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https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#1
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28229065/foreign-body-aspiration-in-adults-two-unusual-foreign-bodies-knife-and-tube-tracheostomy
#2
Seyed Mozafar Hashemi, Mohsen Kolahdouzan, Shahab Shahabi, Hamid Talebzadeh, Mohammad Taghi Rezaei
INTRODUCTION: Foreign body aspiration is usually a serious condition that is most common among the pediatric population, and rare in adults. In adults, aspiration may be tolerated for a long time. CASE REPORTS: Our first case is a 38-year-old man who presented with a 2-day history of swallowing a foreign body. He was completely asymptomatic. Chest X-ray revealed the presence of 5-cm foreign object in the right main bronchus. Rigid bronchoscopy was performed and a knife was removed from the right main bronchus...
January 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28228052/inhalation-therapy-in-patients-with-tracheostomy-a-guide-to-clinicians
#3
Arzu Ari, James B Fink
Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation therapy because of the many factors affecting aerosol therapy to this patient population, and the lack of literature providing guidance in this area of research. Areas covered: The purpose of this paper is to describe the factors affecting aerosol drug delivery to patients with tracheostomy and to explain how to optimize inhalation therapy through device selection, interface selection and delivery technique in this patient population...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28225467/comparison-of-anesthetic-management-and-outcomes-in-patients-having-either-transnasal-or-transoral-endoscopic-odontoid-process-surgery
#4
Matthew A Sexton, Arnoley S Abcejo, Jeffrey J Pasternak
BACKGROUND: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. METHODS: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively)...
February 20, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#5
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28217183/affection-of-the-respiratory-muscles-in-combined-complex-i-and-iv-deficiency
#6
Josef Finsterer, Helmut Rauschka, Liane Segal, Gabor G Kovacs, Boris Rolinski
OBJECTIVES: Combined complex I+IV deficiency has rarely been reported to manifest with the involvement of the respiratory muscles. CASE REPORT: A 45y male was admitted for hypercapnia due to muscular respiratory insufficiency. He required intubation and mechanical ventilation. He had a previous history of ophthalmoparesis since age 6y, ptosis since age 23y, and anterocollis since at least age 40y. Muscle biopsy from the right deltoid muscle at age 41y was indicative of mitochondrial myopathy...
2017: Open Neurology Journal
https://www.readbyqxmd.com/read/28217079/suction-catheter-as-a-crucial-rescuer-in-lost-tracheostomy-tract-situation-during-percutaneous-tracheostomy
#7
Ankur Khandelwal, Ashutosh Kaushal, Gyaninder Pal Singh, Surya Kumar Dube
No abstract text is available yet for this article.
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28217065/unsuspected-subglottic-web-in-a-child-managed-for-severe-respiratory-obstruction
#8
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28208859/diphtheroids-important-nosocomial-pathogens
#9
Reshmi Chandran, Dinju Raj Puthukkichal, Ethel Suman, Shashidhar Kotian Mangalore
INTRODUCTION: Diphtheroids are defined as aerobic, non-sporulating, pleomorphic Gram-positive bacilli which are more uniformly stained than Corynebacterium diphtheriae, lack the metachromatic granules and are arranged in a palisade manner. They are usually commensals of the skin and mucous membranes. They differ from C.diphtheriae in biochemical rea-ctions as well as in toxin production. Since, they are usually found as commensals on the skin, they are often considered as mere contaminants when isolated from clinical samples...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203439/evolutional-trends-in-the-management-of-tracheal-and-bronchial-injuries
#10
REVIEW
Brendan Patrick Madden
Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28199137/patient-and-hospital-characteristics-associated-with-inter-hospital-transfer-for-adults-with-ventilator-dependent-respiratory-failure
#11
Nandita R Nadig, Andrew J Goodwin, Annie N Simpson, Kit N Simpson, Jeremy Richards, Dee W Ford
RATIONALE: Patients with ventilator-dependent respiratory failure have improved outcomes at centers with greater expertise, yet most patients are not treated in such facilities. Efforts to align care for respiratory failure and hospital capability would necessarily require inter-hospital transfer. OBJECTIVES: To characterize the prevalence and patient and hospital factors associated with inter-hospital transfer of adults residing in Florida with ventilator-dependent respiratory failure...
February 15, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28197044/the-impact-of-early-tracheostomy-in-neurotrauma-patients-a-retrospective-study
#12
Kapil G Zirpe, Deepali Vishnu Tambe, Abhijit M Deshmukh, Sushma K Gurav
BACKGROUND: Although majority of neurotrauma patients require long term ventilatory support but the timing of tracheostomy in such patients is controversial. METHOD: This retrospective study was conducted at a Tertiary Care Hospital, Pune, India. Patients >18 years of age, who underwent percutaneous tracheostomy (PCT) from June 2010 to November 2014 at neurotrauma unit (NTU) of hospital, were included. Patients were divided in two groups according to the timing of tracheostomy, early tracheostomy (ET) group (≤5 days; N=100) and late tracheostomy (LT) group (>5 days; N=64)...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28195000/prevention-of-tracheostomy-related-hospital-acquired-pressure-ulcers
#13
Thomas R O'Toole, Natalie Jacobs, Brian Hondorp, Laura Crawford, Lisa R Boudreau, Jill Jeffe, Brian Stein, Phillip LoSavio
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28190872/upper-airway-obstruction-requiring-emergent-tracheostomy-secondary-to-laryngeal-sarcoidosis-a-case-report
#14
Changwan Ryu, Erica L Herzog, Hongyi Pan, Robert Homer, Mridu Gulati
BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea...
