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Subglottic aspiration

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https://www.readbyqxmd.com/read/28758081/development-of-a-dysphagia-screening-test-for-preterm-infants-dst-pi
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27152574/a-study-of-foreign-body-aspiration-in-children
#12
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
https://www.readbyqxmd.com/read/26823020/visualization-of-the-supraglottis-in-laryngomalacia-with-3-dimensional-pediatric-endoscopy
#13
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
https://www.readbyqxmd.com/read/26570331/670-impact-of-subglottic-suction-endotracheal-tubes-on-aspiration-and-ventilator-associated-conditions
#14
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
https://www.readbyqxmd.com/read/26523433/randomized-pilot-trial-of-two-modified-endotracheal-tubes-to-prevent-ventilator-associated-pneumonia
#15
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26505655/findings-of-abnormal-videofluoroscopic-swallowing-study-identified-by-high-resolution-manometry-parameters
#16
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
https://www.readbyqxmd.com/read/26362482/the-utility-of-bronchoalveolar-lavage-findings-in-the-diagnosis-of-eosinophilic-esophagitis-in-children
#17
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
https://www.readbyqxmd.com/read/26182754/microbiological-pattern-of-ventilator-associated-pneumonia
#18
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
https://www.readbyqxmd.com/read/26026978/clinical-predictors-of-aspiration-after-esophagectomy-in-esophageal-cancer-patients
#19
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
https://www.readbyqxmd.com/read/25934723/withholding-or-continuing-enteral-feedings-during-repositioning-and-the-incidence-of-aspiration
#20
MULTICENTER STUDY
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
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