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https://www.readbyqxmd.com/read/29148205/inhaled-corticosteroids-and-the-risks-of-low-energy-fractures-in-patients-with-chronic-airway-diseases-a-propensity-score-matched-study
#1
Chun-Hao Tsai, Lin-Yu Laio, Cheng-Li Lin, Wei-Sheng Chung
BACKGROUND AND AIMS: Inhaled corticosteroids (ICSs) are crucial anti-inflammatory medications for chronic airway diseases. Studies investigating the relationship between ICSs and fractures in Asian populations are scant. We investigated whether ICSs increased the risk of low-energy fractures in patients with chronic airway diseases. METHODS: We used the Longitudinal Health Insurance Database to select patients aged 20 years and older with chronic airway diseases (asthma and COPD) between 2000 and 2011 as the base cohort...
November 17, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29109835/anterior-submandibular-approach-for-transmylohyoid-endotracheal-intubation-a-reappraisal-with-prospective-study-in-206-cases-of-craniomaxillofacial-fractures
#2
Nitin Bhola, Anendd Jadhav, Atul Kala, Rahul Deshmukh, Umesh Bhutekar, G S V Prasad
Despite a paradigm shift in anesthesia and trauma airway management, the craniomaxillofacial fracture (CMF) patients continue to pose a challenge. A prospective study was planned between April 2007 and March 2015 to investigate the safety, efficacy, utility, and complications of anterior submandibular approach for transmylohyoid intubation (TMI) in CMFs using an armored endotracheal tube (ETT). Out of 1,207 maxillofacial trauma cases reported, this study recruited 206 patients (152 males and 54 females) aged between 21 and 60 years...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29084114/comparison-of-postoperative-outcomes-between-monitored-anesthesia-care-and-general-anesthesia-in-closed-reduction-of-nasal-fracture
#3
Hyunwoo Kyung, Jae-Ik Choi, Seung-Han Song, Sang-Ha Oh, Nakheon Kang
Fracture of nasal bone is among the most common facial bone fractures. Reduction of nasal bone fracture is able to be performed under local or general anesthesia. The aim of this study is to compare monitored anesthetic care (MAC) and general anesthesia (GA) based on intraoperative vital signs, and the adverse effects after closed reduction of nasal bone fractures.The authors performed a retrospective study of 45 patients who underwent a closed reduction of nasal bone fracture between January 1, 2016 and December 31, 2016...
October 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29054228/novel-airway-and-ventilator-management-of-tracheobronchial-disruption-after-blunt-trauma
#4
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/28990960/anesthesia-simulator-based-functional-capacity-evaluation-of-an-anesthesiologist-after-radial-fracture-a-case-report
#5
Ceferina Suarez, Jesús Maxide, Demian Szyld, Jose M Maestre
We used simulation as a job-specific functional capacity evaluation method after a distal radius fracture in an anesthesiologist. Treatment included open reduction followed by an internal fixation with an arthrodesis plate. The patient performed simulated anesthesia inductions to assess her response to endotracheal intubation, bag-mask ventilation, and the manual opening of the airway. Data collected helped to guide the rehabilitation protocol, and to assess pain and the time to safely return to work. The patient began her clinical duties after 7 weeks of therapy and was able to fully perform her daily tasks with confidence, and full functional capacity...
October 5, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28988443/effects-of-supramaximal-balloon-dilatation-pressures-on-adult-cricoid-and-tracheal-cartilage-a-cadaveric-study
#6
Venkata S P B Durvasula, Sara C Shalin, Ozlem E Tulunay-Ugur, James Y Suen, Gresham T Richter
OBJECTIVES/HYPOTHESIS: Cricoid fracture is a serious concern for balloon dilatation in airway stenosis. Furthermore, there are no studies examining tracheal rupture in balloon dilatation of stenotic segments. The aim of this study was to evaluate the effect of supramaximal pressures of balloons on the cricoid and tracheal rings. STUDY DESIGN: Prospective cadaveric study. METHODS: Seven cadaveric laryngotracheal complexes of normal adults with intact cricothyroid membranes were acquired...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#7
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28918181/flared-sign-of-flail-mandible-on-computed-tomography-an-unstable-fracture-associated-with-a-compromised-airway
#8
I Papadiochos, L Goutzanis, K-I Karydi, E Kalfarentzos, N Papadogeorgakis
A mandibular fracture alone rarely causes a life-threatening injury. The aim of this paper was to emphasise the importance of prompt identification of the radiological signs of a flail mandible in a patient with maxillofacial trauma who eventually needed definitive management of her airway.
September 13, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28913284/comparison-study-of-the-use-of-absorbable-materials-as-internal-splints-with-airway-silicone-splint-and-absorbable-materials-as-internal-splints-alone
#9
So Young Ji, Seung Soo Kim, Ki Sung Park, Bong Soo Baik
BACKGROUND: Packing after closed reduction of nasal fracture causes uncomfortable nasal obstruction in patients. We packed the superior meatus with synthetic polyurethane foam (SPF) to support the nasal bone, and packed the middle nasal meatus with a nasal airway splint (NAS) and SPF. The aim of this article is prospectively to compare the subjective patient discomfort of SPF (Nasopore Forte plus) packing alone and SPF with NAS. METHODS: We compared the prospectively subjective patient discomfort of SPF packing alone (group A) and SPF with NAS (group B) via visual analog scale (VAS; 0, no symptom; 100, most severe symptom)...
