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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/29907900/-anesthesia-ventilation-and-pain-treatment-in-thoracic-trauma
#3
REVIEW
M Weigeldt, M Paul, S Schulz-Drost, M D Schmittner
The management of anesthesia plays a central role in the treatment of thoracic trauma, both in the initial phase when safeguarding the difficult airway and in the intensive care unit. A rapid transfer to a trauma center should be considered in order to recognize and treat organ dysfunction in time. Development of atelectasis, pneumonia and acute lung failure are common pulmonary complications. Non-invasive ventilation combined with physiotherapy and respiratory training can help to minimize these pulmonary complications...
June 15, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29905977/inspiromatic-safety-and-efficacy-study-of-a-new-generation-dry-powder-inhaler-in-asthmatic-children
#4
Guy Steuer, Dario Prais, Huda Mussaffi, Meir Mei-Zahav, Ophir Bar-On, Hagit Levine, Yulia Gendler, Hannah Blau, Patrick Stafler
BACKGROUND: Dry powder inhalers (DPI) are effective but forceful inhalation required to fluidize the powder may be difficult for children and patients with airway disease. Inspiromatic is a new generation active DPI that actively suspends drugs in synchrony with inhalation. We evaluated safety and efficacy of Formoterol delivery via Inspiromatic, compared to Aerolizer, a conventional DPI, in pediatric asthmatic subjects. METHODS: A phase I/II, randomized, single-center, double-blind, double-dummy, placebo-controlled, cross-over study...
June 15, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29903033/treatment-of-giant-cervico-mediastinal-lymphatic-malformations-a-case-series
#5
So-Hyun Nam, Kyoung-Ah Kwon
BACKGROUND: Lymphatic malformations are histologically benign vascular structures that vary in anatomic lesion and size. Extensive head and neck lymphatic malformations may be life-threatening. In the present study, we described three difficult-to-treat infants with giant cervico-mediastinal lymphatic malformations accompanied by severe respiratory distress. CASE PRESENTATIONS: Case 1. A Korean girl born at a gestational age of 37 weeks and weighing 2920 g had a large cervical mass compressing the trachea...
June 15, 2018: Journal of Medical Case Reports
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
#6
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/29889671/evaluation-of-two-neck-ultrasound-measurements-as-predictors-of-difficult-direct-laryngoscopy-a-prospective-study
#7
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/29887292/dexmedetomidine-in-difficult-airway-management-with-a-fibre-optic-bronchoscope-in-the-awake-patient-with-klippel-feil-syndrome
#8
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/29886648/-a-cross-sectional-survey-of-treatment-acceptance-and-influence-factors-in-patients-with-obstructive-sleep-apnea
#9
B X Chen, Q Ou, M X Pan
Objective: To investigate the treatment acceptance in patients with obstructive sleep apnea (OSA) and its influence factors. Methods: This cross-sectional survey recruited OSA patients diagnosed at sleep center in Guangdong General Hospital from January 2014 to December 2015. By phone follow-up, a pre-designed questionnaire was performed for all adults, which composed of the following sections: treatment or none, treatment method, reason for non-treatment, revisit or none. Results: From 524 OSA patients with completed contact information, 480 (91...
May 29, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29878008/volatile-organic-compound-signature-from-co-culture-of-lung-epithelial-cell-line-with-pseudomonas-aeruginosa
#10
Oluwasola Lawal, Hugo Knobel, Hans Weda, Lieuwe D Bos, Tamara M E Nijsen, Royston Goodacre, Stephen J Fowler
Bacteria are found ubiquitously within and on nearly every site within humans, including the airways. Microbes interact with airway epithelial cells in lung infections such as ventilator-associated pneumonia (VAP). Development of infection results in the production of oxidants such as hydrogen peroxide that may further damage the epithelium. VAP is difficult to diagnose and associated with significant mortality. Current methods are invasive and time consuming impacting on appropriate therapy, antimicrobial resistance and financial costs...
June 7, 2018: Analyst
https://www.readbyqxmd.com/read/29876333/pediatric-inflammatory-myofibroblastic-tumors-of-the-airway-two-case-reports-with-varying-clinical-presentation
#11
Nuthan Kumar, Thirunavukkarasu Saravanamuthu, Arathi Srinivasan, Thulasi Raman, Julius-Xavier Scott
Introduction: An inflammatory myofibroblastic tumor (IMT) is a rare tumor of intermediate malignant potential. It may occur in a wide range of anatomical locations. One-third are found in the respiratory tract. We report two cases of IMT of the airway diagnosed at our institution. Case Report: Case 1: A 6-year-old male child presented with a 1-month history of hoarseness of the voice. On evaluation, a polypoid nodule was noted in the right vocal cord which was excised through the endolaryngeal route...
