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Subglottic aspiration

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
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
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
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
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
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
Ünal Bakal, Erol Keleş, Mehmet Saraç, Turgut Karlidağ, İrfan Kaygusuz, Ahmet Kazez
AIM: To analyze diagnostic and therapeutic methods used in the diagnosis and treatment of foreign body aspiration (FBA) and to determine the impact of technical infrastructure on mortality and morbidity. METHODS: Hospital records of patients diagnosed with FBA between the years 1987 and 2015 were retrospectively evaluated. The patients were grouped according to the length of time until their admission to the hospital as follows: Group I (0-24 h); Group II (1-7 days); Group III (>7 days)...
June 2016: Journal of Craniofacial Surgery
Philip Gaudreau, M Taylor Fordham, Tiffany Dong, Xinyang Liu, Sukryool Kang, Diego Preciado, Brian K Reilly
IMPORTANCE: The use of 3-dimensional (3D) endoscopy has been described in the pediatric airway and has been shown to improve visualization of complex airway anatomy. Laryngomalacia is one of the most common airway disorders evaluated in pediatric otolaryngology offices. Whether 3D visualization is superior to standard endoscopy as a means for assessment and surgical management of complex airway anatomy is unclear. OBJECTIVE: To describe a pilot case series using 3D endoscopy to facilitate supraglottoplasty and to assess surgical outcomes...
March 2016: JAMA Otolaryngology—Head & Neck Surgery
Melody Bennett, Mary Sole, Lara Deaton, Aurea Middleton, Daleen Penoyer, Xin Yan, Janet Conrad, Devendra Mehta
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Steven Deem, David Yanez, Laura Sissons-Ross, Jo Ann Elrod Broeckel, Stephen Daniel, Miriam Treggiari
RATIONALE: Ventilator-associated pneumonia (VAP) is a prevalent and costly nosocomial infection related to instrumentation of the airway with an endotracheal tube (ETT), enabling microaspiration of contaminated secretions. Modification of the ETT design to reduce microaspiration and/or biofilm formation may play an important role in VAP prevention. However, there is insufficient evidence to provide strong recommendations regarding the use of modified ETT and unaddressed safety concerns...
January 2016: Annals of the American Thoracic Society
Donghwi Park, Yoongul Oh, Ju Seok Ryu
OBJECTIVE: To identify the parameters of high-resolution manometry (HRM) with a significant correlation to abnormal findings of videofluoroscopic swallowing study (VFSS). DESIGN: Prospective study. SETTING: Hospital rehabilitation department. PARTICIPANTS: Patients with dysphagia symptoms (N=40). INTERVENTION: Participants were evaluated once using VFSS in neutral head position and evaluated twice using HRM with 5mL of thin fluid...
March 2016: Archives of Physical Medicine and Rehabilitation
Robert J Yawn, Mohammad Fazili, Gwen Provo-Bell, Christopher T Wootten
INTRODUCTION: Bronchoalveolar lavage (BAL)-nucleated cell counts and the lipid-laden alveolar macrophage index (LLMI) have been investigated in predicting chronic aspiration as well as reflux esophagitis with variable results. To date, BAL neutrophil percentages and the LLMI have not been described in patients with eosinophilic esophagitis (EoE). OBJECTIVES: To evaluate BAL neutrophil percentages and LLMI levels in patients with EoE and compare these levels in patients with aerodigestive concerns without biopsy-proven EoE...
November 2015: International Journal of Pediatric Otorhinolaryngology
Shamshad Ali, Khalid Waheed, Zafar H Iqbal
BACKGROUND: Ventilator associated pneumonia (VAP) is an important and common complication of mechanically ventilated patients. It is the leading cause of morbidity and mortality in Intensive Care Units (ICU) worldwide. The aim of study was to determine the pattern of bacteria involved in VAP in intensive care unit of Jinnah hospital Lahore. METHODS: It was descriptive case series study, conducted over a period of one year on mechanically ventilated 50 patients. American Thoracic Society (ATS) guidelines recommend quantitative/semi-quantitative culture of endotracheal aspirates (ETA) or bronchoscopic aspirates/washing from the infected lung segments for the diagnosis of VAP...
January 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Seung Yeol Lee, Hee-Jung Cheon, Sang Jun Kim, Young Mog Shim, Jae Ill Zo, Ji Hye Hwang
PURPOSE: The purposes of this study are to assess the usefulness of bedside swallowing tests and identify the clinical risk factors for subglottic aspiration after esophagectomy in esophageal cancer patients. METHODS: The study included patients who underwent esophagectomy for esophageal cancer between January and August 2013. Videofluoroscopic swallowing study (VFSS) was carried out 7 to 10 days post-surgery, and clinical bedside swallowing tests were conducted to determine the risk factors for subglottic aspiration...
