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Fiberoptic intubation

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https://www.readbyqxmd.com/read/29802903/difficult-intubation-and-extubation-in-adult-anaesthesia
#1
O Langeron, J-L Bourgain, D Francon, J Amour, C Baillard, G Bouroche, M Chollet Rivier, F Lenfant, B Plaud, P Schoettker, D Fletcher, L Velly, K Nouette-Gaulain
OBJECTIVE: To provide an update to French guidelines about « Difficult intubation and extubation in adult anaesthesia 2006 » DESIGN: A consensus committee of 13 experts was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independent of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence...
May 23, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29756059/pre-selection-of-primary-intubation-technique-is-associated-with-a-low-incidence-of-difficult-intubation-in-patients-with-a-bmi-of-35-kg-m-2-or-higher
#2
Tiberiu Ezri, Ronen Waintrob, Yuri Avelansky, Alexander Izakson, Katia Dayan, Mordechai Shimonov
Background: The incidence of difficult intubation (DI) in obese patients may reach a two-digit figure. No studies have assessed the effect of primary use of special intubation devices on lowering the incidence of DI. We assessed the effect of primary selection of special intubation techniques on the incidence of DI in patients with a BMI of 35 kg/m2 or higher. Patients and methods: Data from 546 patients with a BMI of 35 kg/m2 or higher who underwent bariatric surgery at Wolfson Medical Center from 2010 through 2014 was retrospectively extracted and analyzed for demographics, predictors of DI and intubation techniques employed...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29744389/orotracheal-intubation-in-a-patient-with-difficult-airway-by-using-fiberoptic-nasotracheal-intubation-a-case-report
#3
Hye Joo Yun, Eunsun So, Myong-Hwan Karm, Hyun Jeong Kim, Kwang-Suk Seo
In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube...
April 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29701889/emergency-department-adult-fiberoptic-intubations-incidence-indications-and-implications-for-training
#4
Emily M Hayden, Daniel J Pallin, Susan R Wilcox, James A Gordon, Jestin N Carlson, Ron M Walls, Calvin A Brown
BACKGROUND: To describe the frequency, indications and outcomes of flexible fiberoptic intubations (FFI) performed in the emergency department (ED). METHODS: From the National Emergency Airway Registry (NEAR), we identified all encounters during 7/1/02 through 12/31/12 with the use of FFI. We determined patient, provider and intubation characteristics, success and failure rates, and modes of intubation rescue. RESULTS: Among 17,910 intubations of patients >15 years old at 13 EDs, FFI was used in 204 cases (1...
April 27, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29688927/securing-the-airway-in-pretracheal-dermal-metastases-from-oropharyngeal-carcinoma-a-case-report
#5
Angela T Truong, Dam-Thuy Truong, Ann M Gillenwater, Jose M Soliz, Thomas F Rahlfs
Dermal metastases reflect the ominous and aggressive spread of oropharyngeal squamous cell carcinomas. The rampant proliferation of these metastatic tumors to the neck results in respiratory distress and impending airway obstruction. We report a case of a patient with massive neck dermal metastases requiring urgent airway control for intermittent stridor. Awake tracheostomy is generally regarded as the gold standard to manage the compromised airway. However, in this unusual case, after discussion between surgeon and anesthesiologist, because of the anticipated formidable difficulties in performing awake tracheostomy, it was decided that awake fiberoptic intubation would provide the best chance of success...
April 23, 2018: A&A practice
https://www.readbyqxmd.com/read/29688857/less-invasive-treatment-of-sleep-disordered-breathing-in-children-with-syndromic-craniosynostosis
#6
Silvia Müller-Hagedorn, Cornelia Wiechers, Jörg Arand, Wolfgang Buchenau, Margit Bacher, Michael Krimmel, Siegmar Reinert, Christian F Poets
BACKGROUND: Infants and children with syndromic craniosynostosis (SCS), such as Apert-, Crouzon- or Pfeiffer syndrome, are prone to sleep disordered breathing (SDB) including obstructive sleep apnea and upper airway resistance syndrome (OSAS, UARS), potentially leading to tracheostomy. We modified the Tübingen Palatal Plate (TPP), an oral appliance with a velar extension effectively treating airway obstruction in Robin sequence, by attaching a tube to its velar extension to bridge the narrow pharyngeal airway in SCS patients...
