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https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#1
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28318970/transcricothyroid-endoscopic-subglottic-surgery-for-posterior-glottic-stenosis-a-case-report
#2
Koji Matsushima, Kentaro Matsuura, Teppei Takeda, Yuko Sasaki, Akira Fukuo, Kota Wada, Yusuke Watanabe
Posterior glottic stenosis (PGS) is a rare but life-threatening condition mostly caused by damage to the interarytenoid mucosa by an endotracheal tube. In surgical treatment of PGS, airway patency is prioritized, and the laryngeal functions involved in swallowing and phonation are considerably sacrificed. In the majority of cases, lateralization of a vocal fold or partial excision of a vocal fold and arytenoid cartilage results in glottal closure insufficiency and deterioration of phonatory function. We present the first report of transcricothyroid endoscopic subglottic surgery to treat a 46-year-old man with PGS who was intubated for 10 days...
March 16, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28318598/pediatric-eating-assessment-tool-10-as-an-indicator-to-predict-aspiration-in-children-with-esophageal-atresia
#3
Tutku Soyer, Sule Yalcin, Selen Serel Arslan, Numan Demir, Feridun Cahit Tanyel
AIM: Airway aspiration is a common problem in children with esophageal atresia (EA). Pediatric Eating Assessment Tool-10 (pEAT-10) is a self-administered questionnaire to evaluate dysphagia symptoms in children. A prospective study was performed to evaluate the validity of pEAT-10 to predict aspiration in children with EA. METHODS: Patients with EA were evaluated for age, sex, type of atresia, presence of associated anomalies, type of esophageal repair, time of definitive treatment, and the beginning of oral feeding...
March 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28315819/a-case-report-of-thoracic-endometriosis-a-rare-cause-of-haemothorax
#4
Lina Pankratjevaite, Diana Samiatina-Morkuniene
INTRODUCTION: The presence of endometrial tissue in airways, pleura and lung parenchyma is called thoracic endometriosis syndrome (TES). It is a rare pathology, and typically consists of catamenial pneumothorax, haemothorax, haemoptysis, and pulmonary nodules. We report a case of a 36-year-old woman with thoracic endometriosis causing catamenial haemothorax. CONCLUSIONS: The diagnosis of thoracic endometriosis is complicated and often delayed. TES should be suspected in a reproductive age woman with exacerbating symptoms during the menstruation...
March 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28315747/multivariate-analysis-of-airway-obstruction-and-reintubation-after-anterior-cervical-surgery
#5
REVIEW
Haoxi Li, Yufeng Huang, Bin Shen, Zhaoyu Ba, Desheng Wu
STUDY DESIGN: A retrospective study PURPOSE: To explore the risk factors for reintubation after airway obstruction following anterior cervical surgery. STUDY BACKGROUND: Anterior cervical surgery is an effective surgical therapy for cervical spine disorders. As the anterior approach is adopted more frequently, some rare postoperative complications come under the spotlight, among which, airway obstruction is extremely detrimental. However, the risk factors and the pathogenesis of the airway obstruction still remain unknown...
March 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28314808/cervical-diffuse-idiopathic-skeletal-hyperostosis-dish-causing-oropharyngeal-dysphagia
#6
Nellowe Candelario, Kevin Bryan Lo, Mario Naranjo
Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory condition characterised by calcification and ossification of the vertebral ligaments. It is most commonly seen to affect the thoracic and lumbar vertebrae and is usually seen among elderly men. The cause of this condition is unknown. Risk factors include male gender, obesity, diabetes and advancing age. The majority of these cases are found incidentally on imaging and patients are generally asymptomatic. Cervical DISH is less common than its thoracic and lumbar counterparts...
March 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28302227/anaesthetic-concerns-of-surgical-emphysema-following-thyroidectomy
#7
Sanum Kashif, Amna Gulrez
Surgical emphysema secondary to tracheal tear is a rare but serious complication after thyroidectomy. It is usually resolved by conservative management; but in case of compromised airway, early airway control and surgical intervention is required. This is the case report of a 52-year woman diagnosed as thyroid carcinoma, who developed rapidly progressive surgical emphysema involving head and upper thorax, following total thyroidectomy, in post anesthesia care unit (PACU). The complication was related to tracheal tear occurring during excision of huge thyroid mass, encroaching trachea...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28299255/changes-in-posterior-airway-space-and-mandibular-plane-hyoid-distance-following-mandibular-advancement-do
#8
Pushpa Kumari, S K Roy, Indranil Dev Roy, A K Rajput, M P Prasanna Kumar, Sanjeev Datana, Serat Rahman
AIM: To study the changes in posterior airway space (PAS) and mandibular plane hyoid (MPH) distance following mandibular advancement using distraction osteogenesis (DO). SUBJECTS AND METHODS: A prospective study was conducted at a tertiary care dental center from May 2009 to May 2014. Twenty-five consecutively operated patients of mandibular hypoplasia who underwent mandibular advancement using distraction with at least 12 months follow-up were included in the study...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28299194/recent-trends-in-airway-management
#9
REVIEW
Joelle Karlik, Michael Aziz
Tracheal intubation remains a life-saving procedure that is typically not difficult for experienced providers in routine conditions. Unfortunately, difficult intubation remains challenging to predict and intubation conditions may make the event life threatening. Recent technological advances aim to further improve the ease, speed, safety, and success of intubation but have not been fully investigated. Video laryngoscopy, though proven effective in the difficult airway, may result in different intubation success rates in various settings and in different providers' hands...
