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Airway management device

Jung-In Ko, Sang Ook Ha, Min Seok Koo, Miyoung Kwon, Jieun Kim, Jin Jeon, So Hee Park, Sangwoo Shim, Youjin Chang, Taejin Park
OBJECTIVE: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared. METHODS: Nine physician experts in airway management participated in this study...
December 2015: Clin Exp Emerg Med
Jonathan Kei, Donald P Mebust
BACKGROUND: It has been suggested that an adult 8.0 endotracheal tube (ETT) connected to a neonatal meconium aspirator would improve suctioning during emergent endotracheal intubation compared to the Yankauer suction instrument, the standard tool used by emergency physicians. OBJECTIVES: This study was designed to compare the effectiveness of a Yankauer vs. an ETT-meconium aspirator set-up in suctioning liquids of different viscosities. METHODS: The Yankauer and ETT-meconium aspirator device underwent a head-to-head timed comparison, suctioning 250 mL of three different fluids, varying in viscosity...
October 14, 2016: Journal of Emergency Medicine
Brooks V Udelsman, Jessica Eaton, Ashok Muniappan, Christopher R Morse, Cameron D Wright, Douglas J Mathisen
OBJECTIVE: Patients with complicated airway defects that exceed the limits of primary repair represent a challenging clinical problem and require alternative techniques for repair. The aim of this study was to evaluate bioprosthetic reconstruction of large tracheal and bronchial defects. METHODS: Retrospective chart review of patients treated at a single tertiary center from 2008 to 2015 who underwent repair of tracheal or bronchial defects with a bioprosthetic device, namely aortic homograft or acellular dermal matrix...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Mostafa Somri, Sonia Vaida, Gustavo Garcia Fornari, Gabriela Renee Mendoza, Pedro Charco-Mora, Naser Hawash, Ibrahim Matter, Forat Swaid, Luis Gaitini
BACKGROUND: The Laryngeal Tube Suction Disposable (LTS-D) and the Supreme Laryngeal Mask Airway (SLMA) are second generation supraglottic airway devices (SADs) with an added channel to allow gastric drainage. We studied the efficacy of these devices when using pressure controlled mechanical ventilation during general anesthesia for short and medium duration surgical procedures and compared the oropharyngeal seal pressure in different head and-neck positions. METHODS: Eighty patients in each group had either LTS-D or SLMA for airway management...
October 6, 2016: BMC Anesthesiology
Hoang Kim Tu Trinh, Ga-Young Ban, Ji-Ho Lee, Hae-Sim Park
Elderly asthma (EA) is regarded as a distinct phenotype of asthma and is associated with age-related changes in airway structure and alterations in lung function and immune responses. EA is difficult to diagnose because of aging and co-morbidities, and overlaps with fixed airway obstructive disease. Novel modalities to differentiate between EA and chronic obstructive pulmonary disease (COPD) are necessary. A multifaceted approach, including clinical history, smoking habits, atopy, and measurement of lung function, is mandatory to differentiate asthma from COPD...
October 6, 2016: Drugs & Aging
Jodi Taylor, Sarah Black, Stephen J Brett, Kim Kirby, Jerry P Nolan, Barnaby C Reeves, Maria Robinson, Chris A Rogers, Lauren J Scott, Adrian South, Elizabeth A Stokes, Matthew Thomas, Sarah Voss, Sarah Wordsworth, Jonathan R Benger
Health outcomes after out of hospital cardiac arrest (OHCA) are extremely poor, with only 7-9% of patients in the United Kingdom (UK) surviving to hospital discharge. Currently emergency medical services (EMS) use either tracheal intubation or newer supraglottic airway devices (SGAs) to provide advanced airway management during OHCA. Equipoise between the two techniques has led to calls for a well-designed randomised controlled trial. The primary objective of the AIRWAYS-2 trial is to assess whether the clinical effectiveness of the i-gel, a second-generation SGA, is superior to tracheal intubation in the initial airway management of OHCA patients in the UK...
September 30, 2016: Resuscitation
Andreas Moritz, Sebastian Heinrich, Andrea Irouschek, Torsten Birkholz, Johannes Prottengeier, Joachim Schmidt
BACKGROUND: Single-use plastic blades (SUPB) and single-use metal blades (SUMB) for direct laryngoscopy and tracheal intubation have not yet been compared with reusable metal blades (RUMB) in difficult airway scenarios. OBJECTIVE: The purpose of our manikin study was to compare the effectiveness of these different laryngoscope blades in a difficult airway scenario, as well as in a difficult airway scenario with simulated severe inhalation injury. METHODS: Thirty anesthetists performed tracheal intubation (TI) with each of the three laryngoscope blades in the two scenario manikins...