December 2016: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#10
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28879322/difficult-airway-management-in-a-patient-with-a-thin-mandible
#11
Hong-Seok Choi, Jong-Shik Oh, Eun-Jung Kim, Ji-Young Yoon, Ji-Uk Yoon, Cheul-Hong Kim
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28864483/cadaveric-study-of-movement-in-the-unstable-upper-cervical-spine-during-emergency-management-tracheal-intubation-and-cervical-spine-immobilisation-a-study-protocol-for-a-prospective-randomised-crossover-trial
#12
Shiyao Liao, Erik Popp, Petra Hüttlin, Frank Weilbacher, Matthias Münzberg, Niko Schneider, Michael Kreinest
INTRODUCTION: Emergency management of upper cervical spine injuries often requires cervical spine immobilisation and some critical patients also require airway management. The movement of cervical spine created by tracheal intubation and cervical spine immobilisation can potentially exacerbate cervical spinal cord injury. However, the evidence that previous studies have provided remains unclear, due to lack of a direct measurement technique for dural sac's space during dynamic processes...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28858549/submental-intubation-in-cases-of-panfacial-fractures-a-retrospective-study
#13
Willian Caetano Rodrigues, Willian Morais de Melo, Rafael Santiago de Almeida, Shajadi Carlos Pardo-Kaba, Celso Koogi Sonoda, Elio Hitoshi Shinohara
Surgical treatment of panfacial fractures usually requires intraoperative temporary occlusion of the teeth and simultaneous access to the nasal pyramid. In such cases, the standard method of airway management is to perform a tracheostomy, but this may be associated with a significant number of perioperative and late complications. This study aimed to determine if submental endotracheal intubation (SEI) is a viable alternative to tracheostomy, especially when short-term postoperative control of the airway is foreseen...
December 0: Anesthesia Progress
https://www.readbyqxmd.com/read/28857990/andy-gump-fracture-of-the-mandible-in-a-pediatric-patient
#14
Gabriel Mulinari-Santos, Valthierre Nunes Lima, Xiomara Mónica Johanna Palacio-Muñoz, André Hergesel de Oliva, Gustavo Antonio Correa Momesso, Tárik Ocon Braga Polo, Francisley Ávila Souza, Idelmo Rangel Garcia-Júnior, Leonardo Perez Faverani
The mandibular fractures in pediatric patients are rare, and they can need a fast and safe treatment. We present a case of a pediatric patient with "Andy Gump" fracture, resulting in a retrognathic mandible, distress to breathe, and functional discomfort to the patient caused by a cycling accident. The treatment was successful with the fast release of airway path and use of titanium plates to fix the fracture.
October 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28846011/how-to-overcome-the-challenges-of-non-detachable-connector-tubes-in-submental-intubation-for-panfacial-fractures
#15
Sahand Samieirad, Hussein Khalife, Mehrdad Noroozi, Elahe Tohidi, Maryam Alsadat Hashemipour
INTRODUCTION: Armored removable connector tubes are not always available in operating rooms for routine Altemir submental intubation (SMI) technique. The present study addresses a fiber-optic glidoscopy assisted 2-tubes modification of Green & Moore sequence for submandibular intubation. METHODS: The sample was composed of 11 patients (8 males and 3 females) with panfacial fractures where neither the oral and nasal intubation techniques nor tracheostomy were feasible...
August 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28838826/dental-injury-associated-with-anaesthesia-an-8-year-database-analysis-of-592-claims-from-a-major-french-insurance-company
#16
Antoine Giraudon, Guillaume de Saint Maurice, Matthieu Biais, Dan Benhamou, Karine Nouette-Gaulain
INTRODUCTION: Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. METHODS: A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed...
August 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#17
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28756495/percutaneous-dilatational-tracheostomy-using-the-etview-tracheoscopic-ventilation-tube-%C3%A2-a-teaching-course-in-a-pig-model
#18
Alfonso Fiorelli, Fausto Ferraro, Elisabetta Frongillo, Pierluigi Fusco, Matteo Pierdiluca, Francesca Nagar, Angela Iuorio, Mario Santini
OBJECTIVE: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model. METHODS: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model...
October 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28738936/favorable-outcomes-in-blunt-chest-injury-with-noninvasive-bi-level-positive-airway-pressure-ventilation
#19
Pascal Udekwu, Sahill Patel, Meagan Farrell, Rhonda Vincent
Recent clinical research in patients with blunt chest injury has focused on the benefits of surgical fixation of rib fractures. Noninvasive ventilation (NIV) has been demonstrated to prevent the need for intubation and ventilation in posttraumatic respiratory failure. The preemptive use of NIV in patients with rib fractures has not been extensively studied. Our study evaluated the outcomes of patients with ≥3 rib fractures and hospitalized for ≥ 4 days. Seventy-one patients treated with NIV were compared with 270 patients without NIV...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28713750/comminuted-laryngeal-fracture-following-blunt-trauma-a-need-for-strict-legislation-on-roads
#20
Shraddha Jain, Pragya Singh, Minal Gupta, Bhavna Kamble, Suresh S Phatak
Laryngeal fracture is a rare condition with potential life-long implications related to airway patency, voice quality, and swallowing. Rarity of the condition leads to lack of consensus on the most suitable way to manage this injury. The mode of injury can be prevented by strict legislation on the roads. We report a case of a 28-year-old Indian male who sustained a comminuted displaced fracture of the thyroid cartilage with disruption of anterior commissure due to blunt trauma caused by the metallic side rod of a ladder projecting from the rear of a vehicle in front of the bike on which he was riding...
January 2017: Annals of Maxillofacial Surgery
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