April 23, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29684995/successful-airway-management-with-combined-use-of-mcgrath-%C3%A2-mac-video-laryngoscope-and-fiberoptic-bronchoscope-in-a-severe-obese-patient-with-huge-goiter-a-case-report
#7
Mee Young Chung, Byunghoon Park, Jaeho Seo, Chang Jae Kim
Huge goitor can lead to tracheal compression and hence difficulty in intubation. This is compounded by severe obesity. Failed tracheal intubation in difficult intubation is a serious event that may lead to increased patient morbidity and mortality. Current intubation rescue techniques and combination of different rescue techniques may increase the success rate of difficult intubation. In a 47-year-old female patient, with severe obesity and a huge goiter, our attempts at intubation using direct laryngoscope, video laryngoscope, and awake fiberoptic bronchoscope had failed...
June 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29683824/a-randomized-trial-comparing-the-effect-of-fiberoptic-selection-and-guidance-versus-random-selection-blind-insertion-and-direct-laryngoscopy-on-the-incidence-and-severity-of-epistaxis-after-nasotracheal-intubation
#8
Jeffrey Leighton Tong, Avery Tung
BACKGROUND: Epistaxis, or nasal bleeding, is a common complication after nasotracheal intubation (NTI). Because such bleeding is likely related to trauma during intubation, use of fiberoptic visualization and guidance rather than direct laryngoscopy may affect the incidence and severity of epistaxis. We compared the incidence of epistaxis after NTI using a fiberoptic versus a direct laryngoscopy approach. METHODS: Seventy patients who were able to breathe easily through unobstructed nostrils and required NTI as part of their anesthetic management were recruited...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#9
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29657064/-selective-left-mainstem-bronchial-intubation-in-the-neonatal-intensive-care-unit
#10
Anthony M H Ho, Michael P Flavin, Melinda L Fleming, Glenio Bitencourt Mizubuti
BACKGROUND: Selective neonatal left mainstem bronchial intubation to treat right lung disease is typically achieved with elaborate maneuvers, instrumentation and devices. This is often attributed to bronchial geometry which favors right mainstem entry of an endotracheal tube deliberately advanced beyond the carina. CASE SUMMARY: A neonate with severe bullous emphysema affecting the right lung required urgent non-ventilation of that lung. We achieved left mainstem bronchial intubation by turning the endotracheal tube 180° such that the Murphy's eye faced the left instead of the right, and simulated a left-handed intubation by slightly orientating the endotracheal tube such that its concavity faced the left instead of the right as in a conventional right-handed intubation...
May 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29649032/airway-management-practice-in-adults-with-an-unstable-cervical-spine-the-harborview-medical-center-experience
#11
Michael G Holmes, Armagan Dagal, Bryan A Feinstein, Aaron M Joffe
BACKGROUND: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Our aim was to describe the frequency of airway management techniques used in patients with CSI at our level I trauma center and report the incidence of neurological injury attributable to airway management...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29628599/temporomandibular-joint-ankylosis-a-pediatric-difficult-airway-management
#12
Anoop Sharma, Deepak Dwivedi, Ram Murti Sharma
Intubating a pediatric patient with temporomandibular joint ankylosis is a daunting task, and it becomes more challenging with limited mouth opening. Fiberoptic nasotracheal intubation technique is considered a gold standard. We describe an improvised technique of securing airway in the absence of appropriate-sized fiberoptic scope. The endotracheal tube inserted in the left nostril for maintaining depth of anesthesia was advanced under vision by the fiberoptic scope inserted into the right nostril, and with external laryngeal manipulation, the airway was secured with no complications...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628546/hemodynamic-responses-and-safety-of-sedation-following-premedication-with-dexmedetomidine-and-fentanyl-during-fiberoptic-assisted-intubation-in-patients-with-predicted-difficult-airway
#13
Sunil Rajan, Rittick Talukdar, Pulak Tosh, Jerry Paul, Bindu K Vasu, Lakshmi Kumar
Background: Awake fiberoptic intubation (AFOI) is the gold standard for the management of predicted difficult airway, and inappropriate sedation is a major cause leading to its failure. Aims: The primary objective was to compare the heart rate (HR) changes that accompany AFOI following sedation with dexmedetomidine and fentanyl. Secondary objectives included comparison of changes in blood pressure, patient comfort, ease of intubation, and degree of sedation. Settings and Designs: This prospective double-blinded randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29621098/comparison-of-the-efficacy-and-efficiency-of-the-use-of-virtual-reality-simulation-with-high-fidelity-mannequins-for-simulation-based-training-of-fiberoptic-bronchoscope-manipulation
#14
Bailin Jiang, Hui Ju, Ying Zhao, Lan Yao, Yi Feng
INTRODUCTION: This study compared the efficacy and efficiency of virtual reality simulation (VRS) with high-fidelity mannequin in the simulation-based training of fiberoptic bronchoscope manipulation in novices. METHODS: Forty-six anesthesia residents with no experience in fiberoptic intubation were divided into two groups: VRS (group VRS) and mannequin (group M). After a standard didactic teaching session, group VRS trained 25 times on VRS, whereas group M performed the same process on a mannequin...
