, Jeremy D Prager
OBJECTIVE: To review tracheal paragangliomas and describe the clinical presentation, radiologic findings, operative management, and histologic findings of a pediatric patient who presented with stridor refractory to traditional asthma therapy. METHODS: Chart review of an 8-year-old male who presented to a tertiary care pediatric hospital and literature review of tracheal paragangliomas. RESULTS: We present the case of an 8-year-old male who presented with new-onset of wheezing and dyspnea on exertion...
April 2018: International Journal of Pediatric Otorhinolaryngology
Anke Rissmann, Andrea Koehn, Marja Loderstedt, Cornelia Schwemmle, Gerrit Goetze, Sylva Bartel, Stefan K Plontke, Joerg Langer, Klaus Begall, Peter Matulat, Friedrich-Wilhelm Roehl, Ulrich Vorwerk
OBJECTIVES: Airway management during adenoidectomy is traditionally performed through endotracheal intubation (ETT). Laryngeal mask airway (LMA) may be less stimulating to the airway and allow for shorter overall operating room time. Previous studies report LMA use during adenotonsillectomy with conversion rates to ETT of up to 17%. There has been no prior evaluation of LMA use during adenoidectomy alone. In this study, we attempt to identify the rate and contributing factors of LMA failure during adenoidectomy...
April 2018: International Journal of Pediatric Otorhinolaryngology
Francesca Lucca, Margherita Guarnieri, Mirco Ros, Giovanna Muffato, Roberto Rigoli, Liviana Da Dalt
INTRODUCTION: Pseudomonas aeruginosa is the predominant pathogen responsible of chronic colonization of the airways in Cystic Fibrosis patients. There are few European data about antibiotic susceptibility evolution of Pseudomonas aeruginosa in Cystic Fibrosis patients. OBJECTIVES: The aim of this study is to evaluate the evolution of antibiotic resistance in the period 2010-2013 in Cystic Fibrosis patients chronically colonized by Pseudomonas aeruginosa and to highlight the characteristics of this evolution in patients younger than 20 years...
March 2, 2018: Clinical Respiratory Journal
Paul D Robinson, Philipp Latzin, Kathryn A Ramsey, Sanja Stanojevic, Paul Aurora, Stephanie D Davis, Monika Gappa, Graham L Hall, Alex Horsley, Renee Jensen, Sooky Lum, Carlos Milla, Kim G Nielsen, Jessica E Pittman, Margaret Rosenfeld, Florian Singer, Padmaja Subbarao, Per M Gustafsson, Felix Ratjen
BACKGROUND: Obstructive airway disease is nonuniformly distributed throughout the bronchial tree, although the extent to which this occurs can vary among conditions. The multiple-breath washout (MBW) test offers important insights into pediatric lung disease, not available through spirometry or resistance measurements. The European Respiratory Society/American Thoracic Society inert gas washout consensus statement led to the emergence of validated commercial equipment for the age group 6 years and above; specific recommendations for preschool children were beyond the scope of the document...
March 1, 2018: American Journal of Respiratory and Critical Care Medicine
George A Mandelaris, Bradley S DeGroot, Robert Relle, Brian Shah, Iwei Huang, Brian S Vence
Comorbidities that negatively impact orthodontic (malocclusion), periodontal (periodontitis, deficient dentoalveolar bone volume, mucogingival), and prosthetic (structural integrity compromise from caries, attrition, and erosion) conditions can affect the general health of the patient. In addition, emerging data highlights the importance of undiagnosed airway volume deficiencies and sleep-disordered breathing conditions in the adult and pediatric population. Deficiencies in dentoalveolar bone and discrepancies in skeletal relationships can impact the volume of hard- and soft-tissue structures of the periodontium and decrease oral cavity volume...
March 2018: Compendium of Continuing Education in Dentistry
Binglan Yu, Michele Ferrari, Grigorij Schleifer, Martin Wepler, Warren M Zapol, Donald B Bloch
OBJECTIVES: To test the safety of a novel miniaturized device that produces nitric oxide (NO) from air by pulsed electrical discharge, and to demonstrate that the generated NO can be used to vasodilate the pulmonary vasculature in rabbits with chemically-induced pulmonary hypertension. STUDY DESIGN: A miniature NO (mini-NO) generator was tested for its ability to produce therapeutic levels (20-80 parts per million (ppm)) of NO, while removing potentially toxic gases and metal particles...
February 24, 2018: Nitric Oxide: Biology and Chemistry
Meredith Merz Lind, Marco Corridore, Cameron Sheehan, Melissa Moore-Clingenpeel, Tensing Maa
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork...
February 1, 2018: Otolaryngology—Head and Neck Surgery
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