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https://www.readbyqxmd.com/read/29145308/comparison-of-the-pentax-airwayscope-and-mcgrath-mac-videolaryngoscope-for-endotracheal-intubation-in-patients-with-a-normal-airway
#1
Jiyoung Lee, Hyun Jeong Kwak, Ji Yeon Lee, Min Young Chang, Sook Young Lee, Jong Yeop Kim
Various videolaryngoscopes (VLs) have been developed to provide a better laryngeal view and facilitate difficult intubations. The goal of this study was to compare 2 VLs, the Pentax AWS and the McGrath VL, with respect to intubation time and ease of intubation.One hundred forty patients aged 19 to 65 years (American Society of Anesthesiologists classification I or II), who required tracheal intubation for elective surgery, were randomly assigned to 1 of the 2 groups: the Pentax AWS (n = 70) or the McGrath VL (n = 70)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143551/independent-validation-of-the-icu-requirement-score-in-a-cohort-of-acutely-poisoned-adults
#2
Regina Böll, Katrin Romanek, Sabrina Schmoll, Raphael Stich, Armin Ott, Jochen Stenzel, Stefanie Geith, Florian Eyer, Christian Rabe
OBJECTIVE: To independently validate the predictive value of the intensive care requirement score (IRS) in unselected poisoned patients. DESIGN: Retrospective chart review. PATIENTS AND METHODS: Five hundred and seventeen out of 585 admissions for acute intoxications could be analyzed. Eleven were excluded for a condition already requiring intensive care unit (ICU) support at admission (e.g., preclinical intubation). A further 57 admissions were excluded due to missing data...
November 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29142836/preoperative-intraoperative-and-postoperative-anesthetic-prospective-for-thyroid-surgery-what-s-new
#3
REVIEW
I-Cheng Lu, I-Hua Lin, Che-Wei Wu, Hsiu-Ya Chen, Yi-Chu Lin, Feng-Yu Chiang, Pi-Ying Chang
The aim of this review is to analyze what's new on anesthetic prospective to perioperative management for thyroid surgery. For recent decades intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. For example, the precise position of EMG tube and optimal use of neuromuscular blocking agents (NMBAs) play key roles in successful IONM system. Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142835/trachway-video-intubating-stylet-allows-for-optimization-of-electromyographic-endotracheal-tube-placement-for-monitored-thyroidectomy
#4
Pi-Ying Chang, Pin-Yang Hu, Yi-Chu Lin, Hsiu-Ya Chen, Feng-Yu Chiang, Che-Wei Wu, Gianlorenzo Dionigi, I-Cheng Lu
Background: Endotracheal tube-based surface electrodes are now commonly applied to measure evoked electromyographic (EMG) response of the vocal cord during monitored thyroidectomy. The aim of the study was to determine the incidence of difficult intubation and to assess the effectiveness of using video-assisted intubating stylet (Trachway) for EMG tube placement in patients undergoing monitored thyroidectomy. Methods: Medical records were collected from consecutive patients undergoing thyroid surgery before and after implementation of the protocol...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142801/idiopathic-acquired-dacryocystocele-presenting-only-with-epiphora-a-very-rare-case-report
#5
Muhammad Jahanzaib Anwar, Saad A Choudhry, Muhammad Aadil, Ahmer Asif, Atif Ameer
A 42-years-old male presented with left medial canthal swelling, accompanied with only mild epiphora. There was no history of dacryocystitis, mid-facial trauma, surgery, or bloody tears. On examination, there was an immobile, subcutaneous, non-inflammatory mass below the medial canthal tendon. Lacrimal irrigation showed blockade at the nasolacrimal duct. A computerized axial tomography (CAT) scan revealed a non-enhancing, low-density, cystic lesion at the inferomedial margin of the orbit. There were no signs of bony erosion, consistent with idiopathic acquired dacryocystocele...
