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https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#1
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740999/advanced-cardiac-life-support-2016-singapore-guidelines
#2
Chi Keong Ching, Siew Hon Benjamin Leong, Siang Jin Terrance Chua, Swee Han Lim, Kenneth Heng, Sohil Pothiawala, Venkataraman Anantharaman
The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defibrillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740687/infections-causing-central-airway-obstruction-role-of-bronchoscopy-in-diagnosis-and-management
#3
REVIEW
Sevak Keshishyan, Lawrence DeLorenzo, Kassem Hammoud, Arpine Avagyan, Hussein Assallum, Kassem Harris
Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740684/pediatric-airway-surgery
#4
REVIEW
Konrad Hoetzenecker, Thomas Schweiger, Doris Maria Denk-Linnert, Walter Klepetko
The management of pediatric airway pathology can be challenging and requires a dedicated team, consisting of thoracic surgeons, phoniatricians, logopedics, pediatricians and anesthetists. It necessitates a tailored treatment approach for each individual patient in order to address the minor variances that exist between cases. The majority of pediatric airway problems are a sequela of prematurity and prolonged post-partal intubation/tracheostomy. Surgical repair is often complicated by additional malformation or severe comorbidities...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740668/socioeconomic-impact-of-asthma-chronic-obstructive-pulmonary-disease-and-asthma-copd-overlap-syndrome
#5
Jinhee Kim, Young Sam Kim, Kyungjoo Kim, Yeon-Mok Oh, Kwang Ha Yoo, Chin Kook Rhee, Jin Hwa Lee
BACKGROUND: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is defined as having both features of asthma and COPD, which are airway hyper-responsiveness and incompletely reversible airway obstruction. However, socioeconomic impact of ACOS have not been well appreciated. METHODS: Adults with available wheezing history and acceptable spirometry were selected from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) in 2007-2009...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#6
REVIEW
Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu, Gui-Zhen Yang
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28739243/heaven-criteria-derivation-of-a-new-difficult-airway-prediction-tool
#7
Daniel P Davis, David J Olvera
OBJECTIVE: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. METHODS: A retrospective descriptive analysis was performed in a population of air medical rapid sequence intubation patients requiring more than 1 attempt...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28738377/updated-nasal-surgery-for-obstructive-sleep-apnea
#8
David M Johnson, Ryan J Soose
Numerous studies report that difficulty breathing through the nose is associated with reduced sleep quality, increased daytime dysfunction, and increased risk of snoring and obstructive sleep apnea (OSA). Additionally, chronic nasal obstruction often complicates and limits successful medical device therapy for OSA, particularly with continuous positive airway pressure (CPAP). When medical evaluation and management of the nose is inadequate, surgical therapy to lower nasal resistance has been shown to substantially improve sleep and breathing outcome measures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28737566/high-flow-nasal-cannula-a-novel-approach-to-airway-management-in-awake-craniotomies
#9
Sara C Smith, Mark Burbridge, Richard Jaffe
No abstract text is available yet for this article.
July 21, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28737047/the-role-of-mucoactive-agents-in-the-mechanically-ventilated-patient-a-review-of-the-literature
#10
Bradley L Icard, Edmundo Rubio
The management of airway secretions in the mechanically ventilated patient is a routine task throughout all intensive care units. The current treatment strategies are primarily based on anecdotal experiences rather than statistical evidence. Areas Covered: This review article evaluates the data from published trials surrounding mucoactive agents and their use in the critically ill patient population. We completed an extensive search through PUBMED and CINAHL via EBSCO, along with the Cochran library to find all trials using mucoactive agents in the critically ill patient population...
July 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28734941/sleep-chronic-pain-and-opioid-risk-for-apnea
#11
REVIEW
Serguei Marshansky, Pierre Mayer, Dorrie Rizzo, Marc Baltzan, Ronald Denis, Gilles J Lavigne
Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain)...