September 29, 2016: Journal of Emergency Medicine
Asako Watanabe, Mitsutaka Edanaga, Hiromichi Ichinose, Michiaki Yamakage
STUDY OBJECTIVES: Recently, i-Gel intubating laryngeal airway (ILA) has been frequently used because of the ease for airway insertion by residents and young anesthesiologists. However, it sometimes fails to fit or ventilate sufficiently in Japanese patients. Use of Air-Qsp, which is a new non-inflatable cuffed ILA, in a clinical setting has become possible. The purpose of this study was to compare the clinical performance of Air-Qsp with that of i-Gel for airway management in Japanese adult patients...
November 2016: Journal of Clinical Anesthesia
Fangfan Ye, Gaoyin Kong, Jia Huang
INTRODUCTION: Scleroderma is a progressive fibrotic disorder of connective tissue which can present multiple anesthetic challenges to anesthetists, especially airway management. Awake intubation with fiberoptic bronchoscope is widely accepted and implemented for progressive systematic scleroderma patients. With the development and improvement of intubation devices these years, there is no report addressing other intubation methods for sclerotic patients. CASE DESCRIPTION: A 47 year-old, 42-kg man with 1-year history of localized scleroderma was scheduled for the operation of inner fixation after 6 days of his acetabular fracture...
2016: SpringerPlus
Andrea Vianello, Valeria Bisogni, Claudia Rinaldo, Federico Gallan, Giuseppe Maiolino, Fausto Braccioni, Luca Guarda-Nardini, Beatrice Molena, Gian P Rossi, Rosario Marchese-Ragona
Affecting a large number of middle-aged, frequently overweight subjects, obstructive sleep apnea (OSA) is the most common sleep related breathing disorder. Partial or complete upper airway (UA) collapse during sleep causing repeated apneic episodes, which is the leading pathophysiological mechanism underlying the disorder, results in arterial oxygen desaturation and recurrent arousals from sleep to re-establish airway patency. Untreated OSA is commonly associated with a range of adverse consequences, including cardiovascular complications, such as arterial and/or pulmonary hypertension, arrhythmias, stroke, as well as diabetes mellitus and metabolic syndrome, and motor vehicle accidents...
December 2016: Minerva Medica
Clemens Heiser, Andreas Knopf, Murat Bas, Constanze Gahleitner, Benedikt Hofauer
Selective upper airway stimulation (UAS) is a novel therapy for patients with obstructive sleep apnea (OSA). The aim of this study was to analyze the application and outcome of UAS in patients with moderate to severe OSA in the clinical routine of a tertiary referral center. The design of this study is single-center, prospective clinical trial. Thirty-one patients who received a UAS device (Inspire Medical Systems) were included. Treatment outcome was evaluated at 2, 3, 6, and 12 months after surgery. Data collection included demographics, body mass index (BMI), apnea hypopnea index (AHI), oxygen saturation and desaturation index (ODI), Epworth Sleepiness Score (ESS), adverse events, and adherence to therapy...
September 12, 2016: European Archives of Oto-rhino-laryngology
Matthew A Warner, Hugh M Smith, Martin D Zielinski
Invasive airway access by emergent cricothyrotomy remains an essential treatment modality in "can't intubate/can't ventilate" scenarios. Although numerous commercial devices are available, limited comparative data exist with regard to the ventilation and oxygenation parameters of these devices. We report a case of severely compromised respiratory function while using the Quicktrach II, a commercially available emergency cricothyrotomy device. Because of oxygenation and ventilatory insufficiency, our patient required emergent removal of the device and surgical tracheostomy to improve respiratory function...
