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https://www.readbyqxmd.com/read/29027675/ultrasound-guided-percutaneous-dilatational-tracheostomies-in-2-difficult-airways
#1
José A Valencia, David J Romero, Enrique Arango, Javier E Cubillos, Hugo A Mantilla, Luis G García-Herreros
Ultrasound has become a rapid, safe, and easy-to-use tool for anesthesiologists. It reduces complications, morbidity, and mortality, especially in patients with anatomic abnormalities in whom a traditional approach may be both difficult and risky. We report 2 cases of symptomatic patients with a difficult airway due to displacement of the trachea by a neck mass. Real-time ultrasound imaging was performed for percutaneous dilatational tracheostomies, identifying important structures, without any complications...
October 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29026807/airway-management-in-pierre-robin-sequence-the-vancouver-classification
#2
Wai-Yee Li, Alana Poon, Douglas Courtemanche, Cynthia Verchere, Sandra Robertson, Marija Bucevska, Claudia Malic, Jugpal S Arneja
BACKGROUND: Pierre Robin sequence (PRS) is a triad of micrognathia, glossoptosis, and respiratory distress. There is no standard clinical classification used in the management of neonatal airway in patients with PRS. The goal of our study was to review the presentation and management of patients with PRS and formulate a clinical grading system and treatment algorithm. METHODS: A 10-year retrospective review of all neonates diagnosed with PRS was performed after obtaining institutional ethics approval...
February 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026472/clinical-features-and-antimicrobial-resistance-of-bacterial-agents-of-ventilator-associated-tracheobronchitis-in-hamedan-iran
#3
Seyyed Hamid Hashemi, Naeimeh Hashemi, Farzaneh Esna-Ashari, Abbas Taher, Arash Dehghan
OBJECTIVES: Ventilator-associated tracheobronchitis (VAT) is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs). This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. METHODS: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29025380/early-tracheostomy-reduces-time-of-mechanical-ventilation-in-respiratory-high-risk-patients-after-liver-transplant
#4
Sebastian Cammann, Kai Timrott, Florian W R Vondran, Harald Schrem, Frank Lehner, Jürgen Klempnauer, Wolfgang Knitsch, Moritz Kleine
OBJECTIVES: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. MATERIALS AND METHODS: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29021953/bilateral-lung-disease-extensive-and-diffuse-diagnosis-of-pulmonary-alveolar-proteinosis-by-bronchoscopic-cryobiopsy
#5
Sebastián Gando, Roberto Duré, Damián Violi, Bibiana Vazquez, Gonzalo Labarca, Sebastián Fernandez-Bussy
Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the intra-alveolar accumulation of a proteinaceous phospholipid-laden material called surfactant. Clinically, this disease should be suspected with respiratory failure in association with a crazy paving pattern on high-resolution chest computed tomography. We report a 24-year-old gentleman who was referred to us for a history of respiratory failure, treatment with invasive ventilation and tracheostomy. His blood exams and biochemistry were normal...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29021454/a-case-of-sudden-respiratory-failure-due-to-tracheobronchomalacia-by-relapsing-polychondritis-successfully-rescued-by-multiple-metallic-stenting-and-tracheostomy
#6
Daisuke Oryoji, Nobuyuki Ono, Daisuke Himeji, Kyoko Yoshihiro, Yasufumi Kai, Motohiro Matsuda, Hiroshi Tsukamoto, Akira Ueda
Relapsing polychondritis (RP) is a rare systemic autoimmune disease that affects cartilaginous structures. RP causes tracheobronchomalacia (TBM) by affecting the bronchial cartilage. TBM is a fatal condition characterized by excessive weakening of the walls of the trachea and bronchi. We herein report a case of a 73-year-old man who experienced sudden respiratory failure due to TBM caused by RP. Immunosuppressive treatment did not improve his respiratory failure. Multiple metallic stentings dramatically improved his severe airway symptoms...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29020869/a-review-of-four-health-procedures-that-school-nurses-may-encounter
#7
Rebecca Toothaker, Pamela Cook
The school nurse plays a vital role in providing care and meeting the health needs of students in the school setting. Students attend school with chronic conditions and complex medical problems such as quadriplegia, cerebral palsy, spina bifida, and muscular dystrophy. It is the responsibility of the school nurse to provide appropriate assessment, early intervention, and care for children in the school environment. The purpose of this article is to review and discuss the knowledge and skills the school nurse needs to care for students with central venous lines, gastrostomy tubes, altered urinary elimination, and tracheostomies...
October 1, 2017: NASN School Nurse
https://www.readbyqxmd.com/read/29019001/anaplastic-thyroid-cancer-and-hyperfractionated-accelerated-radiotherapy-hart-with-and-without-surgery
#8
Anne-Birgitte Jacobsen, Krystyna K Grøholt, Bianca Lorntzsen, Terje A Osnes, Ragnhild Sørum Falk, Eva Sigstad
Anaplastic carcinoma of the thyroid gland (ATC) is one of the most aggressive cancers in humans. With insufficient treatment, the disease most often leads to death in suffocation. From 2002, our treatment strategy has been hyperfractionated accelerated radiotherapy (HART) with high doses (64 Gy) to the neck, followed by surgery 4-8 weeks later if feasible, with the aim to gain control in the neck. After a pathology review, 51 patients were diagnosed with ATC in the period 2002-2014 in the south-east of Norway...
