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Subglottic aspiration

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https://www.readbyqxmd.com/read/29732908/airway-anomalies-in-patients-with-22q11-2-deletion-syndrome-a-5-year-review
#1
Joel W Jones, Meghan Tracy, Mollie Perryman, Jill M Arganbright
OBJECTIVES: To characterize the frequency of airway anomalies in patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Retrospective review of patients with 22q11DS who had undergone microlaryngoscopy/bronchoscopy (MLB) for aerodigestive symptoms at a tertiary care children's hospital from 2011 to 2016. RESULTS: Thirty patients underwent an MLB due to the following indications: aspiration (11), stridor (10), chronic respiratory failure due to ventilator dependence (8), and difficult intubation (1)...
May 1, 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29675058/foreign-body-removal-by-flexible-bronchoscopy-using-retrieval-basket-in-children
#2
Kyunghoon Kim, Hye Jin Lee, Eun Ae Yang, Hwan Soo Kim, Yoon Hong Chun, Jong-Seo Yoon, Hyun Hee Kim, Jin Tack Kim
OBJECTIVES: Aspiration of foreign bodies into the tracheobronchial tree is a common accident in children. This study aimed to evaluate the safety and outcome of foreign body removal by flexible bronchoscopy using a retrieval basket in children. METHODS: This was a retrospective study of children treated for foreign bodies in the airway via flexible bronchoscopy using a retrieval basket at a tertiary hospital in Korea between February 2014 and October 2017. The medical records of the patients were retrospectively reviewed and analyzed...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29662613/efficacy-of-continuous-versus-intermittent-subglottic-secretion-drainage-in-preventing-ventilator-associated-pneumonia-in-patients-requiring-mechanical-ventilation-a-single-center-randomized-controlled-trial
#3
Hiroko Fujimoto, Osamu Yamaguchi, Hajime Hayami, Mika Shimosaka, Sayaka Tsuboi, Mitsunori Sato, Shigeo Takebayashi, Satoshi Morita, Mari Saito, Takahisa Goto, Kiyoyasu Kurahashi
Objective: Aspiration of subglottic secretion is a widely used intervention to prevent ventilator-associated pneumonia (VAP). This study aimed to compare the efficacy of continuous and intermittent subglottic secretion drainage (SSD) in preventing VAP. Methods: A single-center randomized controlled trial was conducted on adult postoperative patients who were expected to undergo mechanical ventilation for more than 48 hours. Primary outcome measure was incidence of VAP and secondary outcome measures were length of mechanical ventilation and intensive-care unit (ICU) stay...
March 23, 2018: Oncotarget
https://www.readbyqxmd.com/read/29425465/excess-mucin-impairs-subglottic-epithelial-host-defense-in-mechanically-ventilated-patients
#4
Jason Powell, James Garnett, Michael W Mather, Faye A H Cooles, Andrew Nelson, Bernard Verdon, Jon Scott, Kasim Jiwa, Marie-Hélène Ruchaud-Sparagano, Stephen P Cummings, John D Perry, Stephen E Wright, Janet A Wilson, Jeffrey Pearson, Chris Ward, A John Simpson
RATIONALE: Aspiration of infective subglottic secretions causes ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Mechanisms underlying subglottic colonization in critical illness have not been defined, limiting strategies for targeted prevention of VAP. OBJECTIVES: To characterize subglottic host defense dysfunction in mechanically ventilated patients in the intensive care unit (ICU). To determine whether subglottic mucin contributes to neutrophil phagocytic impairment and bacterial growth...
February 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29422724/effect-of-continuous-versus-intermittent-subglottic-suctioning-on-tracheal-mucosa-by-the-mallinckrodt-taperguard-evac-oral-tracheal-tube-in-intensive-care-unit-ventilated-patients-a-prospective-randomized-study
#5
Philippe Seguin, Harmonie Perrichet, Estelle Le Pabic, Yoann Launey, Marie Tiercin, Romain Corre, Graziella Brinchault, Bruno Laviolle
Background and Aims: A risk of tracheal mucosa injury induced by subglottic suctioning has been raised. Therefore, this prospective randomized study aims to compare the effect of continuous suctioning of subglottic secretions versus intermittent suctioning of subglottic secretions (CSSS vs. ISSS) secretions on tracheal mucosa in front of the suctioning port of the endotracheal tube. Patients and Methods: Patients requiring intubation or reintubation in Intensive Care Unit with an expected ventilation duration > 24 h were eligible...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29340765/orotracheal-tube-as-a-risk-factor-for-lower-respiratory-tract-infection-preliminary-data-from-a-randomised-trial
#6
Igor Muzlovic, Janja Perme, David Stubljar
PURPOSE: The aim of the study was to investigate whether polyurethane (PU) endotracheal tubes, continuous measurements of cuff pressure and aspiration of the subglottic space as a bundle of parameters could reduce patients' risk for developing ventilator associated pneumonia (VAP). METHODS: Two groups of patients that differed only in terms of endotracheal tubes and intubation intervention were compared. Group A was ventilated using PU tubes a with conical cuff; they also had continuous cuff pressure measurement and continuous subglottic aspiration...