July 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28732541/endobronchial-embolization-for-life-threatening-hemoptysis-with-endobronchial-watanabe-spigot
#12
Sze Shyang Kho, Swee Kim Chan, Mei Ching Yong, Siew Teck Tie
BACKGROUND: Massive hemoptysis is a common encounter in respiratory medicine. Bronchoscopy plays an important role in localizing the origin of bleeding, as well as endoscopic treatment of centrally located lesions. Endobronchial embolization is a novel technique enabling the management of hemoptysis arising even from peripheral lesions, via occlusion of the culprit bronchus, thereby securing the airway. Endobronchial Watanabe Spigot had been advocate in the treatment of bronchopleural fistula and the use of this novel technique had since then been expanded into the management of massive hemoptysis...
July 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28732224/three-dimensional-changes-in-the-upper-airway-of-skeletal-class-iii-patients-after-different-orthognathic-surgical-procedures
#13
Yuxue Yang, Kai Yang, Ying Zhao
PURPOSE: We hypothesized that 3-dimensional changes in the upper airway of patients with skeletal Class III malocclusion are different after mandibular setback and maxillary advancement (MSMA) compared with mandibular setback (MS) and that upper airway changes and the amount of jaw movement are correlated. PATIENTS AND METHODS: Skeletal Class III patients who underwent MS surgery or MSMA surgery were included in this retrospective cohort study. Cone beam computed tomography scans were acquired before and 3 months after surgery...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28730908/electrical-stimulation-for-the-treatment-of-obstructive-sleep-apnoea-a-review-of-the-evidence
#14
Valeria Bisogni, Martino F Pengo, Andrea De Vito, Giuseppe Maiolino, Gian Paolo Rossi, John Moxham, Joerg Steier
Obstructi ve sleep apnoea is an increasingly prevalent clinical condition with significant impact on individuals and public health. Continuous positive airway pressure therapy is the standard treatment, but adherence is limited and alternative treatments are needed. In this context, non-invasive and invasive methods for the electrical stimulation of upper airway dilator muscles have been demonstrated to be effective in selected patients. Areas covered: This review will cover investigations on the clinical effects, safety, and tolerability of non-invasive and invasive electrical stimulation of the upper airway for the management of obstructive sleep apnoea...
July 21, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28729000/airway-microbiota-signals-anabolic-and-catabolic-remodeling-in-the-transplanted-lung
#15
Stéphane Mouraux, Eric Bernasconi, Céline Pattaroni, Angela Koutsokera, John-David Aubert, Johanna Claustre, Christophe Pison, Pierre-Joseph Royer, Antoine Magnan, Romain Kessler, Christian Benden, Paola M Soccal, Benjamin J Marsland, Laurent P Nicod
BACKGROUND: Homeostatic turnover of the extracellular matrix conditions the structure and function of the healthy lung. In lung transplantation, long-term management remains limited by Chronic Lung Allograft Dysfunction (CLAD), an umbrella term used for a heterogeneous entity ultimately associated with pathological airway and/or parenchyma remodeling. OBJECTIVE: To assess whether the local cross-talk between the pulmonary microbiota and host cells is a key determinant in the control of lower airway remodeling post-transplantation...
July 17, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28728716/thoracic-trauma-injuries-evaluation-and-treatment
#16
REVIEW
Joseph J Platz, Loic Fabricant, Mitch Norotsky
Thoracic injury is common in high-energy and low-energy trauma, and is associated with significant morbidity and mortality. Evaluation requires a systematic approach prioritizing airway, respiration, and circulation. Chest injuries have the potential to progress rapidly and require prompt procedural intervention. For the diagnosis of nonemergent injuries, a careful secondary survey is essential. Although medicine and trauma management have evolved throughout the decades, the basics of thoracic trauma care have remained the same...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#17
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#18
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28722758/asthma-in-the-elderly-and-late-onset-adult-asthma
#19
REVIEW
Ryan M Dunn, Paula J Busse, Michael E Wechsler
Elderly asthmatics are at a higher risk for morbidity and mortality from their asthma than younger patients. There are important age-related physiologic and immunologic changes that complicate the presentation, diagnosis and management of asthma in the aged population. Evidence suggests that elderly asthmatics are more likely to be under-diagnosed and under-treated. Additionally, elderly patients with asthma have highest rates of morbidity and mortality from their disease than younger patients. The underlying airway inflammation of asthma in this age group likely differs from younger patients and is felt to be non-Type 2 mediated...
July 19, 2017: Allergy
https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#20
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
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