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Obese tracheostomy

David F Smith, Ting Sa, Matthew Fenchel, Aliza P Cohen, Christine Heubi, Sally R Shott, Christine G Gourin, Stacey L Ishman
OBJECTIVES/HYPOTHESIS: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. STUDY DESIGN: Repeated cross-sectional study. METHODS: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling...
September 19, 2016: Laryngoscope
Rena Gale, Julia Namestnic, Pierre Singer, Ilya Kagan
BACKGROUND AND OBJECTIVE: Israeli law mandates chronic ventilator support for children and adolescents who are severely brain impaired and show minimal responses. Feeding protocols in these cases have been based on the caloric requirements of healthy children, deducting calories for lack of activity as well as an individual adjustment according to the cerebral palsy growth curves. However, patients are still inclined to gain excessive weight. Our objective was to determine the caloric requirements of these patients...
August 15, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
S Ibáñez-Micó, A M Marcos Oltra, S de Murcia Lemauviel, R Ruiz Pruneda, C Martínez Ferrández, R Domingo Jiménez
INTRODUCTION: ROHHAD syndrome (rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation) is a rare and complex disease, presenting in previously healthy children at the age of 2-4 years. Up to 40% of cases are associated with neural crest tumours. DEVELOPMENT: We present the case of a 2-year-old girl with symptoms of rapidly progressing obesity, who a few months later developed hypothalamic dysfunction with severe electrolyte imbalance, behaviour disorder, hypoventilation, and severe autonomic dysregulation, among other symptoms...
June 20, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Ryan V Marshall, Patrick J Haas, John M Schweinfurth, William H Replogle
IMPORTANCE: Surgeons need to understand the expected outcomes for super obese patients undergoing tracheotomy to appropriately counsel patients and families about likely risks and benefits. OBJECTIVE: To determine the outcomes, complications, and mortality after tracheotomy in super obese patients (those with a body mass index [BMI] greater than 50). DESIGN, SETTING, AND PARTICIPANTS: A retrospective review was conducted of billing records from a tertiary care academic medical center from November 1, 2010, through June 30, 2013, to identify patients undergoing tracheotomy...
August 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
Denise Mifsud Bonnici, Thomas Sanctuary, Alex Warren, Patrick B Murphy, Joerg Steier, Philip Marino, Hina Pattani, Ben C Creagh-Brown, Nicholas Hart
OBJECTIVES: According to National Health Service England (NHSE) specialist respiratory commissioning specification for complex home ventilation, patients with weaning failure should be referred to a specialist centre. However, there are limited data reporting the clinical outcomes from such centres. SETTING: Prospective observational cohort study of patients admitted to a UK specialist weaning, rehabilitation and home mechanical ventilation centre between February 2005 and July 2013...
2016: BMJ Open
Xiuyu Du, Shangjiong Yin, Hongquan Liu
No abstract text is available yet for this article.
July 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Raj C Dedhia, Vishesh K Kapur, Edward M Weaver
Tracheostomy has demonstrated effectiveness in the control of obstructive sleep apnea (OSA) in most patients; however, current evidence suggests significant sleep disordered breathing may persist, particularly in morbidly obese individuals. While several mechanisms have been proposed to explain this phenomenon, we demonstrate evidence of a previously unidentified pathophysiology: excessive dynamic airway collapse (EDAC) of the lower airway. We present the case of a 62-year-old woman status post tracheostomy with persistent dyspnea in the supine position...
November 2015: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Kevin Pilarczyk, Guenter Marggraf, Michaela Dudasova, Ender Demircioglu, Valerie Scheer, Heinz Jakob, Fabian Dusse
OBJECTIVE: To assess the impact of timing of percutaneous dilatational tracheotomy (PDT) on incidence of deep sternal wound infections (DSWI) after cardiac surgery with median sternotomy. DESIGN: Retrospective study between 2003 and 2013. SETTING: Single-center university hospital. PARTICIPANTS: Eight hundred seventy-nine patients after cardiac surgery with extracorporeal circulation and median sternotomy. INTERVENTIONS: PDT using the Ciaglia-technique with direct bronchoscopic guidance...