2017: F1000Research
https://www.readbyqxmd.com/read/28298802/infantile-cystic-hygroma-an-unusual-perioperative-course
#10
Suman Saini, Madhu Dayal, Amita Gupta
Airway management of an infant with a giant cervical lump may be a difficult task. The anesthesiologist must be prepared to face associated challenges during securing the airway in such patients. We report our experience with One year old infant who presented with huge cystic hygroma in the cervical region leading to recurrent episodes of respiratory tract infection and distress. Surgical removal was needed as sclerotherapy proved ineffective in reducing its size. Proseal laryngeal mask airway was used as a conduit after inhalational induction since airway could not be maintained with bag and mask...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298767/airway-management-in-patients-with-tracheal-compression-undergoing-thyroidectomy-a-retrospective-analysis
#11
Binu Sajid, K Rekha
BACKGROUND: Airway management in large and retrosternal goiters with tracheal compression is often fraught with challenges and is a source of apprehension among anesthesiologists globally. AIMS: In this study we attempt to delineate the preferred techniques of airway management of such cases in our institution and also to assess whether airway management was unnecessarily complicated. SETTING AND DESIGN: Retrospective analysis. MATERIALS AND METHODS: A retrospective review was conducted of thyroidectomies performed in our institution over a three year period from January 2013...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28294946/continuing-the-original-stanford-sleep-surgery-protocol-from-upper-airway-reconstruction-to-upper-airway-stimulation-our-first-successful-case
#12
Stanley Yung Liu, Robert Wayne Riley
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness...
February 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28293872/effect-of-high-laser-output-on-the-central-bronchi-and-pulmonary-artery
#13
A Kirschbaum, P Rexin, D K Bartsch, K Quint
A diode-pump Nd:YAG high-power laser (wavelength 1320 nm, power 100 W) is routinely used to surgically remove lung metastases. Even pulmonary lesions in central locations are resectable via this method, yet it also carries a potential risk of damaging the larger bronchi and vessels in the vicinity. Studies investigating the safety of using high-power lasers are lacking. We therefore aimed to examine the direct effects of a 100-watt laser on the bronchi and pulmonary artery at a standard working velocity. From freshly slaughtered pigs, we isolated cylindrical specimens of the trachea, the main and lobar bronchi, and the central pulmonary artery from the both lungs...
March 14, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28293700/optimal-age-for-elective-surgery-of-asymptomatic-congenital-pulmonary-airway-malformation-a-meta-analysis
#14
REVIEW
Katrina J Sullivan, Michelle Li, Sarah Haworth, Elizabeth Chernetsova, Carolyn Wayne, Jessica Kapralik, Emily Chan, Ahmed Nasr
Controversy exists on the optimal age for elective resection of asymptomatic congenital pulmonary airway malformation. Current recommendations vary widely, highlighting the overall lack of consensus. A systematic search of Embase, MEDLINE, CINAL, and CENTRAL was conducted in January 2016. Identified citations were screening independently in duplicate and consensus was required for inclusion. Results were pooled using inverse variance fixed effects meta-analysis. Meta-analysis results indicate no statistically significant differences for complications within the 3-month and 6-month age comparison groups [odds ratio (OR) 4...
March 14, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28292706/effect-of-airflow-and-material-models-on-tissue-displacement-for-surgical-planning-of-pharyngeal-airways-in-pediatric-down-syndrome-patients
#15
Dhananjay Radhakrishnan Subramaniam, Goutham Mylavarapu, Robert J Fleck, Raouf S Amin, Sally R Shott, Ephraim J Gutmark
Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy...
March 8, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28291454/the-abc-s-of-pancreatic-trauma-airway-breathing-and-computerized-tomography-scan
#16
Matthew Vasquez, Cassandra Cardarelli, Jacob Glaser, Sarah Murthi, Deborah Stein, Thomas Scalea
OBJECTIVES: Missed pancreatic injury carries significant morbidity. Computerized tomography (CT) imaging is useful, but may lack sensitivity to identify pancreatic injury. New-generation CT scanners should improve sensitivity, but this has not been studied. A previous study published in 2002 evaluating the sensitivity for identifying pancreatic injury with single-slice CT scanners yielded a 68% correlation between operative and CT findings. We aim to study the accuracy of modern CT for diagnosis and grading of pancreatic injury...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291399/resection-and-primary-closure-of-edematous-glossoepiglottic-mucosa-in-a-dog-causing-laryngeal-obstruction
#17
Kevin J Schabbing, Jeffrey A Seaman
An approximately 22 mo old male neutered English bulldog was evaluated for acute onset of dyspnea with suspected brachycephalic obstructive airway syndrome (BOAS). Laryngoscopic exam revealed diffuse, severe edema and static displacement of redundant glossoepiglottic (GE) mucosa causing complete obstruction of the larynx and epiglottic entrapment. Static displacement of the GE mucosa was observed and determined to be the overriding component of dyspnea in this patient with BOAS. Resection and primary closure with two separate, simple continuous sutures of the GE mucosa were performed...
March 14, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#18
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290230/cilia-and-ear
#19
Gioia Piatti, Maria Margherita De Santi, Sara Torretta, Lorenzo Pignataro, Daniela Soi, Umberto Ambrosetti
OBJECTIVE: To investigate the prevalence of otological complications derived from primary ciliary dyskinesia (PCD) in adulthood. METHODS: Twenty-three patients with diagnosed PCD underwent medical history aimed at recording the presence of ear, nose, and throat manifestations (ENT) and any surgical treatments. The ENT objectivity was annotated, and then patients were subjected to audiometric test, tympanometry, registration of otoacoustic emission, and vestibular evaluation...
April 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28289832/indirect-costs-related-to-caregivers-absence-from-work-after-paediatric-tonsil-surgery
#20
Gunnhildur Gudnadottir, G Ragnarson Tennvall, J Stalfors, J Hellgren
Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers' absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1-11 were included, n = 4534...
March 14, 2017: European Archives of Oto-rhino-laryngology
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