May 2018: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29875191/-pathogen-eradication-and-emerging-pathogens-difficult-definitions-in-cystic-fibrosis
#12
Peter H Gilligan, Damian G Downey, J Stuart Elborn, Patrick A Flume, Sebastian Funk, Deirdre Gilpin, Timothy J Kidd, John McCaughan, B Cherie Millar, Philip G Murphy, Jacqueline C Rendall, Michael M Tunney, John E Moore
Infection is a common complication of cystic fibrosis (CF) airways disease. Current treatment approaches include early intervention with the intent to eradicate pathogens in the hope of delaying development of chronic infection and chronic use of aerosolized antibiotics to suppress infection. The use of molecules that help restore CFTR function, modulate pulmonary inflammation, or improve pulmonary clearance, may also influence the microbial communities in the airways. As the pipeline of these new entities continues to expand, it is important to define when key pathogens are eradicated from the lungs of CF patients and equally important, when new pathogens might emerge as a result of these novel therapies...
June 6, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29869857/laryngeal-chondrosarcoma-a-rare-cause-of-critical-upper-airway-obstruction
#13
K Tuite, J C Oosthuizen, T Subramaniam, J B Kinsella
Laryngeal cancers are rare, encompassing around one percent of all cancers. Suspicion should be raised if a patient presents with classical signs and symptoms; i.e. dysphonia, inspiratory stridor, dysphagia, odynophagia, neck mass, or persistent cough. Laryngeal chondrosarcoma is a rare form of laryngeal cancer, the diagnosis of which can be difficult. The case in question describes an unusual presentation of one such case, and its subsequent investigation, management and outcome.
January 10, 2018: Irish Medical Journal
https://www.readbyqxmd.com/read/29869158/lamb-larynx-model-for-training-in-endoscopic-and-co-2-laser-assisted-surgeries-for-benign-laryngotracheal-obstructions
#14
François Gorostidi, Pauline Vinckenbosch, Karma Lambercy, Kishore Sandu
PURPOSE: With adequate indication and meticulous execution, endoscopic procedures can efficiently treat a subset of adult and pediatric benign laryngotracheal stenosis and obstructions, but these procedures are precise and very demanding. The difference between a successful and a failed surgery, with potentially debilitating side effects, resides in small details. The learning curve is long and very few centers worldwide have a sufficient case load making adequate training difficult. While indications and concepts of endoscopic procedures can be learned in books and by observing trained colleagues, the dexterity and the precise realization need to be practiced, ideally not initially on patients...
June 4, 2018: European Archives of Oto-rhino-laryngology
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
#15
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/29866144/standardised-data-reporting-from-pre-hospital-advanced-airway-management-a-nominal-group-technique-update-of-the-utstein-style-airway-template
#16
G A Sunde, A Kottmann, J K Heltne, M Sandberg, M Gellerfors, A Krüger, D Lockey, S J M Sollid
BACKGROUND: Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. We aimed to identify which airway data were most important to report today and to revise and update a previously reported Utstein-style airway management dataset. METHODS: We recruited sixteen international experts in pre-hospital airway management from Australia, United States of America, and Europe...
June 4, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29859590/rigid-endoscope-assisted-orotracheal-intubation-for-vallecular-cyst-surgery-in-neonates-and-young-infants
#17
Haoyue Tan, Qi Huang, Antoine Paul, Wei Wang, Jingjie Li, Huan Jia
OBJECTIVES: To investigate the outcomes of rigid endoscope-assisted orotracheal intubation (REI) in neonates and young infants with difficult airway conditions as an alternative intubation technique when more specific airway instruments are not available in most developing countries, and to evaluate the safety and advantages of this method. METHODS: Neonatal and young infantile patients undergoing vallecular cyst surgery with a Cormack-Lehane Grade 3 or 4 glottic view between June 2013 and June 2015 were studied...
July 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29854469/airway-management-during-thyroidectomy-for-a-giant-goitre-due-to-mccune-albright-syndrome
#18
Hiroyuki Nakao
There have been no case reports to date describing the technical aspects of tracheal intubation in a patient with a goitre associated with McCune-Albright syndrome (MAS), even though goitre is frequently observed in this condition. I describe a case of resection of a giant goitre in a patient with MAS, with difficult airway management. Preoperative investigation showed that the trachea was shifted to the right by the goitre, with the narrowest part of the tracheal lumen 4 mm in diameter. There was dome-shaped protuberance of the posterior pharyngeal wall into the airway...
2018: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29848516/airway-management-in-a-patient-with-crouzon-syndrome-proposed-to-orthognathic-surgery
#19
Melissa Fernandes, Ana Eufrásio, João Bonifácio, João Marcelino
Airway management is one of the most important anaesthetist's skills as major complications of airway management, although rare, can be among the most life threatening in medicine. Crouzon syndrome is a rare condition with physical characteristics that can result in difficult airway manipulation. A correct preanaesthetic evaluation and a planned preinduction strategy should be designed to facilitate intubation.
May 30, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29802903/difficult-intubation-and-extubation-in-adult-anaesthesia
#20
O Langeron, J-L Bourgain, D Francon, J Amour, C Baillard, G Bouroche, M Chollet Rivier, F Lenfant, B Plaud, P Schoettker, D Fletcher, L Velly, K Nouette-Gaulain
OBJECTIVE: To provide an update to French guidelines about « Difficult intubation and extubation in adult anaesthesia 2006 » DESIGN: A consensus committee of 13 experts was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independent of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence...
May 23, 2018: Anaesthesia, Critical Care & Pain Medicine
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