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https://www.readbyqxmd.com/read/29650784/under-pressure-comparison-of-aspiration-techniques-for-endovascular-mechanical-thrombectomy
#1
O Nikoubashman, D Wischer, H M Hennemann, M Büsen, C Brockmann, M Wiesmann
BACKGROUND AND PURPOSE: Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics. MATERIALS AND METHODS: We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29616357/preliminary-experience-on-the-safety-and-tolerability-of-mechanical-insufflation-exsufflation-in-subjects-with-artificial-airway
#2
Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela Del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero, Antonio Núñez-Reiz
BACKGROUND: Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. "Mechanical insufflation-exsufflation" exerts positive pressure, followed by an abrupt drop to negative pressure. Potential advantages of this technique are aspiration of distal airway secretions, avoiding trauma, and improving tolerance. METHODS: We applied insufflation of 50 cmH2 O for 3 s and exsufflation of - 45 cmH2 O for 4 s in patients with an endotracheal tube or tracheostomy cannula requiring secretion suctioning...
April 3, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29615372/catheter-directed-interventions-compared-with-systemic-thrombolysis-achieve-improved-ventricular-function-recovery-at-a-potentially-lower-complication-rate-for-acute-pulmonary-embolism
#3
Efthymios D Avgerinos, Adham N Abou Ali, Nathan L Liang, Belinda Rivera-Lebron, Catalin Toma, Robert Maholic, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis (ST) while decreasing the associated complications. The purpose of this study was to compare outcomes between CDI and ST. METHODS: Consecutive patients who underwent CDIs or ST for massive or submassive PE between 2006 and 2016 were identified. Clinical and echocardiographic parameters at baseline and after treatment were recorded...
March 31, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29501016/management-of-extensive-surgical-emphysema-with-subcutaneous-drain-a-case-report
#4
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29489659/an-innovative-method-for-placing-a-double-lumen-irrigation-suction-tube-in-the-management-of-abdominal-infection-a-case-report
#5
Zheng Yao, Weiliang Tian, Xin Xu, Qian Huang, Yunzhao Zhao
RATIONALE: Currently, the use of double-lumen irrigation-suction tube for drainage has become increasingly more common. However, the insertion process is complex, and the position of the double cannula placed in this manner is not accurate. We developed a method for placing the drainage tube and use it in the treatment of an abdominal infection. PATIENT CONCERNS: A 51-year-old man with an abdominal infection due to colonic anastomotic fistula was admitted. Routine laboratory tests revealed an elevated white blood cell count (17 × 10/L) and C-reactive protein level (78 mg/L)...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29464690/bis-monitoring-versus-clinical-assessment-for-sedation-in-mechanically-ventilated-adults-in-the-intensive-care-unit-and-its-impact-on-clinical-outcomes-and-resource-utilization
#6
REVIEW
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29372629/chest-tube-drainage-of-the-pleural-space-a-concise-review-for-pulmonologists
#7
REVIEW
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
January 24, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29354208/endovascular-treatment-of-pulmonary-embolism-selective-review-of-available-techniques
#8
REVIEW
John L Nosher, Arjun Patel, Sugeet Jagpal, Christopher Gribbin, Vyacheslav Gendel
Acute pulmonary embolism (PE) is the third most common cause of death in hospitalized patients. The development of sophisticated diagnostic and therapeutic modalities for PE, including endovascular therapy, affords a certain level of complexity to the treatment of patients with this important clinical entity. Furthermore, the lack of level I evidence for the safety and effectiveness of catheter directed therapy brings controversy to a promising treatment approach. In this review paper, we discuss the pathophysiology and clinical presentation of PE, review the medical and surgical treatment of the condition, and describe in detail the tools that are available for the endovascular therapy of PE, including mechanical thrombectomy, suction thrombectomy, and fibrinolytic therapy...
December 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/29347980/semiprone-position-is-superior-to-supine-position-for-paediatric-endotracheal-intubation-during-massive-regurgitation-a-randomized-crossover-simulation-trial
#9
Espen Fevang, Karin Haaland, Jo Røislien, Conrad Arnfinn Bjørshol
BACKGROUND: Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotracheal intubation would be easier and quicker to perform when the patient is turned over to a semiprone position, as compared to the supine position. METHODS: In a randomized crossover simulation trial, a child manikin with on-going regurgitation was intubated both in the supine and semiprone positions...
January 18, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29302121/use-of-a-modified-cardiopulmonary-bypass-circuit-for-suction-embolectomy-with-the-angiovac-device
#10
Cara M Michelson, Cornelius M Dyke, Douglas J Wick, Rory Guenther, Dylan Dangerfield, Matthew E Wiisanen
The AngioVac suction cannula and circuit were designed for the percutaneous removal of soft thrombus and emboli in procedures requiring extracorporeal circulatory support. We describe a modification of the AngioVac suction catheter and cardiopulmonary bypass (CPB) circuit to effectively remove thrombus while maintaining the ability to rapidly initiate full CPBs during a medical crisis. This article will discuss the design concepts of the modified circuit as well as procedural protocols and considerations. The design modifications of incorporating an oxygenator, reservoir, and bridge allow for an increased flexibility that allows adaption to veno-venous extracorporeal membrane oxygenation or full CPB support when required for oxygenation or hemodynamic support...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29237133/transhiatal-chest-drainage-after-hybrid-ivor-lewis-esophagectomy-proof-of-concept-study
#11
Emanuele Asti, Andrea Sironi, Gianluca Bonitta, Daniele Bernardi, Luigi Bonavina
BACKGROUND: Intercostal pleural drainage is standard practice after transthoracic esophagectomy but has some drawbacks. We hypothesized that a transhiatal pleural drain introduced through the subxyphoid port site incision at laparoscopy can be as effective as the intercostal drainage and may enhance patient recovery. PATIENTS AND METHODS: A proof of concept study was designed to assess a new method of pleural drainage in patients undergoing hybrid Ivor Lewis esophagectomy (laparoscopy and right thoracotomy)...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29146085/how-to-suction-pancreatic-juice-from-the-duodenum-endoscope-catheter-or-cap-assisted
#12
EDITORIAL
Yan Bi, Baoan Ji, Massimo Raimondo
No abstract text is available yet for this article.