September 7, 2016: A & A Case Reports
Thomas Blakeman, Richard Branson, Dario Rodriquez, James Woods, Daniel Cox, Joel Elterman
BACKGROUND: Successful mechanical ventilation requires that the airway be controlled by an endotracheal tube (ETT) with an inflatable cuff to seal the airway. Aeromedical evacuation represents a unique challenge in which to manage ETT cuffs. We evaluated three methods of automatic ETT cuff pressure adjustment during changes in altitude in an altitude chamber. METHODS: Size 7.5- and 8.0-mm ETTs that are currently included in the Critical Care Air Transport Team allowance standard were used for the evaluation...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Matilde Zaballos, María Dolores Ginel, Maite Portas, María Barrio, Ana María López
BACKGROUND AND OBJECTIVES: The decision whether to manage an ambulatory patient with a previously documented difficult airway with a supraglottic device remain controversial. We report an awake insertion of a Laryngeal Mask Airway Proseal™ in a patient with known difficult airway scheduled for ambulatory surgery. CASE REPORT: A 46-yr-old woman was programmed as a day case surgery for breast nodule resection. Her anesthetic record included an impossible intubation with cancelation of surgery and subsequent awake fibroscopic intubation...
September 2016: Brazilian Journal of Anesthesiology
Fulvio Braido, Henry Chrystyn, Ilaria Baiardini, Sinthia Bosnic-Anticevich, Thys van der Molen, Ronald J Dandurand, Alison Chisholm, Victoria Carter, David Price
Inhaled therapies are the backbone of asthma and chronic obstructive pulmonary disease management, helping to target therapy at the airways. Adherence to prescribed treatment is necessary to ensure achievement of the clinician's desired therapeutic effect. In the case of inhaled therapies, this requires patients' acceptance of their need for inhaled therapy together with successful mastery of the inhaler technique specific to their device(s). This article reviews a number of challenges and barriers that inhaled mode of delivery can pose to optimum adherence-to therapy initiation and, thereafter, to successful implementation and persistence...
September 2016: Journal of Allergy and Clinical Immunology in Practice
Nicolas J Pejovic, Daniele Trevisanuto, Jolly J Nankunda, Thorkild Tylleskär
AIM: We compared the performance of personnel in a low-resource setting when they used the I-gel cuffless neonatal laryngeal mask or a face mask on a neonatal airway management manikin. METHODS: At Mulago Hospital, Uganda, 25 doctors, nurses and midwives involved in neonatal resuscitation were given brief training with the I-gel and face mask. Then, every participant was observed positioning both devices on three consecutive occasions. The success rate and insertion times leading to effective positive pressure ventilation (PPV) were recorded...
September 1, 2016: Acta Paediatrica
Ryan J Soose, M Boyd Gillespie
OBJECTIVES: Review the role of upper airway stimulation (UAS) therapy in the management of moderate to severe obstructive sleep apnea (OSA). DATA SOURCES: A literature search was performed of PubMed and Medline using the search terms clinical trial; obstructive sleep apnea; upper airway stimulation; hypoglossal stimulation; hypoglossal nerve; Inspire; and ImThera. REVIEW METHODS: All published clinical trials of currently available devices were reviewed...
September 2016: Laryngoscope
F E Ucisik-Keser, T L Chi, Y Hamid, A Dinh, E Chang, D Z Ferson
BACKGROUND: Use of general anaesthesia or deep sedation during magnetic resonance imaging (MRI) studies leads to pharyngeal muscle relaxation, often resulting in snoring and subsequent vibrations with head micromotion. Given that MRI is very susceptible to motion, this causes artifacts and image quality degradation. The purpose of our study was to determine the effectiveness of different airway management techniques in overcoming micromotion-induced MRI artifacts. METHODS: After obtaining institutional review board approval, we conducted a retrospective study on the image quality of central nervous system MRI studies in nine patients who had serial MRIs under general anaesthesia...
September 2016: British Journal of Anaesthesia
Ayten Saracoglu, Kemal T Saracoglu
STUDY OBJECTIVE: To evaluate the available data describing the use of single and double lumen VivaSight tubes. DESIGN: Systematic review. SETTING: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications. PATIENTS: Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials...
September 2016: Journal of Clinical Anesthesia
Souvik Maitra, Dalim K Baidya, Mahesh K Arora, Sulagna Bhattacharjee, Puneet Khanna
STUDY OBJECTIVE: i-gel is a single-use supraglottic airway device that has a gastric drain tube similar to laryngeal mask airway (LMA) ProSeal. Randomized trials, when compared i-gel with LMA ProSeal, reported a differing results. Primary objective of this study is to compare LMA ProSeal and i-gel in terms of oropharyngeal leak pressure. DESIGN: Meta-analysis of randomized controlled trials where i-gel has been compared to LMA ProSeal in adult airway management during general anesthesia...
September 2016: Journal of Clinical Anesthesia
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