January 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Justin DiLibero, Mary Lavieri, Sharon O'Donoghue, Susan DeSanto-Madeya
BACKGROUND: Withholding enteral feedings during repositioning is based on tradition, but available evidence does not support this practice. Although research indicates that withholding of enteral feedings during repositioning contributes to undernourishment, the relationship between continuing enteral feedings during repositioning and the incidence of aspiration has not been determined. OBJECTIVE: To determine the feasibility of a study designed to explore differences in the incidence of aspiration when enteral feedings are withheld or continued during repositioning...
May 2015: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Jaewon Beom, Byung-Mo Oh, Kyoung Hyo Choi, Won Kim, Young Jin Song, Dae Sang You, Sang Jun Kim, Tai Ryoon Han
The purpose of this study is to determine whether neuromuscular electrical stimulation of the suprahyoid muscle is effective compared to that of the infrahyoid muscle in brain-injured patients with dysphagia. A total of 132 patients with stroke, traumatic brain injury, or brain tumor in 2 university hospitals were allocated to 2 groups: those who received electrical stimulation therapy (EST) on the suprahyoid muscles (SM group, n = 66) and those who received EST with one pair of electrodes on the suprahyoid muscle and the other pair on the infrahyoid muscle (SI group, n = 66)...
August 2015: Dysphagia
Giselle Cuestas, María Victoria Demarchi, María Pía Martínez Corvalán, Juan Razetti, Carlos Boccio
Hemoptysis is the expectoration of blood from the subglottic airway. The main causes in children are infections of the lower respiratory tract and aspiration of foreign bodies. Pulmonary arteriovenous malformation is a rare etiology of hemoptysis, which involves abnormal communication between the arterial and venous system. Most vascular malformations are present at birth and enlarge proportionately with the growth of the child. Signs and symptoms include dyspnea, exercise intolerance, cyanosis and hemorrhagic or neurologic complications...
January 2015: Archivos Argentinos de Pediatría
Burak Karabulut, Kadir Serkan Orhan, Murat Ulusan, Bora Başaran, Kemal Değer
OBJECTIVES: This study aims to investigate demographic features, type and localization of foreign bodies, mean hospitalization duration, and peri- and postoperative complication ratios of patients with foreign body aspiration. PATIENTS AND METHODS: Seventy patients (23 males, 47 females; mean age 32±14.5 months; range 3 months to 10 years) who were diagnosed with foreign body aspiration in our clinic between January 2007 and August 2010, and performed rigid bronchoscopy under general anesthesia were included in this study...
September 2014: Kulak Burun Boğaz Ihtisas Dergisi: KBB, Journal of Ear, Nose, and Throat
Gianluigi Li Bassi, Nestor Luque, Joan Daniel Martí, Eli Aguilera Xiol, Marta Di Pasquale, Valeria Giunta, Talitha Comaru, Montserrat Rigol, Silvia Terraneo, Francesca De Rosa, Mariano Rinaudo, Ernesto Crisafulli, Rogelio Cesar Peralta Lepe, Carles Agusti, Carmen Lucena, Miguel Ferrer, Laia Fernández, Antoni Torres
BACKGROUND: Improvements in the design of the endotracheal tube (ETT) have been achieved in recent years. We evaluated tracheal injury associated with ETTs with novel high-volume low-pressure (HVLP) cuffs and subglottic secretions aspiration (SSA) and the effects on mucociliary clearance (MCC). METHODS: Twenty-nine pigs were intubated with ETTs comprising cylindrical or tapered cuffs and made of polyvinylchloride (PVC) or polyurethane. In specific ETTs, SSA was performed every 2 h...
May 2015: Chest
Mauro F Andreu, Iris G Salvati, Mariana C Donnianni, Belén Ibañez, Mariana Cotignola, Marco Bezzi
BACKGROUND: During invasive mechanical ventilation, secretions accumulate in the subglottic space; consequently, there is a risk of aspiration of these secretions into the airway during cuff deflation and extubation. To minimize this risk, 2 extubation methods are used. The first consists of introducing a suction catheter into the endotracheal tube (ETT) and the trachea. After initiating suctioning, the cuff is deflated and the ETT is removed together with the suction catheter. The second technique involves applying positive pressure to the ETT using a resuscitation bag...
December 2014: Respiratory Care
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