October 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29018503/parameters-influencing-tracheostomy-decannulation-in-patients-undergoing-rehabilitation-after-severe-acquired-brain-injury-sabi
#9
Cecilia Perin, Roberto Meroni, Vincenzo Rega, Giacomo Braghetto, Cesare Giuseppe Cerri
Introduction  Tracheostomy weaning in patients who suffered a severe acquired brain injury is often a challenge and decannulation failures are not uncommon. Objective  Our study objective is to describe the decannulation failure rate in patients undergoing rehabilitation following a severe acquired brain injury (sABI); to describe the factors associated with a successful tube weaning. Methods  We conduct a retrospective analysis of charts, consecutively retrieved considering a 3-year window. Variables analyzed were: age, sex, body mass index (BMI), Glasgow Coma Scale (GCS), cause of hospitalization (stroke, trauma, cardiac arrest), date of the pathological event, gap between the index event and the first day of hospitalization, duration of Neurorehabilitation Ward hospitalization, comorbidities, chest morphological alteration, kind of tracheostomy tube used (overall dimension, cap, fenestration), SpO2, presentation and quantification of pulmonary secretion, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), respiratory frequency and pattern, cardiac frequency, presence of spontaneous cough, cough strength, and blood gas analysis...
October 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29018502/persistent-tracheostomy-after-organ-preservation-protocol-in-patients-treated-for-larynx-and-hypopharynx-cancer
#10
Carlos Miguel Chiesa Estomba, Frank Alberto Betances Reinoso, Virginia Martinez Villasmil, Maria Jesus González Cortés, Carmelo Santidrian Hidalgo
Introduction  Squamous cell carcinoma of the larynx is currently the second most common malignancy of the airway after lung cancer, and hypopharyngeal cancer accounts for fewer than 5% of head and neck cancers. The nonsurgical options for patients with this disease are related to significant long-term toxicities and the need for persistent tracheostomy, which adversely affects the quality of life of these patients. Objective  To evaluate the need for tracheostomy, and the influence of this in the overall and specific survival rates of patients diagnosed with all stages of laryngeal carcinoma treated by chemoradiotherapy...
October 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28994202/beak-technique-use-of-modified-fuller-s-bivalve-tracheostomy-tube-for-emergency-dilation-of-tracheostomy-stenosis
#11
Rajshekhar Halkud, Sreelekha Ray, Ashok M Shenoy, Gururaj Arakeri, Peter A Brennan
Loss of an already established airway causing stridor is a common condition seen in busy oncology centres of India and other third world countries. Patients attend with acute respiratory distress, and are unable to reinsert the tracheostomy tube, sometimes days after having successfully mastered the technique. We have therefore developed a simple nonsurgical technique to widen simple tracheostomies to establish an emergency airway. In our opinion, since this is an easy non surgical procedure to perform and, can be performed rapidly without the need for any specialized types of equipment...
October 10, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28992728/use-of-ex-utero-intrapartum-treatment-procedure-in-fetal-neck-and-high-airway-anomalies-report-of-four-clinical-cases
#12
Jakub Kornacki, Jarosław Szydłowski, Jana Skrzypczak, Małgorzata Szczepańska, Marcin Rajewski, Agnieszka Koziołek, Michał Gaca, Ewa Wender-Ozegowska
We have presented four different cases of fetal neck or airway pathology which were indications for ex utero intrapartum treatment (EXIT), at our department. In three cases of fetal neck tumors, the primary precise antenatal diagnoses of tumors were confirmed after birth. The airways of all three fetuses were properly secured during EXIT by laryngologist. All these newborns survived. In the fourth case, a primary, antenatal diagnosis of congenital high airway obstruction syndrome due to severe trachea obstruction was not confirmed after birth...
October 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28990962/two-stage-technique-used-to-manage-severe-upper-airway-obstruction-and-avoid-surgical-tracheostomy-a-case-report
#13
Desire N Onwochei, Kariem El-Boghdadly, Imran Ahmad
Severe upper airway obstruction is commonly managed with surgical tracheostomy under local anesthesia. We present a 49-year-old woman with postradiotherapy laryngeal fixation and transglottic stenosis for dilation of a pharyngeal stricture who refused elective tracheostomy. A 2-stage technique was used, which involved an awake fiberoptic intubation, followed by the transtracheal insertion of a Cricath needle and ventilation using an ejector-based Ventrain device. We discuss management aspects of this clinical scenario and the principles by which the Ventrain works...
October 5, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28990261/heated-air-humidification-versus-cold-air-nebulization-in-newly-tracheostomized-patients
#14
Richard Birk, Alexander Händel, Angela Wenzel, Benedikt Kramer, Christoph Aderhold, Karl Hörmann, Boris A Stuck, J Ulrich Sommer
BACKGROUND: After tracheostomy, the airway lacks an essential mechanism for warming and humidifying the inspired air with the consequent functional impairment and discomfort. The purpose of this study was to compare airway hydration with cold-air nebulization versus heated high-flow humidification on medical interventions and tracheal ciliary beat frequency (CBF). METHODS: Newly tracheostomized patients (n = 20) were treated either with cold-air nebulization or heated humidification...