December 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29118797/comparison-of-vacuum-pressures-and-forces-generated-by-different-catheters-and-pumps-for-aspiration-thrombectomy-in-acute-ischemic-stroke
#13
Michael T Froehler
Background: Direct aspiration thrombectomy is an increasingly utilized technique in endovascular stroke treatment that relies on vacuum and suction force to remove the clot. This report assesses the pressures and forces generated by different catheters and pumps. Methods: Vacuum pressures were measured using a vacuum gauge for several catheters (Stryker Catalyst6, Penumbra Ace 064, Medtronic Arc 061, and Penumbra 041) and pumps (Penumbra pump, 60-mL syringe, and the ASPIRE device)...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29076276/hybrid-approach-to-laparoscopic-decapsulation-combined-with-splenic-artery-balloon-occlusion-in-a-patient-with-carbohydrate-antigen-19-9-producing-splenic-cysts
#14
Eri Maeda, Keiichi Okano, Hironobu Suto, Eisuke Asano, Minoru Oshima, Takayoshi Kishino, Masao Fujiwara, Naoki Yamamoto, Takayuki Sanomura, Yasuyuki Suzuki
INTRODUCTION: Carbohydrate antigen 19-9 producing splenic cysts are relatively rare and usually occur in women and young individuals. This report describes the use of a novel splenic-preserving surgical approach in the hybrid operating room to reduce the risk of bleeding. MATERIALS AND SURGICAL TECHNIQUE: A 27-year-old woman presented at our hospital with a chief complaint of chest pain. CT showed an encapsulated left pleural effusion and multiple splenic cysts...
November 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28910958/-therapeutic-effect-of-angiojet-mechanical-thrombus-aspiration-system-combined-with-catheter-directed-thrombolysis-on-acute-deep-vein-thrombosis
#15
Y J Mao, C L Li, F R Lei, Y Q Zhang, A M Qian, H F Sang, X Q Li
Objective: To analyze the curative effect of AngioJet mechanical thrombus aspiration combined with catheter directed thrombolysis (CDT) on acute lower extremity deep vein thrombosis (LEDVT). Methods: The clinical data of 20 cases of acute LEDVT treated by AngioJet combined with CDT were analyzed. The inferior vena cava filter was implanted preoperatively, and then the thrombolysis was performed by using AngioJet. The thrombolytic catheter was placed for CDT treatment, and the thrombolysis was evaluated by review angiography...
September 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28895453/extracranial-internal-carotid-artery-vasospasm-during-thrombectomy
#16
Isamu Miura, Akitsugu Kawashima, Masataka Hayashi, Akane Tanda, Tomomi Ishikawa, Takakazu Kawamata
The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient's National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28806177/laryngeal-mask-airway-embedded-with-pharyngeal-suction-catheters-for-rhinoplasty-a-case-report
#17
Gary X Zhou
A flexible laryngeal mask airway device (LMAD) embedded with 2 pharyngeal suction catheters was used for a young female patient who underwent a revision rhinoplasty, septoplasty, and chin implant. The modified LMAD was constructed by attaching 2 suction catheters onto the back of the mask; it functioned well without signs of malfunction or complications, with a total of 71 mL of blood evacuated from the pharyngeal area during the five and a half hour surgery. The patient emerged from anesthesia without coughing or straining, and reported no sore throat or nausea/vomiting in the recovery room...
January 1, 2018: A&A practice
https://www.readbyqxmd.com/read/28790283/-postoperative-atelectasis-and-pneumonia-after-general-thoracic-surgery
#18
Yasushi Hoshikawa, Daisuke Tochii
Atelectasis and pneumonia are common postoperative complications occurred in patients undergoing general thoracic surgery. Strategies to reduce the risk of postoperative pulmonary complications including these 2 disorders consist of smoking cessation, optimization of underlying chronic obstructive pulmonary disease( COPD), adequate pain control, intensive oral care, and so on. Preoperative treatments for patients with COPD are the same as those for COPD patients being not about to have surgery, which mainly consist of long-acting bronchodilators and pulmonary rehabilitation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28765755/airway-support-using-a-pediatric-intubation-tube-in-adult-patients-with-atrial-fibrillation-a-simple-and-unique-method-to-prevent-heart-movement-during-catheter-ablation-under-continuous-deep-sedation
#19
Masateru Takigawa, Atsushi Takahashi, Taishi Kuwahara, Kenji Okubo, Emiko Nakashima, Yuji Watari, Kazuya Yamao, Jun Nakajima, Yasuaki Tanaka, Katsumasa Takagi, Shigeki Kimura, Hiroyuki Hikita, Kenzo Hirao, Mitsuaki Isobe
BACKGROUND: The present study aimed to elucidate the safety and effectiveness of a noble and unique airway management technique in which a pediatric intubation tube is used in adult patients with atrial fibrillation (AF) undergoing catheter ablation (CA) under continuous deep sedation. METHODS: In total, 246 consecutive patients with AF (mean age, 65±10 years; 60 women) underwent CA under dexmedetomidine-based continuous deep sedation. A 4-mm pediatric intubation tube guided by a 10-French intratracheal suction tube was inserted smoothly, and the tip of the tube was located at the base of the epiglottis...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#20
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
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