December 2015: Journal of Cardiothoracic and Vascular Anesthesia
Venkatakrishna Rajajee, Craig A Williamson, Brady T West
INTRODUCTION: Recent studies have demonstrated the feasibility of real-time ultrasound guidance during percutaneous dilatational tracheostomy, including in patients with risk factors such as coagulopathy, cervical spine immobilization and morbid obesity. Use of real-time ultrasound guidance has been shown to improve the technical accuracy of percutaneous dilatational tracheostomy; however, it is unclear if there is an associated reduction in complications. Our objective was to determine whether the peri-procedural use of real-time ultrasound guidance is associated with a reduction in complications of percutaneous dilatational tracheostomy using a propensity score analysis...
2015: Critical Care: the Official Journal of the Critical Care Forum
Bonnie Diep, Annie Wang, Sheila Kun, J Gordon McComb, Donald B Shaul, Cathy E Shin, Thomas G Keens, Iris A Perez
BACKGROUND: Congenital central hypoventilation syndrome (CCHS) is a rare disorder affecting central control of breathing. Thus, patients require lifelong assisted ventilation. Diaphragm pacing (DP) may permit decannulation in those who are ventilator dependent only during sleep. OBJECTIVE: The purpose of this study is to determine if patients with CCHS can be successfully ventilated by DP without tracheostomy. METHODS: We reviewed the records of 18 CCHS patients (mean age 19...
2015: Respiration; International Review of Thoracic Diseases
Pierpaolo Terragni, Luciana Mascia, Chiara Faggiano, Tommaso Tenaglia, Emanuela Morello, Giovanni Succo, Marco Ranieri, Luca Brazzi
BACKGROUND: Ciaglia et al. originally proposed the percutaneous tracheostomy in 1985 as an alternative to the surgical approach. Several variants have been developed in the years with a convincing evidence that, compared to surgical tracheostomy, the percutaneous approach is more cost-effective without compromising safety. However the procedure is not immune from complications and requires procedural skills and adequate level of expertise with a steep learning curve. In this contest, to optimize safety and efficacy of percutaneous tracheostomy in different clinical scenarios, physicians should be familiar with the different available percutaneous techniques...
February 2016: Minerva Anestesiologica
Parli Raghavan Ravi, M N Vijay
BACKGROUND: The purpose of this study was to evaluate the efficacy of ultrasound guided percutaneous tracheostomy (USPCT) and bronchoscopic guided percutaneous tracheostomy (BPCT) and the incidence of complications in critically ill, obese patients. METHODS: Seventy four consecutive patients were included in a prospective study and randomly divided into USPCT and BPCT. Incidence of complications, ease and efficacy were compared in obese USPCT (n = 38)and BPCT (n = 36)...
April 2015: Medical Journal, Armed Forces India
Xiang Zhai, Jinling Zhang, Wei Hang, Ming Wang, Zhan Shi, Yue Mi, Yunlei Hu, Gang Liu
OBJECTIVE: To Analyze the influence factors on the complications of percutaneous dilational tracheotomy. METHODS: Between August 2008 and February 2014, there were 3 450 patients with the indications of tracheotomy accepted percutaneous dilational tracheostomy, mainly using percutaneous dilational and percutaneous guide wire forceps in these cases. Statistical analysis was performed by SPSS 19.0 software on postoperative complications, the possible influence factors including age, gender, etiology, preoperative hypoxia, obesity, preoperative pulmonary infection, state of consciousness, operation method, operation doctor and whether with tracheal intubation...
January 2015: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Macario Camacho, Jeffrey Teixeira, Jose Abdullatif, Jason L Acevedo, Victor Certal, Robson Capasso, Nelson B Powell
OBJECTIVE: The objective of this study is to systematically review polysomnography data and sleepiness in morbidly obese (body mass index [BMI] ≥40 kg/m(2)) patients with obstructive sleep apnea (OSA) treated with either a maxillomandibular advancement (MMA) or a tracheostomy and to evaluate the outcomes. DATA SOURCES: MEDLINE, Scopus, Web of Science, and the Cochrane Library. REVIEW METHODS: A search was performed from inception through April 8, 2014, in each database...