September 4, 2017: Curēus
https://www.readbyqxmd.com/read/29142783/birth-order-and-maternal-age-for-reported-cases-of-severe-prenatal-cortical-hyperostosis-caffey-silverman-disease
#6
Rolf R Engel, Raul F Cifuentes
The spectrum of prenatal cortical hyperostosis includes a mild phenotype that typically presents after 35 weeks of gestation, and a severe form that presents earlier. The skeletal and systemic manifestations of the severe phenotype remain unexplained. A review of reported cases indicates that older mothers and firstborn infants are overrepresented. This combination suggests decreased fertility. Fourteen years after the birth of the present case, his mother presented with renal failure from multiple myeloma raising the possibility that a maternal antibody may play a role in the etiology of severe prenatal Caffey disease...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29142385/blowing-bubbles-helps-intubation
#7
David Howe
Rocuronium is commonly used in preference to suxamethonium for rapid sequence induction in the Intensive Care Unit (ICU). We describe a patient who suffered significant neck trauma following a suicide attempt. On initial presentation to accident and emergency, he was an easy intubation with a Grade 1 view obtained at laryngoscopy. After surgery to repair his neck laceration, he was extubated and discharged from ICU. He later developed a severe aspiration pneumonia and required reintubation. After induction and paralysis with suxamethonium, the best view at laryngoscopy was a Grade 3 despite the use of different laryngoscopes...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142384/hypercapnic-respiratory-failure-in-case-of-chiari-1-5-malformation-case-report-and-review-of-the-literature
#8
Viralkumar M Vasani, Subhas Kanti Konar, S Satish
Type 2 respiratory failure is defined as hypercapnia associated with hypoxia. Chiari 1.5 is known as herniation of the cerebellar tonsils along with brain stem and fourth ventricle. We report a 35-year-old male who presented with acute hypercapnic respiratory failure (Type 2), without any preexisting neurological or respiratory abnormality. Analysis of blood gases in emergency revealed a pH of 7.12, pCO2 of 132 mmHg, and arterial oxygen tension of 118 mm Hg. He was intubated and ventilated. Magnetic resonance imaging brain revealed herniation of the cerebellar tonsils along with brain stem and fourth ventricle...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29141315/-clinical-efficacy-of-one-lung-ventilation-in-treatment-of-children-postoperatively-intractable-atelectasis
#9
J M Huo, K Bai, Y Q Fu, C J Liu, F Xu
Objective: To investigate the effect of fiberoptic bronchoscope-guided one-lung ventilation (OLV) on treatment of intractable atelectasis in children. Method: This retrospective cohort study was conducted in Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University from December 2014 to May 2017. Six patients with intractable atelectasis of left lung were included. Three cases were male and three female with the age from 1.5 to 11.0 years. The endotracheal tube was intubated to the left main bronchus for OLV by the guidance of fiberoptic bronchoscopy...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29140970/clinical-impact-of-external-laryngeal-manipulation-during-laryngoscopy-on-tracheal-intubation-success-in-critically-ill-children
#10
Taiki Kojima, Elizabeth K Laverriere, Erin B Owen, Ilana Harwayne-Gidansky, Asha N Shenoi, Natalie Napolitano, Kyle J Rehder, Michelle A Adu-Darko, Sholeen T Nett, Debbie Spear, Keith Meyer, John S Giuliano, Keiko M Tarquinio, Ronald C Sanders, Jan Hau Lee, Dennis W Simon, Paula A Vanderford, Anthony Y Lee, Calvin A Brown, Peter W Skippen, Ryan K Breuer, Iris Toedt-Pingel, Simon J Parsons, Eleanor A Gradidge, Lily B Glater, Kathleen Culver, Simon Li, Lee A Polikoff, Joy D Howell, Gabrielle Nuthall, Gokul K Bysani, Ana L Graciano, Guillaume Emeriaud, Osamu Saito, Alberto Orioles, Karen Walson, Philipp Jung, Awni M Al-Subu, Takanari Ikeyama, Rakshay Shetty, Kathleen M Yoder, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: External laryngeal manipulation is a commonly used maneuver to improve visualization of the glottis during tracheal intubation in children. However, the effectiveness to improve tracheal intubation attempt success rate in the nonanesthesia setting is not clear. The study objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in PICUs. DESIGN: A retrospective observational study using a multicenter emergency airway quality improvement registry...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#11
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#12
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137052/arytenoid-cartilage-dislocation-mimicking-bilateral-vocal-cord-paralysis-a-case-report
