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https://www.readbyqxmd.com/read/29049672/high-mortality-in-patients-with-tracheoarterial-fistulas-clinical-experience-and-treatment-recommendations
#1
Brigitte Reger, Reiner Neu, Hans-Stefan Hofmann, Michael Ried
OBJECTIVES: A tracheoarterial fistula (TAF) is an uncommon but a critical complication of tracheostomy and represents a surgical emergency. Surgical therapy with ligation of the brachiocephalic trunk can be considered as the first choice of treatment to control massive and life-threatening haemorrhage. METHODS: We describe 3 cases of TAF in patients who had long-term placement of a tracheostomy tube and the occurrence of a severe massive haemorrhage caused by an injured brachiocephalic trunk...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29044795/ahns-series-do-you-know-your-guidelines-perioperative-antithrombotic-management-in-head-and-neck-surgery
#2
Annika Meyer, Neil Gross, Marita Teng
Head and neck surgeons are commonly faced with surgical patients who have underlying medical problems requiring antithrombotic therapy. It is difficult to achieve a balance between minimizing the risk of thromboembolism and hemorrhage in the perioperative period. Data from randomized, controlled trials are limited, and procedure-specific bleed rates are also difficult to pinpoint. The decision is made more difficult when patients with moderate-to-high risk for thromboembolic events undergo procedures that are high risk for bleeding...
October 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/28956075/-polytrauma-following-a-truck-accident-how-to-save-lives-by-guideline-oriented-emergency-care
#3
M Kippnich, Y Jelting, C Markus, M Kredel, T Wurmb, P Kranke
BACKGROUND: Identification and immediate treatment of life-threatening conditions is fundamental in patients with multiple trauma. In this context, the S3 guidelines on polytrauma and the S1 guidelines on emergency anesthesia provide the scientific background on how to handle these situations. CASE STUDY: This case report deals with a seriously injured driver involved in a truck accident. The inaccessible patient showed a scalping injury of the facial skeleton with massive bleeding and partially blocked airway but with spontaneous breathing as well as centralized cardiovascular circulation conditions and an initial Glasgow coma scale (GCS) of 8...
September 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28936963/-application-of-self-made-guidance-for-difficult-gastric-tube-placement-in-patients-with-artificial-airway
#4
Xiaojie Chen, Jinchao Zhang, Wenxiu Li, Yiqing Jiang, Lingzhi Lin
OBJECTIVE: To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway. METHODS: Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28930978/influenza-a-virus-studies-in-a-mouse-model-of-infection
#5
Laura Rodriguez, Aitor Nogales, Luis Martínez-Sobrido
Influenza viruses cause over 500,000 deaths worldwide(1) and are associated with an annual cost of 12 - 14 billion USD in the United States alone considering direct medical and hospitalization expenses and work absenteeism(2). Animal models are crucial in Influenza A virus (IAV) studies to evaluate viral pathogenesis, host-pathogen interactions, immune responses, and the efficacy of current and/or novel vaccine approaches as well as antivirals. Mice are an advantageous small animal model because their immune system is evolutionarily similar to that found in humans, they are available from commercial vendors as genetically identical subjects, there are multiple strains that can be exploited to evaluate the genetic basis of infections, and they are relatively inexpensive and easy to manipulate...
September 7, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28921537/nasotracheal-intubation-over-a-bougie-vs-non-bougie-intubation-a-prospective-randomised-controlled-trial-in-older-children-and-adults-using-videolaryngoscopy
#6
R O Abrons, M B Zimmerman, Y M S El-Hattab
Conventionally, nasotracheal intubation has consisted of blind nasal passage and external manipulation of the tube through the glottis ('conventional technique'), a technique associated with a high incidence of nasal trauma. We evaluated a novel technique for routine asleep (i.e. post-induction) nasotracheal intubation using a bougie ('bougie technique'), which uses a nasopharyngeal airway to guide a paediatric bougie nasotracheally for use as a Seldinger tracheal intubation guide. Two hundred and fifty-seven older children (> 8 years) and adults were randomly assigned to videolaryngoscopy-assisted nasotracheal intubation using either the conventional or the bougie technique...
