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https://www.readbyqxmd.com/read/29054228/novel-airway-and-ventilator-management-of-tracheobronchial-disruption-after-blunt-trauma
#1
Nitin Mehdiratta, Michael Archer, Melissa Stewart, Bradley Dennis, Eric Grogan
Tracheobronchial injuries can be difficult to diagnose and manage, especially in the presence of polytrauma. A 50-year-old woman presented as a Level I trauma activation after being struck by a motor vehicle. Initial evaluation demonstrated intracranial hemorrhage and multiple chest injuries, including multilevel bilateral rib fractures, pneumomediastinum, and concern for tracheobronchial injury. After initial stabilization, bronchoscopy was performed and demonstrated an injury to the carina. We report a novel airway and ventilation strategy in the setting of concomitant tracheobronchial injury after severe blunt chest trauma in which extracorporeal support is contraindicated...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29051828/intubation-following-high-dose-rocuronium-in-a-cat-with-protracted-laryngospasm
#2
Graeme M Doodnaught, Daniel Sj Pang
CASE SUMMARY: An 11-year-old spayed female domestic shorthair cat with a history of laryngospasm at induction of general anesthesia presented for dental evaluation and treatment. The cat was premedicated with hydromorphone (0.05 mg/kg) and alfaxalone (0.5 mg/kg) intravenously, pre-oxygenated for 5 mins (3 l/min, face mask) and anesthesia was induced with alfaxalone (to effect) intravenously. Lidocaine (0.1 ml, 2%) was applied topically to the arytenoid cartilages following loss of jaw tone...
July 2017: JFMS open reports
https://www.readbyqxmd.com/read/29050062/-cerebral-emergency-important-anesthesiological-aspects
#3
Martin Schott, Klaus-Peter Stein, Martin Bauer
The anesthesiological management of cerebral emergency represents a great challenge for action under pressure and under time pressure and requires smooth interprofessional cooperation. The exact knowledge of the pathophysiological and pharmacological relationships is the basis for rapid identification of therapeutic influences and possible disturbing factors. In the acute situation, paCO2 and MAP are the central determinants for the anesthetist to ensure cerebral perfusion and the resulting cerebral oxygenation...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29046943/congenital-pulmonary-airway-malformations-state-of-the-art-review-for-pediatrician-s-use
#4
REVIEW
Claire Leblanc, Marguerite Baron, Emilie Desselas, Minh Hanh Phan, Alexis Rybak, Guillaume Thouvenin, Clara Lauby, Sabine Irtan
Congenital pulmonary airway malformations or CPAM are rare developmental lung malformations, leading to cystic and/or adenomatous pulmonary areas. Nowadays, CPAM are diagnosed prenatally, improving the prenatal and immediate postnatal care and ultimately the knowledge on CPAM pathophysiology. CPAM natural evolution can lead to infections or malignancies, whose exact prevalence is still difficult to assess. The aim of this "state-of-the-art" review is to cover the recently published literature on CPAM management whether the pulmonary lesion was detected during pregnancy or after birth, the current indications of surgery or surveillance and finally its potential evolution to pleuro-pulmonary blastoma...
October 19, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29044795/ahns-series-do-you-know-your-guidelines-perioperative-antithrombotic-management-in-head-and-neck-surgery
#5
Annika Meyer, Neil Gross, Marita Teng
Head and neck surgeons are commonly faced with surgical patients who have underlying medical problems requiring antithrombotic therapy. It is difficult to achieve a balance between minimizing the risk of thromboembolism and hemorrhage in the perioperative period. Data from randomized, controlled trials are limited, and procedure-specific bleed rates are also difficult to pinpoint. The decision is made more difficult when patients with moderate-to-high risk for thromboembolic events undergo procedures that are high risk for bleeding...
October 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/29038830/a-distance-blended-learning-program-to-upgrade-the-clinical-competence-of-district-non-doctor-anesthesia-providers-in-nepal
#6
Shristi Shah, Stephen Knoble, Oliver Ross, Stephen Pickering
BACKGROUND: Across Nepal, anesthesia at a district level is provided mostly by non-doctor anesthesia providers (anesthesia assistants-AAs). Nepal's Government recognized the need to sustain competence with continuous professional development and to upgrade 6-month trained working AAs to professional equivalence with the new national standard of 12-month training. As they are essential district health workers and AA clinical training sites are full, an innovative distance blended learning, competency-based, upgrade 1-year course was developed and conducted in 2014-2017 for two batches...