April 2015: Otolaryngology—Head and Neck Surgery
Semirra Bayan, Henry T Hoffman
IMPORTANCE: To our knowledge, we report the first series to analyze use of the Montgomery cannula as an airway management tool for indications other than obstructive sleep apnea. OBJECTIVES: To analyze the use and outcomes of Montgomery cannula placement for airway management and to identify indications for placement. DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of 20 patients who received a Montgomery cannula from 2003 through 2012 at the University of Iowa Hospitals and Clinics...
February 2015: JAMA Otolaryngology—Head & Neck Surgery
Ozgür Atmaca, Pınar Zarakolu, Ceren Karahan, Banu Cakır, Serhat Unal
The aim of this study was to evaluate methicillin-resistant Staphylococcus aureus (MRSA) bacteremia cases who were followed at the Infectious Diseases Unit of Internal Medicine Department, at Hacettepe University Adult and Oncology Hospitals between January 2004-December 2011. A total of 198 patients, of them 99 had positive MRSA blood cultures (case group), and 99 without MRSA bacteremia (control group) who were selected randomly among patients at the same wards during the same time period, were included in the study...
October 2014: Mikrobiyoloji Bülteni
Charlisa Gibson, Pius Ochieng, Raymond Jean, Raymonde Jean
Outcomes/Quality ControlSESSION TYPE: Original Investigation SlidePRESENTED ON: Wednesday, October 29, 2014 at 08:45 AM - 10:00 AMPURPOSE: Obstructive sleep apnea (OSA) is an important under diagnosed comorbidity in hospitalized patients, while pneumonia remains a common cause of acute respiratory failure. This retrospective study examined outcomes associated with OSA on patients with pneumonia requiring invasive mechanical ventilation (IMV).METHODS: The Nationwide Inpatient Sample (NIS) was investigated for discharges with a primary diagnosis of pneumonia requiring IMV between the years of 2009 and 2011...
October 1, 2014: Chest
Marcelo Moock, Sergio Elia Mataloun, Marcela Pandolfi, Juliana Coelho, Neil Novo, Patrícia C Compri
STUDY OBJECTIVE: Obese patients seem to have worse outcomes and more complications during intensive care unit (ICU) stay. This study describes the clinical course, complications and prognostic factors of obese patients admitted to an intensive care unit compared to a control group of nonobese patients. DESIGN: Retrospective observational study. SETTING: A 10-bed adult intensive care unit in a university-affiliated hospital. METHODS: All patients admitted to the intensive care unit over 52 months (April 01/2005 to November 30/2008) were included...
June 2010: Revista Brasileira de Terapia Intensiva
Ahmad Alhajhusain, Ailia W Ali, Asif Najmuddin, Kashif Hussain, Masooma Aqeel, Ali A El-Solh
Background. The optimal timing of tracheotomy and its impact on weaning from mechanical ventilation in critically ill morbidly obese patients remain controversial. Methods. We conducted a retrospective chart review of morbidly obese subjects (BMI ≥ 40 kg/m(2) or BMI ≥ 35 kg/m(2) and one or more comorbid conditions) who underwent a tracheotomy between July 2008 and June 2013 at a medical intensive care unit (ICU). Clinical characteristics, rates of nosocomial pneumonia (NP), weaning from mechanical ventilation (MV), and mortality rates were analyzed...
2014: Critical Care Research and Practice
Saadia A Faiz, Diwakar Balachandran, Amy C Hessel, Xiudong Lei, Beth M Beadle, William N William, Lara Bashoura
BACKGROUND: Sleep disturbance is a prominent complaint of cancer patients. Most studies have focused on insomnia and cancer-related fatigue. Obstructive sleep apnea (OSA) has been reported in small studies and case reports. METHODS: In a retrospective review of patients who underwent formal sleep evaluation and polysomnography (PSG) from 2006 to 2011, 56 patients with tumors in the head and neck region were identified. Clinical characteristics, sleep-related history, and PSG data were reviewed...
November 2014: Oncologist
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