September 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28913708/emergency-neurological-life-support-intracerebral-hemorrhage
#7
J Claude Hemphill, Arthur Lam
Intracerebral hemorrhage (ICH) is a subset of stroke due to spontaneous bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, proper diagnosis, and early management of several specific issues such as blood pressure, coagulopathy reversal, and surgical hematoma evacuation for appropriate patients. ICH was chosen as an Emergency Neurological Life Support (ENLS) protocol because intervention within the first hours may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28891836/feasibility-and-safety-of-flexible-bronchoscopy-performed-via-tracheal-tubes-in-patients-with-tracheostomies-a-retrospective-single-center-experience
#8
Gustavo Ferrer, Chi Chan Lee, Sameer Shaharyar, Osman Perez, Molly Moor, Frank Gomez, Fanny Tse, Hamid Feiz, Mauricio Danckers
BACKGROUND: Flexible bronchoscopy (FB) is commonly performed to assess, diagnose, and treat patients with respiratory disease, and is typically performed via transnasal or transoral approaches. FB can be performed via tracheal tubes in patients with tracheostomies; however, the safety and technical feasibility has not been established. The present study evaluates the safety and feasibility of performing FB via tracheal tubes. MATERIALS AND METHODS: A total of 45 patients underwent 56 procedures involving FB via tracheal tubes at a single institution from November 2013 to November 2014 and were included in this retrospective case series...
October 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28886353/initial-manifestation-of-acquired-hemophilia-a-after-a-routine-tooth-extraction-a-case-report-and-literature-review
#9
Nicholas A Bennetts, James E Mergelmeyer, Eric J Reimer, James C Melville
Although surgical treatment of patients on anticoagulation regimens is common practice among oral and maxillofacial surgeons, unexpected and unknown coagulopathies can have devastating and catastrophic consequences for the most routine of procedures. Acquired hemophilia A (AHA) is an extremely rare life-threatening bleeding disorder characterized by autoantibodies directed against circulating coagulation factor VIII. The effects of AHA can produce catastrophic bleeding and hematomas. The effect of this uncontrolled hemorrhage after dentoalveolar surgery can mimic severe head and neck infection by causing dysphagia, odynophagia, and acute airway complications...
August 12, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28877919/high-lipoprotein-a-and-low-risk-of-major-bleeding-in-brain-and-airways-in-the-general-population-a-mendelian-randomization-study
#10
Anne Langsted, Pia R Kamstrup, Børge G Nordestgaard
BACKGROUND: The physiological role of lipoprotein(a) is unclear; however, lipoprotein(a) may play a role in hemostasis and wound healing. We tested the hypothesis that high lipoprotein(a) concentrations are associated with low risk of major bleeding in the brain and airways both observationally and causally (from human genetics). METHODS: We examined 109169 individuals from the Copenhagen City Heart Study and the Copenhagen General Population study, 2 similar prospective studies conducted in the Danish general population...
September 6, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28851683/delayed-extrusion-of-embolic-coils-into-the-airway-after-embolization-of-an-external-carotid-artery-pseudoaneurysm
#11
Zachary Wilseck, Luis Savastano, Neeraj Chaudhary, Aditya S Pandey, Julius Griauzde, Sumanna Sankaran, D Andrew Wilkinson, Joseph J Gemmete
Carotid blowout syndrome (CBS) is a known devastating complication of head and neck surgery. The risk of developing CBS increases in the setting of radiation therapy, wound breakdown, or tumor recurrence. Traditionally, the treatment of choice for CBS is surgical ligation of the bleeding artery; however, recently, endovascular occlusion has become a more common option. If a pseudoaneurysm is present, treatment consists of trapping with endovascular coils or occlusion with a liquid embolic agent. Delayed migration of embolization coils into the airway causing acute respiratory distress is a rare occurrence...
August 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28832913/first-aid-training-in-school-amount-content-and-hindrances
#12
H K Bakke, H K Bakke, R Schwebs
BACKGROUND: To increase knowledge and competence about first aid in the population, first-aid instruction is included in primary and secondary school curricula. This study aimed to establish how much time is spent on first-aid training, which first-aid measures are taught, and which factors prevent teachers from providing the quantity and quality of first-aid training that they wish to give. METHODS: A questionnaire was distributed to teachers in physical education in primary and secondary schools and to teachers in vocational subjects in higher secondary schools...