October 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28984565/risk-factors-for-and-role-of-oprd-protein-in-increasing-minimal-inhibitory-concentrations-of-carbapenems-in-clinical-isolates-of-pseudomonas-aeruginosa
#15
Aki Hirabayashi, Daizo Kato, Yuka Tomita, Mitsutaka Iguchi, Keiko Yamada, Yuichi Kouyama, Hiroshi Morioka, Nobuyuki Tetsuka, Tetsuya Yagi
PURPOSE: This study examined the risk factors for, and molecular mechanisms underlying, the increase in carbapenem minimum inhibitory concentrations (MICs) in clinical isolates of Pseudomonas aeruginosa. METHODOLOGY: Consecutive clinical isolates of P. aeruginosa were collected. The MicroScan WalkAway system detected more than fourfold increases in the MICs of carbapenems in P. aeruginosa isolates serially recovered from some patients during their clinical course...
October 6, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28984426/caregiver-knowledge-and-skills-to-safely-care-for-pediatric-tracheostomy-ventilation-at-home
#16
Reshma Amin, Chris Parshuram, Jeannie Kelso, Audrey Lim, Dimas Mateos, Ian Mitchell, Hema Patel, Madan Roy, Faiza Syed, Rita Troini, David Wensley, Louise Rose
OBJECTIVE: Caregivers of children using home mechanical ventilation (HMV) via tracheostomy require appropriate knowledge and skills. Existing training curricula are locally developed and content variable. We sought to develop a competency checklist to inform initial training and subsequent assessment of knowledge and skills of family caregivers. METHODS: We used a 2-step process. Candidate items were generated by synthesis of a scoping review, existing checklists, with additional items suggested by an eight member inter-professional group representing pediatric HMV programs across Canada...
October 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28983551/association-of-enrollment-in-an-aerodigestive-clinic-with-reduced-hospital-stay-for-children-with-special-health-care-needs
#17
Swathi Appachi, Anne Banas, Lisa Feinberg, Douglas Henry, Diane Kenny, Nathan Kraynack, Amy Rosneck, John Carl, Paul Krakovitz
Importance: Children with special health care needs (CSHCN) have disproportionate health care utilization. Previous studies have demonstrated that a primary medical home improves health care outcomes for this population. Objective: To elucidate if enrollment in a multidisciplinary aerodigestive clinic improves outcomes and reduces health care costs by decreasing admissions and inpatient days. Design, Setting, and Participants: A retrospective medical record review of 113 patients with aerodigestive disorders enrolled in a pediatric multidisciplinary clinic from June 2009 to December 2013 was performed...
October 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28982549/achieving-a-3-star-society-of-thoracic-surgery-lobectomy-ranking-by-using-continuing-process-improvement-lean-methodology-and-root-cause-analysis
#18
Robert J Cerfolio, Douglas J Minnich, Benjamin Wei, Caroline Watson, Malcolm M DeCamp
Our purpose is to identify the metrics used by the Society of Thoracic Surgeons (STS) to rank lobectomy and to show our process to improve. This is a review of our STS data for lobectomy and our results using the process of root cause analysis and lean methodology to improve our outcomes. The STS metrics are 30-day mortality, pneumonia, adult respiratory distress syndrome, bronchopleural fistula, pulmonary embolus, initial ventilator support greater than 48 hours, reintubation and respiratory failure, tracheostomy, myocardial infarction, or unexpected return to the operating room...
August 18, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28982219/mechanical-ventilation-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#19
REVIEW
Aleksandar Radunovic, Djillali Annane, Muhammad K Rafiq, Ruth Brassington, Naveed Mustfa
BACKGROUND: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, is a fatal neurodegenerative disease. Neuromuscular respiratory failure is the most common cause of death, which usually occurs within two to five years of the disease onset. Supporting respiratory function with mechanical ventilation may improve survival and quality of life. This is the second update of a review first published in 2009. OBJECTIVES: To assess the effects of mechanical ventilation (tracheostomy-assisted ventilation and non-invasive ventilation (NIV)) on survival, functional measures of disease progression, and quality of life in ALS, and to evaluate adverse events related to the intervention...
October 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28980589/-the-iatrogenic-complications-of-tracheostomy
#20
E A Kirasirova, E A Kuzina, N V Lafutkina, O K Piminidi, R F Mamedov, R A Rezakov
The objective of the present study was to analyze the complications of tracheostomy associated with bleeding from the brachiocephalic trunk. A total of 13 protocols of the autopsy study of the patients who had died in the intensive care unit were available for the analysis. These patients had experienced heavy external bleeding from the tracheostomy defect shortly before death. The study has demonstrated that all the victims had the tracheostomy hole localized below the level of the standard dissection of the tracheal rings...
2017: Vestnik Otorinolaringologii
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