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Obese tracheostomy

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https://www.readbyqxmd.com/read/28735907/the-relationship-between-weight-change-and-daytime-sleepiness-the-sleep-heart-health-study
#1
Winda L Ng, Liliana Orellana, Jonathan E Shaw, Evelyn Wong, Anna Peeters
OBJECTIVE: Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. METHODS: From the Sleep Heart Health Study, we selected individuals who were: (1) 40-64 years old, with (2) body mass index (BMI) ≥18.5 kg/m(2), (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468)...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#2
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28649379/is-transoral-robotic-surgery-a-safe-and-effective-multilevel-treatment-for-obstructive-sleep-apnoea-in-obese-patients-following-failure-of-conventional-treatment-s
#3
George Garas, Anthousa Kythreotou, Christos Georgalas, Asit Arora, Bhik Kotecha, Floyd C Holsinger, David G Grant, Neil Tolley
A best evidence topic was written according to a structured protocol. The question addressed was whether TransOral Robotic Surgery (TORS) is a safe and effective multilevel treatment for Obstructive Sleep Apnoea (OSA) in obese patients following failure of conventional treatment(s). A total of 39 papers were identified using the reported searches of which 5 represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28647299/otolaryngology-consultation-tracheostomies-and-complex-patient-population
#4
Kristan P Alfonso, Michael R Kaufman, Emily V Dressler, Meng Liu, Rony K Aouad
PURPOSE: To assess for the differences in patients undergoing tracheostomy by the otolaryngology consult service versus other specialties. MATERIALS AND METHODS: A series of 1035 tracheostomies performed at our institution from January 2013 through November 2015 was retrospectively reviewed. Patient-related factors that contribute to procedural difficulty were reviewed. RESULTS: 805 consecutive tracheostomies were included. Otolaryngology performed 176/805 (21...
June 17, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28590065/safety-and-efficacy-of-laryngeal-mask-airway-ventilation-in-obese-patients-with-airway-stenosis
#5
D Cole Pourciau, D Peter Hotard, Schuylor Hayley, Kasey Hayley, Collin Sutton, Andrew J McWhorter, Daniel S Fink
OBJECTIVE: To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis. STUDY DESIGN: A retrospective chart review was conducted in an academic practice in a tertiary care center. METHODS: We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O2 saturation and maximum-end tidal carbon dioxide (CO2 ) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded...
June 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28542048/case-report-of-a-massive-retropharyngeal-goiter-resulting-in-laryngeal-compression
#6
Carissa M Thomas, Jameson K Mattingly, Adrian Hendrickse, John I Song
This is a rare presentation of a morbidly obese male with a massive retropharyngeal goiter causing laryngeal compressive symptoms and unique airway management challenges. Flexible laryngoscopy revealed a retropharyngeal mass circumferentially compressing the oropharynx and supraglottis and preventing the visualization of the glottis. Awake tracheostomy was performed before total thyroidectomy. Airway compression from a goiter typically results from substernal extension, which usually does not cause difficulty with endotracheal intubation...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#7
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28395275/tracheostomy-extubation-reintubation-airway-management-decisions-in-intubated-stroke-patients
#8
Corinna Steidl, Julian Boesel, Sonja Suntrup-Krueger, Silvia Schoenenberger, Faisal Al-Suwaidan, Tobias Warnecke, Jens Minnerup, Rainer Dziewas
BACKGROUND: Both delayed and premature extubation increase complication rate, the need for tracheostomy (TT), the duration of intensive care unit stay, and mortality. In this study, we therefore investigated factors associated with primary TT and predictors for extubation failure (EF) in a sample of severely affected ventilated stroke patients. METHODS: One hundred eighty five intubated stroke patients were prospectively analyzed in this observational study. Patients not meeting predefined clinical and respiratory extubation criteria received a TT...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28387620/reoperation-and-readmission-after-clipping-of-an-unruptured-intracranial-aneurysm-a-national-surgical-quality-improvement-program-analysis
#9
Hormuzdiyar H Dasenbrock, Timothy R Smith, Robert F Rudy, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured aneurysm electively were extracted from the prospective National Surgical Quality Improvement Program registry (2011-2014). Multivariable logistic regression and recursive partitioning analysis evaluated the independent predictors of nonroutine hospital discharge, unplanned 30-day reoperation, and readmission...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28063276/tracheostomy-in-the-morbidly-obese-difficulties-and-challenges
#10
REVIEW
Tirbod Fattahi, Christopher Chafin, Anthony Bunnell
PURPOSE: This study evaluated the difficulties and challenges associated with open tracheostomy in the morbidly obese patient (body mass index [BMI] ≥30 kg/m(2)). PATIENTS AND METHODS: Forty patients met all the inclusion criteria. A retrospective chart review was performed to evaluate indications for tracheostomy, duration of intubation before tracheostomy, history of tracheostomy, duration of operative procedure, duration in the operating room, and all perioperative complications...
December 30, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28007041/risk-factors-for-adult-acquired-subglottic-stenosis
#11
E A Nicolli, R M Carey, D Farquhar, S Haft, K P Alfonso, N Mirza
OBJECTIVE: The aetiology and outcomes for patients with acquired subglottic stenosis are highly variable. This study aimed to identify risk factors for subglottic stenosis and patient characteristics that predict long-term clinical outcomes. METHODS: A retrospective review was performed on 63 patients with subglottic stenosis and 63 age-matched controls. Patient demographics and clinical characteristics were compared. Subglottic stenosis patients were further grouped according to tracheostomy status (i...
March 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#12
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27908527/-historical-review-on-obstructive-sleep-apnea-in-children
#13
Y H Chien, C Guilleminault
An historical review on the discoveries on pediatric obstructive sleep apnea syndrome and sleep-disordered breathing is outlined. Starting with the description by Dickens of "Joe" the obese, snoring and sleepy individual, the authors trace more than 50 years of questions and research starting with the lean adult to the child and from the recognition of obstructive sleep apnea syndrome to the outline of upper-airway resistance syndrome. The pathophysiological knowledge on sleep-disordered breathing has evolved over time, as have treatment approaches in children, from tracheostomy to positive-airway-pressure therapy, to adenotonsillectomy with and without orthodontic treatments to oral-facial myofunctional therapy...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27641366/temporal-trends-in-inpatient-pediatric-sleep-apnea-surgery-1993-2010
#14
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...
May 2017: Laryngoscope
https://www.readbyqxmd.com/read/27528359/caloric-requirements-of-patients-with-brain-impairment-and-cerebral-palsy-who-are-dependent-on-chronic-ventilation
#15
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
https://www.readbyqxmd.com/read/27340018/rapid-onset-obesity-with-hypothalamic-dysregulation-hypoventilation-and-autonomic-dysregulation-rohhad-syndrome-a-case-report-and-literature-review
#16
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
https://www.readbyqxmd.com/read/27228561/tracheotomy-outcomes-in-super-obese-patients
#17
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
https://www.readbyqxmd.com/read/26956162/prospective-observational-cohort-study-of-patients-with-weaning-failure-admitted-to-a-specialist-weaning-rehabilitation-and-home-mechanical-ventilation-centre
#18
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...
March 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/26672249/-applications-of-improved-micro-invasive-percutaneous-tracheostomy-in-the-obese-severe-patients-of-neurosurgery
#19
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
https://www.readbyqxmd.com/read/26235162/excessive-dynamic-airway-collapse-of-the-lower-airway-a-cause-for-persistent-sleep-disordered-breathing-after-tracheostomy
#20
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
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