January 16, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29230286/asthma-mimic-case-report-and-literature-review-of-vocal-cord-nodule-associated-with-wheezing
#7
Muhammad Kashif, Tushi Singh, Ahsan Aslam, Misbahuddin Khaja
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29114887/cough-strength-and-expiratory-force-in-aspirating-and-nonaspirating-postradiation-head-and-neck-cancer-survivors
#8
Katherine A Hutcheson, Martha P Barrow, Carla L Warneke, Yiqun Wang, George Eapen, Stephen Y Lai, Denise A Barringer, Emily K Plowman, Jan S Lewin
OBJECTIVE: Expiratory functions that clear aspiration from the airway are compromised in patients with neurogenic dysphagia for whom cough and expiratory force may be impaired by the primary disease process. The relationship between expiratory function, cough, and aspiration is less clear in head and neck cancer (HNC) survivors for whom the disease process does not directly impact the lower respiratory system. Our objective was to compare mechanisms of airway clearance (expiratory force and cough) with aspiration status in postradiated HNC survivors...
November 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29098448/incidence-of-airway-complications-in-patients-using-endotracheal-tubes-with-continuous-aspiration-of-subglottic-secretions
#9
Jordi Vallés, Susana Millán, Emili Díaz, Eva Castanyer, Xavier Gallardo, Ignacio Martín-Loeches, Marta Andreu, Mario Prenafeta, Paula Saludes, Jorge Lema, Montse Batlle, Néstor Bacelar, Antoni Artigas
BACKGROUND: Continuous aspiration of subglottic secretions is effective in preventing ventilator-associated pneumonia, but it involves a risk of mucosal damage. The main objective of our study was to determine the incidence of airway complications related to continuous aspiration of subglottic secretions. METHODS: In consecutive adult patients with continuous aspiration of subglottic secretions, we prospectively recorded clinical airway complications during the period after extubation...
November 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28758081/development-of-a-dysphagia-screening-test-for-preterm-infants-dst-pi
#10
Kyoung Moo Lee, Young Tak Seo
OBJECTIVE: To explore both the early prediction and diagnosis of dysphagia in preterm infants as an important developmental aspect as well as the prevention of respiratory complications, we developed the simple and-easy-to-apply Dysphagia Screening Test for Preterm Infants (DST-PI) to predict supraglottic penetration and subglottic aspiration. METHODS: Fifty-two infants were enrolled in a videofluoroscopic swallowing study (VFSS) due to clinical suspicions of dysphagia...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28688566/dysphagia-in-healthy-children-characteristics-and-management-of-a-consecutive-cohort-at-a-tertiary-centre
#11
Orysya Svystun, Wendy Johannsen, Rabin Persad, Justine M Turner, Carina Majaesic, Hamdy El-Hakim
OBJECTIVE: Whereas the literature is replete with reports on complex children with dysphagia (DP), the parameters characterizing non-neurologically impaired (NNI) children have been underreported, leaving a substantial knowledge gap. We set to characterize a consecutive cohort of NNI children, their management, and outcomes. METHODS: We undertook a retrospective case series. Children (<18 years old) attending a tertiary multidisciplinary swallowing clinic were eligible...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28609773/transoral-robotic-surgery-total-laryngectomy-evaluation-of-functional-and-survival-outcomes-in-a-retrospective-case-series-at-a-single-institution
#12
Giri Krishnan, Suren Krishnan
BACKGROUND: Transoral robotic surgery total laryngectomy (TORS-TL) is a minimally invasive endoscopic surgical approach which can theoretically minimise the morbidity of large external incisions and limit dissection of tissue planes so as to reduce the risk of pharyngocutaneous fistulae related to poor tissue healing secondary to radiation soft tissue injury or malnutrition. The purpose of this paper was to report our experience with this uncommon surgical approach. METHODS: A retrospective chart review was conducted at a single institution to evaluate the functional and survival outcomes of a series of patients who underwent TORS-TL...