August 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28782106/sirolimus-as-treatment-for-19-patients-with-refractory-cervicofacial-lymphatic-malformation
#13
Julie E Strychowsky, Reza Rahbar, Meghan J O'Hare, Alexandria L Irace, Horacio Padua, Cameron C Trenor
OBJECTIVE: Lymphatic malformations (LMs) are challenging to manage, particularly those involving the cervicofacial region and airway. Traditional therapy is sclerotherapy and/or resection. We aim to establish the emerging therapeutic role of sirolimus. STUDY DESIGN: Institutional review board-approved retrospective review. METHODS: All patients treated for cervicofacial LM with sirolimus at Boston Children's Hospital, Massachusetts, from November 2012 to October 2016 were included...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28781841/perioperative-airway-management-of-a-16-year-old-boy-with-progressive-airway-obstruction-due-to-juvenile-nasopharyngeal-angiofibroma
#14
Kei Kamiyama, Maiko Satomoto, Kotaro Minami, Yukiko Baba, Koshi Makita
Juvenile nasopharyngeal angiofibroma (JNA) involves difficult anesthetic management because of the risk of massive bleeding, while airway management is rarely a problem in JNA. This report presents an unusual case of JNA causing airway obstruction.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28775102/life-threatening-airway-bleeding-after-palliation-of-single-ventricle-congenital-heart-disease
#15
Konstantin Averin, Jonathan W Byrnes, Dan T Benscoter, Wendy Whiteside, Holly DeSena, Russel Hirsch, Bryan H Goldstein
OBJECTIVE: To describe acute and mid-term outcomes following presentation with, and treatment for, life-threatening airway bleeding (hemoptysis) in palliated single ventricle congenital heart disease (SV-CHD). METHODS: Case series of patients with SV-CHD who presented to a large congenital heart centre with hemoptysis between 2004 and 2015. RESULTS: Twenty-one episodes of hemoptysis occurred in 12 patients (58% female, median 10.5 (IQR 7.2, 16...
August 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28765758/clinical-benefits-of-deep-sedation-with-a-supraglottic-airway-while-monitoring-the-bispectral-index-during-catheter-ablation-of-atrial-fibrillation
#16
Satoru Hida, Masao Takemoto, Akihiro Masumoto, Takahiro Mito, Kazuhiro Nagaoka, Hiroshi Kumeda, Yuki Kawano, Ryota Aoki, Honsa Kang, Atsushi Tanaka, Atsutoshi Matsuo, Kiyoshi Hironaga, Teiji Okazaki, Kiyonobu Yoshitake, Kei-Ichiro Tayama, Ken-Ichi Kosuga
BACKGROUND: Pulmonary vein antrum isolation (PVAI) under sedation has proven to be a useful strategy for catheter ablation of atrial fibrillation (AF). METHODS: To evaluate the clinical benefits of respiratory management using supraglottic airways (SGAs) under deep sedation while monitoring the bispectral (BIS) index during the PVAI and the durations from admission to the catheterization room to starting the radiofrequency energy delivery (Time α), and from starting the radiofrequency energy delivery to completion of the PVAI (Time β), X-ray time, frequency of dislocations of the three-dimensional maps (D3DM), procedure-related complications, and proportion of an AF-free rate 15 months after the PVAI (PAFFR) in patients who received deep sedation without SGAs (Group A: n=48) and those with SGAs (Group B: n=51) were evaluated...
August 2017: Journal of Arrhythmia
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
#17
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/28732541/endobronchial-embolization-for-life-threatening-hemoptysis-with-endobronchial-watanabe-spigot
#18
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/28714226/extranasopharyngeal-angiofibroma-revisited
#19
Jochen P Windfuhr, Julia Vent
BACKGROUND: Angiofibromas in the head and neck region usually arise in the nasopharynx, but may also occur elsewhere. This study aims at evaluating the incidence and clinical features of extranasopharyngeal angiofibroma (ENA). MATERIAL AND METHODS: Systematic review of the literature (Medline(®) and Google(™) ) up to December 31(st) , 2015. RESULTS: 174 cases of ENA were retrieved from a total of 170 publications. In contrast to former publications and previous understanding, the nasal septum was by far the most common site of the disease...
July 17, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28695576/mechanical-ventilation-and-extracorporeal-membrane-oxygenation-as-a-bridging-strategy-to-lung-transplantation-significant-gains-in-survival
#20
A J Hayanga, A L Du, K Joubert, M Tuft, R Baird, J Pilewski, M Morrell, J D'Cunha, N Shigemura
Mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) are increasingly used to bridge patients to lung transplantation. We investigated the impact of using MV, with or without ECMO, before lung transplantation on survival after transplantation by performing a retrospective analysis of 826 patients who underwent transplantation at our high-volume center. Recipient characteristics and posttransplant outcomes were analyzed. Most lung transplant recipients (729 patients) did not require bridging; 194 of these patients were propensity matched with patients who were bridged using MV alone (48 patients) or MV and ECMO (49 patients)...
July 11, 2017: American Journal of Transplantation
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