October 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29037744/intoxication-from-the-novel-synthetic-cannabinoids-ab-pinaca-and-adb-pinaca-a-case-series-and-review-of-the-literature
#7
REVIEW
Patil Armenian, Michael Darracq, Jirair Gevorkyan, Shane Clark, Bryan Kaye, Nicklaus P Brandehoff
Synthetic cannabinoids (SC), are a novel class of designer drugs which emerged as a drug of abuse in the late 2000's. We report a case series of 6 patients who may have smoked a synthetic cannabinoid product in a remote wilderness setting. They presented with varying degrees of altered mental status, agitation, and seizures. Two were confirmed to have AB-PINACA, ADB-PINACA and their respective pentanoic acid metabolites in biological specimens via liquid chromatography time-of-flight mass spectrometry (LC-TOF/MS)...
October 13, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29032316/fiber-reinforced-silicone-for-tracheobronchial-stents-an-experimental-study
#8
Samanta Bianchi Vearick, Kétner Bendo Demétrio, Rogério Gastal Xavier, Alexandre Heitor Moreschi, André Frotta Muller, Paulo Roberto Stefani Sanches, Luis Alberto Loureiro Dos Santos
A trachea is a tubular structure composed of smooth muscle that is reinforced with cartilage rings. Some diseases can cause sagging in smooth muscle and cartilaginous tissue. The end result is reduction (narrowing) of the trachea diameter. A solution to this problem is the use of tracheal stents, which are small tubular devices made of silicone. One is inserted into the trachea to prevent or correct its constriction. The purpose of tracheal stent use is to maintain cartilage support that would otherwise be lost in the airway...
October 9, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29031661/guidelines-and-algorithms-for-managing-the-difficult-airway
#9
M A Gómez-Ríos, L Gaitini, I Matter, M Somri
The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms.
October 11, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29027675/ultrasound-guided-percutaneous-dilatational-tracheostomies-in-2-difficult-airways
#10
José A Valencia, David J Romero, Enrique Arango, Javier E Cubillos, Hugo A Mantilla, Luis G García-Herreros
Ultrasound has become a rapid, safe, and easy-to-use tool for anesthesiologists. It reduces complications, morbidity, and mortality, especially in patients with anatomic abnormalities in whom a traditional approach may be both difficult and risky. We report 2 cases of symptomatic patients with a difficult airway due to displacement of the trachea by a neck mass. Real-time ultrasound imaging was performed for percutaneous dilatational tracheostomies, identifying important structures, without any complications...
October 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29026386/effect-of-posture-on-swallowing
#11
Ahmad H Alghadir, Hamayun Zafar, Einas S Al-Eisa, Zaheen A Iqbal
BACKGROUND: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while swallowing. OBJECTIVES: To observe the effect of different body postures on the self-perceived difficulty while swallowing in normal healthy subjects...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/28991120/-difficult-airway-bibliometrics-importance-of-capturing-the-correct-literature
#12
Jaideep J Pandit, Mansukh T Popat
No abstract text is available yet for this article.
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28991116/incidence-and-operative-factors-associated-with-discretional-postoperative-mechanical-ventilation-after-general-surgery
#13
Juliet J Ray, Meredith Degnan, Krishnamurti A Rao, Jonathan P Meizoso, Charles A Karcutskie, Danielle B Horn, Luis Rodriguez, Richard P Dutton, Carl I Schulman, Roman Dudaryk
BACKGROUND: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28987399/review-of-difficult-airway-management-in-thoracic-surgery
#14
M Granell, M J Parra, M J Jiménez, L Gallart, A Villalonga, O Valencia, M C Unzueta, A Planas, J M Calvo
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers...