#13
Eun H Chun, Hee J Baik, Rack K Chung, Hun J Lee, Kwangseob Shin, Jae H Woo
RATIONALE: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat. PATIENT CONCERNS: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrodt oral tracheal tube of 7.5 mm internal diameter, was used to successfully intubate his trachea. The duration of surgery was 25 minutes. In the recovery room, he complained of sore throat and dyspnea with inspiratory stridor, which were not resolved after intravenous injection of 10 mg of dexamethasone...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137035/enteral-nutrition-tube-placement-assisted-by-ultrasonography-in-patients-with-severe-acute-pancreatitis-a-novel-method-for-quality-improvement
#14
Gang Li, Yiyuan Pan, Jing Zhou, Zhihui Tong, Lu Ke, Weiqin Li
To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP).Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136003/longitudinal-acquisition-of-endotracheal-intubation-skills-in-novice-physicians
#15
Shinya Takeuchi, Takashi Shiga, Yasuaki Koyama, Taizo Nakanishi, Yosuke Honma, Hiroshi Morita, Tadahiro Goto
Little is known about the acquisition of intubation skills among novice physicians during their one-year clinical training. Our primary objective was to determine the changes in the intubation skills of novice physicians between prior to the clinical training and after completion of the clinical training. We used data of a prospective longitudinal multicenter data registry developed to investigate factors associated with the improvement of intubation skills among novice physicians. The study participants included 90 postgraduate year 1 physicians in 2015-2016...
2017: PloS One
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#16
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29135753/prevention-of-neonatal-unplanned-extubations-in-the-neonatal-intensive-care-unit-a-best-practice-implementation-project
#17
Xiaojing Hu, Yuxia Zhang, Yun Cao, Guoying Huang, Yan Hu, Alexa McArthur
BACKGROUND: Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. OBJECTIVES: The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29133291/watcher-initiative-associated-with-decrease-in-failure-to-rescue-events-in-pediatric-population
#18
Melanie McClain Smith, Maryanne Chumpia, Lindsey Wargo, Julie Nicol, Mark Bugnitz
BACKGROUND AND OBJECTIVES: Improved situation awareness may prevent unplanned ICU transfers. Transfers with serious safety issues may be classified as unrecognized situation awareness failure events (UNSAFE) and are associated with intubation, vasopressors, or >3 fluid boluses within 1 hour before or after ICU arrival. Our aim was to decrease the proportion of unplanned ICU transfers that met UNSAFE criteria by 50% in 1 year. METHODS: We adapted a previously described huddle-based intervention...
November 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29133271/rescue-transtracheal-jet-ventilation-during-difficult-intubation-in-patients-with-upper-airway-cancer
#19
G Bouroche, C Motamed, J M de Guibert, D Hartl, J L Bourgain
INTRODUCTION: The failure rates of intubation and/or mask ventilation are higher in patients with neck or upper airway disease. To ensure oxygenation, Rescue Trans-Tracheal Jet ventilation (RTTJV) may be used. In this critical situation, a high rate of complications has been reported. The aim of this study was to report RTTJV performed by a jet ventilator with an end-expiratory pressure control in an experienced institution. PATIENTS AND METHODS: From a computerised database of 63905 anaesthesia cases, the anaesthetic reports of patients who underwent emergency RTTJV during intubation were studied retrospectively...
November 10, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29133257/comparative-efficacy-of-colonoscope-distal-attachment-devices-in-increasing-rates-of-adenoma-detection-a-network-meta-analysis
#20
REVIEW
Antonio Facciorusso, Valentina Del Prete, Rosario Vincenzo Buccino, Nicola Della Valle, Maurizio Cosimo Nacchiero, Fabio Monica, Renato Cannizzaro, Nicola Muscatiello
BACKGROUND & AIMS: Several add-on devices have been developed to increase rates of colon adenoma detection (ADR). We assessed their overall and comparative efficacy, and estimated absolute magnitude of benefit through a network meta-analysis. METHODS: We searched the PubMed/Medline and Embase database through March 2017 and identified 25 randomized controlled trials (comprising 16,103 patients) that compared the efficacy of add-on devices (cap, Endocuff, and Endorings) with each other or with standard colonoscopy...
November 10, 2017: Clinical Gastroenterology and Hepatology
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