June 14, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28502210/-esophageal-complications-of-gastroesophageal-reflux-disease-consequences-or-defensive-reactions
#13
REVIEW
Örs Péter Horváth, Laura Bognár, András Papp, András Vereczkei
Gastroesophageal reflux disease affects more than 10% of the adult population. Most patients can be effectively treated with lifestyle changes and adequate acid-reducing therapy. However, about 10% of the patients remain symptomatic despite treatment and severe complications may develop. Interestingly, some of these complications seem to be a sort of defensive mechanism that may either alleviate the patient's symptoms or prevent developing further complications. In Barrett's esophagus, which can be unambigously considered as a complication of gastroesophageal reflux disease, reflux symptoms ruining the quality of life may significantly improve, since the metaplastic Barrett epithelium is much more resistent to gastric acid, than the normal epithelial lining of the esophagus...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28493877/co2-driven-endotracheal-tube-cuff-control-in-critically-ill-patients-a-randomized-controlled-study
#14
RANDOMIZED CONTROLLED TRIAL
Gennaro De Pascale, Mariano Alberto Pennisi, Maria Sole Vallecoccia, Giuseppe Bello, Riccardo Maviglia, Luca Montini, Valentina Di Gravio, Salvatore Lucio Cutuli, Giorgio Conti, Massimo Antonelli
BACKGROUND: To determine the safety and clinical efficacy of an innovative integrated airway system (AnapnoGuard™ 100 system) that continuously monitors and controls the cuff pressure (Pcuff), while facilitating the aspiration of subglottic secretions (SS). METHODS: This was a prospective, single centre, open-label, randomized, controlled feasibility and safety trial. The primary endpoint of the study was the rate of device related adverse events (AE) and serious AE (SAE) as a result of using AnapnoGuard (AG) 100 during mechanical ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/28377403/evaluation-of-the-safety-and-effectiveness-of-the-rapid-flow-expulsion-maneuver-to-clear-subglottic-secretions-in-vitro-and-in-vivo
#15
Jie Li, Yajuan Zong, Quan Zhou, Huaping Dai, Chen Wang
BACKGROUND: Clearing subglottic secretions has been proved to reduce ventilator-associated pneumonia. A manual method named the rapid flow expulsion maneuver was developed to clear subglottic secretions. This study evaluates its safety and effectiveness and analyzes the influential factors. METHODS: This study was composed of 2 parts. In an in vitro study, secretions were instilled directly to the area above the cuff in an intubated tracheal model. Secretions were expelled by the rapid flow expulsion maneuver with different volumes and peak flows in 3 tracheal positions (0, 15, and 30°)...
April 4, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28257624/endotracheal-tubes-and-fluid-aspiration-an-in-vitro-evaluation-of-new-cuff-technologies
#16
Maryanne Z Mariyaselvam, Lucy L Marsh, Sarah Bamford, Ann Smith, Matt P Wise, David W Williams
BACKGROUND: Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. METHODS: ETTs were positioned vertically in 2 cm diameter cylinders. Four ml of a standard microbial suspension was added above inflated cuffs...
March 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28217065/unsuspected-subglottic-web-in-a-child-managed-for-severe-respiratory-obstruction
#17
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28118221/prevention-of-ventilator-associated-pneumonia
#18
REVIEW
Gianluigi Li Bassi, Tarek Senussi, Eli Aguilera Xiol
PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) is an iatrogenic disease. Here we appraise recent advancements in the development and testing of strategies to prevent VAP. We also provide recommendations on the most promising interventions that should be applied. RECENT FINDINGS: In the last year, preventive bundles have consistently let to a reduction of VAP. A few trials on endotracheal tubes (ETTs) with novel cuffs failed to translate positive bench findings into clinical settings...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27651976/efficacy-of-hi-lo-evac-endotracheal-tube-in-prevention-of-ventilator-associated-pneumonia-in-mechanically-ventilated-poisoned-patients
#19
Ahmad Ghoochani Khorasani, Shahin Shadnia, Mohammad Mashayekhian, Mitra Rahimi, Abbas Aghabiklooei
Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU. Materials and Methods...
2016: Scientifica
https://www.readbyqxmd.com/read/27589983/the-use-of-a-sternothyroid-muscle-flap-to-prevent-the-re-recurrence-of-a-recurrent-tracheoesophageal-fistula-found-10%C3%A2-years-after-the-primary-repair
#20
Hajime Takayasu, Kouji Masumoto, Miki Ishikawa, Takato Sasaki, Kentaro Ono
Recurrent tracheoesophageal fistula (TEF) is still difficult to diagnose and repair. In almost all cases, recurrence appears relatively soon after the primary surgery. We herein describe a case of recurrent TEF that appeared 10 years after the primary repair. At 2 years of age, the patient suffered from mental retardation due to encephalitis and developed a hiatus hernia with gastro-esophageal reflux. He underwent the repair of a hiatus hernia and fundoplication at 3 years of age. However, the hiatus hernia recurred 6 months after the operation...
December 2016: Surgical Case Reports
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