February 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28188061/evidence-based-guides-in-tracheostomy-use-in-critical-patients
#15
N Raimondi, M R Vial, J Calleja, A Quintero, A Cortés Alban, E Celis, C Pacheco, S Ugarte, J M Añón, G Hernández, E Vidal, G Chiappero, F Ríos, F Castilleja, A Matos, E Rodriguez, P Antoniazzi, J M Teles, C Dueñas, J Sinclair, L Martínez, I Von der Osten, J Vergara, E Jiménez, M Arroyo, C Rodriguez, J Torres, S Fernandez-Bussy, J L Nates
OBJECTIVES: Provide evidence based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A task force composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28187797/airway-management-and-mechanical-ventilation-in-acute-brain-injury
#16
D B Seder, J Bösel
Patients with acute neurologic disease often develop respiratory failure, the management of which profoundly affects brain physiology and long-term functional outcomes. This chapter reviews airway management and mechanical ventilation of patients with acute brain injury, offering practical strategies to optimize treatment of respiratory failure and minimize secondary brain injury. Specific concerns that are addressed include physiologic changes during intubation and ventilation such as the effects on intracranial pressure and brain perfusion; cervical spine management during endotracheal intubation; the role of tracheostomy; and how ventilation and oxygenation are utilized to minimize ischemia-reperfusion injury and cerebral metabolic distress...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28185629/the-role-of-adjunctive-procedures-in-reducing-postoperative-tracheobronchial-obstruction-in-single-lung-patients-with-congenital-tracheal-stenosis-undergoing-slide-tracheoplasty
#17
Akiko Yokoi, Yoshihiro Oshima, Eiji Nishijima
PURPOSE: Congenital tracheal stenosis (CTS) and a single right lung treated with slide tracheoplasty (ST) has relatively high rates of mortality and morbidity. We report a single institution's experience with adjunctive procedures at the time of ST to reduce postoperative tracheal obstruction in patients with a single right lung and CTS. METHODS: With IRB approval, 8 patients with a single right lung and CTS who underwent ST in our institution between 2008 and 2016 were reviewed...
January 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28181997/inter-center-variation-in-death-or-tracheostomy-placement-in-infants-with-severe-bronchopulmonary-dysplasia
#18
K Murthy, N F M Porta, J M Lagatta, I Zaniletti, W E Truog, T R Grover, L D Nelin, R C Savani
OBJECTIVE: To estimate the presence and sources of inter-center variation (ICV) in the risk of death or tracheostomy placement (D/T) among infants with severe bronchopulmonary dysplasia (sBPD)Study design:We analyzed the Children's Hospitals Neonatal Database between 2010 and 2013 to identify referred infants born <32 weeks' gestation with sBPD. The association between center and the primary outcome of D/T was analyzed by multivariable modeling. Hypothesized diagnoses/practices were included to determine if these explained any observed ICV in D/T...
February 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28181947/fiberoptic-guided-blue-rhino-dilator-assisted-dilation-of-postintubation-tracheal-stenosis-a-case-report-about-a-novel-technique
#19
Nishkarsh Gupta, Prasant Sahoo, Karan Madan, Sachidanand Jee Bharti
Posttracheostomy tracheal stenosis is a rare complication of prolonged tracheal intubation. Treatment modalities that may be used include surgical resection and anastomosis, endoscopic tracheal dilation, laser resection, and tracheal stenting. We describe a novel salvage modality for dilation of a symptomatic tracheal stenosis using a percutaneous tracheostomy dilator wherein rigid bronchoscopic dilation was not feasible and balloon tracheal dilation had failed.
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28181294/adverse-outcomes-associated-with-postoperative-atrial-arrhythmias-after-lung-transplantation-a-meta-analysis-and-systematic-review-of-the-literature
#20
REVIEW
Nathan H Waldron, Rebecca Y Klinger, Matthew G Hartwig, Laurie D Snyder, James P Daubert, Joseph P Mathew
BACKGROUND: Postoperative atrial arrhythmias (AAs) are common after lung transplantation but studies are mixed regarding their impact on outcomes. We therefore performed this systematic review and meta-analysis to determine whether AAs after lung transplantation impede postoperative recovery. METHODS: MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched to identify studies comparing outcomes in adult patients undergoing lung transplantation who experienced postoperative AAs in the immediate postoperative period versus those without postoperative AAs...
February 9, 2017: Clinical Transplantation
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