April 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29619784/comparison-between-lignocaine-nebulization-and-airway-nerve-block-for-awake-fiberoptic-bronchoscopy-guided-nasotracheal-intubation-a-single-blind-randomized-prospective-study
#15
Pooja Rawat Mathur, Neena Jain, Aji Kumar, Beena Thada, Veena Mathur, Deepak Garg
BACKGROUND: The preferred management strategy for difficult airways is awake fiberoptic bronchoscopy-guided intubation, which requires effective airway anesthesia to ensure patient comfort and acceptance. This randomized single-blind prospective study was conducted to compare lignocaine nebulization and airway nerve block for airway anesthesia prior to awake fiberoptic bronchoscopy-guided intubation. METHODS: Sixty adult patients scheduled for surgical procedures under general anesthesia were randomly allocated to two groups...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29556460/retrograde-intubation-through-nasal-route-in-patients-with-limited-mouth-opening-undergoing-oral-and-maxillofacial-surgery
#16
Ashwant Kumar Vadepally, Ramen Sinha, A V S S Subramanya Kumar
Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening...
January 2018: Journal of Oral Biology and Craniofacial Research
https://www.readbyqxmd.com/read/29509524/facial-artery-pseudoaneurysm-challenges-of-airway-management
#17
Roman Dudaryk, Danielle B Horn, J Marshall Green
A patient with recent jaw reconstruction presented for treatment of postoperative oropharyngeal hemorrhage. Asleep nasal fiberoptic intubation was attempted, but a rare and unanticipated complication ensued: rupture of right facial artery pseudoaneurysm. The difficult airway algorithm was followed up to the point of surgical airway. While nasal or oral fiberoptic intubation is often perceived as the safest approach for management of a difficult airway, we discuss alternative treatment strategies for patients with a facial pseudoaneurysm...
2018: Anesthesia Progress
https://www.readbyqxmd.com/read/29465052/nasotracheal-intubation-in-children-for-outpatient-dental-surgery-is-fiberoptic-bronchoscopy-useful
#18
A S Ozkan, S Akbas
Background: The aim of our study was to compare the hemodynamic responses and adverse events associated with nasotracheal intubation (NTI) using a fiberoptic bronchoscope (FOB) and a direct laryngoscope (DLS) in children undergoing general anesthesia for outpatient dental surgery. Methods: Eighty children (aged 5-15 years) were scheduled to undergo outpatient dental surgery under general anesthesia and of these children those who required NTI were included. Results: NTI was significantly longer in the FOB group (P = 0...
February 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29416263/fiberoptic-guided-intubation-after-awake-insertion-of-the-i-gel%C3%A2-supraglottic-device-in-a-patient-with-predicted-difficult-airway
#19
Julian Arevalo Ludena, Jose Juan Arcas Bellas, Rafael Alvarez-Rementeria, Luis Enrique Munoz
No abstract text is available yet for this article.
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29349508/impact-of-intervention-time-on-hospital-survival-in-patients-requiring-emergent-airway-management-a-preliminary-study
#20
Kuo-Chuan Hung, Hsiu-Jung Lin, Shao-Wei Hsieh, Cheuk-Kwan Sun
BACKGROUND: The time in the day of intervention for physiological deterioration reportedly impacts patient outcomes. This study aimed at determining the impact of the time of ETI on hospital survival in critically ill patients. METHODS: Between January 2014 and December 2016, 151 patients who underwent emergency tracheal intubation (ETI) by the airway response team (ART) in the general wards of a tertiary referral center were retrospectively reviewed. Patients were divided into two groups based on the time of ETI (daytime group, 8:00 a...
April 2018: Journal of Anesthesia
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