October 4, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28981980/conditional-reprogramming-of-pediatric-airway-epithelial-cells-a-new-human-model-to-investigate-early-life-respiratory-disorders
#15
Seth Wolf, Geovanny F Perez, Lana Mukharesh, Nataliza Isaza, Diego Preciado, Robert J Freishtat, Dinesh Pillai, Mary C Rose, Gustavo Nino
BACKGROUND: Airway epithelial cells (AEC) are quite difficult to access in newborns and infants. It is critically important to develop robust life-extended models to conduct translational studies in this age group. We propose the use of a recently described cell-culture technology (conditionally reprogrammed cells - CRC) to generate continuous primary cell cultures from nasal and bronchial AEC of young children. METHODS: We collected nasal and/or bronchial AEC from a total of 23 subjects of different ages including newborns/infants/toddlers (0-2 years; N=9), school age children (4-11 years; N=6), and a group of adolescent/adult donors (N=8)...
October 5, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28976458/evaluation-of-the-c-mac-miller-video-laryngoscope-sizes-0-and-1-during-tracheal-intubation-of-infants-less-than-10-kg
#16
Florian J Raimann, Colleen E Cuca, Detlev Kern, Kai Zacharowski, Udo Rolle, Dirk Meininger, Christian F Weber, Christian Byhahn, Haitham Mutlak
STUDY OBJECTIVE: Video laryngoscopy has primarily been developed to assist in difficult airways. Using video laryngoscopy in pediatric airway management is an up-and-coming topic. The aim of the presented study was to compare the intubation conditions obtained when using the C-MAC video laryngoscope with Miller blades sizes 0 and 1 for standard direct laryngoscopy and indirect laryngoscopy in children weighing less than 10 kg. DESIGN: This was a prospective study...
October 2, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28975073/usefulness-of-ultrasound-view-of-larynx-in-pre-anesthetic-airway-assessment-a-comparison-with-cormack-lehane-classification-during-direct-laryngoscopy
#17
Sussan Soltani Mohammadi, Alireza Saliminia, Nasim Nejatifard, Roxana Azma
BACKGROUND: One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28974913/successful-endotracheal-intubation-with-trachway-after-failed-fiber-optic-manipulations-in-a-patient-with-retropharyngeal-cervical-chordoma
#18
Yi-Ting Chen, Chun-Ning Ho, Kuo-Chuan Hung
A retropharyngeal mass may distort the airway anatomy and reduce the space available for manipulation of intubation devices. We encountered a patient with a cervical chordoma occupying the retropharyngeal space. Fiber-optic orotracheal intubation was attempted to secure the airway. Although the fiber-optic bronchoscope (FOB) was successfully placed into the trachea, the tracheal tube could not be passed through the glottis. An airway was then successfully established with the Trachway device, a video-assisted system with a rigid but malleable intubating stylet...
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28974645/noninvasive-ventilation-in-obese-subjects-after-acute-respiratory-failure
#19
Charlotte Bry, Sandrine Jaffré, Béatrice Guyomarc'h, Frédéric Corne, Sylvaine Chollet, Antoine Magnan, François-Xavier Blanc
INTRODUCTION: Noninvasive ventilation (NIV) has been widely used to treat acute respiratory failure in obese patients. Criteria that could help clinicians to decide whether they should continue to use NIV after such an initial episode remain unclear. Our retrospective study aims to analyze characteristics of subjects receiving long-term NIV after an initial hospitalization for acute respiratory failure. METHODS: From January 2011 to December 2012, 77 obese adults were admitted in the ICU of the respiratory disease department in Nantes University Hospital in France...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28969598/bougies-as-an-aid-for-endotracheal-intubation-with-the-airway-scope-bench-and-manikin-comparison-studies
#20
Ichiro Takenaka, Kazuyoshi Aoyama, Tamao Iwagaki, Yukari Takenaka
BACKGROUND: When encountering a difficult airway with an Airway Scope (AWS) a bougie can be inserted into the endotracheal tube in the AWS channel. The angulated tip of the bougie can be guided toward the glottis by rotating it. We tested the ease of rotating bougies (Venn reusable, Boussignac, Portex single-use, and Frova) in an endotracheal tube when placed in the AWS channel. METHODS: Bench study: Seven anesthesiologists inserted each of the four types of bougies into a 7...
October 2, 2017: BMC Anesthesiology
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