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Tracheostomi

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https://www.readbyqxmd.com/read/29244167/tracheal-surgery-in-children-outcome-of-a-12-year-survey
#1
Luigi Arcieri, Vitali Pak, Vincenzo Poli, Roberto Baggi, Paola Serio, Nadia Assanta, Riccardo Moschetti, Bruno Noccioli, Salvatore De Masi, Lorenzo Mirabile, Bruno Murzi
OBJECTIVES: Despite the fact that team management has improved the results in recent years, perioperative deaths and complications remain high in paediatric tracheal surgery. We reviewed our institutional experience by comparing our results with those in the literature. METHODS: Between 2005 and 2017, 30 children underwent surgery for tracheal disease. Fifteen were boys and fifteen were girls (50% vs 50%). The median age at operation was 7 months (15 days-9...
December 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29238992/an-innovative-solution-for-t-tube-obstruction-the-tracheostomy-customized-stent-combination
#2
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rasika Rao, Ritesh Agarwal
The Montgomery T-tube (MTT) is a useful tool for post-tracheostomy tracheal stenosis. However, MTTs can get blocked. We present a case series of life-threatening MTT blockage, wherein a split-function option was implemented, which was a customized silicone Dumon stent above the tracheostomy to maintain both airway and phonation. This tracheostomy-customized stent combination serves the same function as an MTT, with a greater margin of safety due to the easy suctioning capacity of the tracheostomy. With a fenestrated tracheostomy and stent above, speech is effectively preserved...
December 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29238683/flexible-laryngoscopy-in-management-of-congenital-stridor
#3
Prasanna Kumar Saravanam, Vinoth Manimaran
The incidence of congenital stridor is on rise due to improved neonate and infant survival rate. The gold standard investigation for evaluation of stridor is rigid laryngotracheobronchoscopy, but this is invasive and requires general anesthesia. Flexible fibreoptic laryngoscopy, a relatively simple and less invasive procedure can be done under topical anaesthesia for evaluation of stridor. In this study, we have presented our experience of flexible laryngoscopy in children with congenital stridor, their results and management...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29237917/influence-of-risk-factors-on-stomal-recurrence-after-total-laryngectomy-for-laryngeal-carcinomas-a-meta-analysis
#4
Zhi-Yi Wang, Ze-Qin Li, Han Ji, Wei Chen, Kun-Min Wu, Min-Hui Zhu, Hong-Liang Zheng
BACKGROUND: Total laryngectomy is preserved for those the most advanced larynx cancer and nonsurgical cases. However, stomal recurrence is frequently occurred and leads to high mortality. Herein, we aimed to determine the risk factors for the stomal recurrence after total laryngectomy (SRAL). METHODS: Databases such as PubMed and EMBASE were comprehensively searched using the keywords "stomal recurrence" and "total laryngectomy." Based on the inclusion and exclusion criteria, qualified studies would be incorporated in this meta-analysis, followed by quality evaluation and data extraction...
2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#5
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29236845/comparison-between-conventional-protective-mechanical-ventilation-and-high-frequency-oscillatory-ventilation-associated-with-the-prone-position
#6
José Roberto Fioretto, Susiane Oliveira Klefens, Rafaelle Fernandes Pires, Cilmery Suemi Kurokawa, Mario Ferreira Carpi, Rossano César Bonatto, Marcos Aurélio Moraes, Carlos Fernando Ronchi
OBJECTIVE: To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. METHODS: Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15)...
December 7, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29232299/the-axillary-intra-aortic-balloon-pump-as-a-bridge-to-recovery-allows-early-ambulation-in-long-term-use-case-series-and-literature-review
#7
Nnamdi Nwaejike, Andre Y Son, Chetan B Patel, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29230133/invasive-insular-thyroid-carcinoma-presenting-as-nonparalytic-dysphonia
#8
Blake S Raggio, Blair M Barton, Maria C Grant, Judith A Fornadley, Jeffrey P Marino
Background: Patients with suspected thyroid malignancy often undergo preoperative laryngeal examination with a focus on vocal fold mobility. We present the unique case of a patient with invasive thyroid carcinoma who presented with dysphonia despite intact vocal fold motion. Case Report: A 73-year-old female with a remote thyroid lobectomy presented with dysphonia. Thyroid ultrasound and fine-needle aspiration revealed a 1.1-cm nodule consistent with a colloid cyst...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29229347/post-operative-stridor-and-acute-respiratory-failure-after-parkinson-s-disease-deep-brain-stimulator-placement-a-case-report-and-review-of-literature
#9
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson's disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech.. Acute upper airway obstruction is a very rare finding in PD, especially in the perioperative settings...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29227367/practice-patterns-and-outcomes-associated-with-early-sedation-depth-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#10
Robert J Stephens, Matthew R Dettmer, Brian W Roberts, Enyo Ablordeppey, Susan A Fowler, Marin H Kollef, Brian M Fuller
OBJECTIVES: Emerging data suggest that early deep sedation may negatively impact clinical outcomes. This systematic review and meta-analysis defines and quantifies the impact of deep sedation within 48 hours of initiation of mechanical ventilation, as described in the world's literature. The primary outcome was mortality. Secondary outcomes included hospital and ICU lengths of stay, mechanical ventilation duration, and delirium and tracheostomy frequency. DATA SOURCES: The following data sources were searched: MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews and Effects, Cochrane Database of Systematic Reviews databases, ClinicalTrials...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29225749/humble-foley-s-catheter-to-the-rescue-in-a-case-of-t-tube-insertion-a-case-report
#11
Upasana Goswami, Praneet Singh
The Montgomery T-tube poses a challenge to anesthesiologists because of loss of anesthetic gases through the open proximal end of the vertical limb and lack of standard anesthesia circuit connectors. Here, we present a case of a 25-year-old woman with a reported history of accidental strangulation 18 months previously. The patient had a metallic tracheostomy tube in situ due to the development of tracheal stenosis. Computed tomography showed significant narrowing in a 7-8-mm segment, 2 cm proximal to the tracheostomy tube in situ...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29225012/comparison-of-3-techniques-in-percutaneous-tracheostomy-traditional-landmark-technique-ultrasonography-guided-long-axis-approach-and-short-axis-approach-randomised-controlled-study
#12
Kupeli Ilke, Nalbant Aysenur
INTRODUCTION: The aim of this study is to compare the reliabilities of traditional landmark method, ultrasonography-guided long-axis in-plane application, and ultrasonography-guided short-axis out-of-plane application in percutaneous dilatational tracheostomy. PATIENTS AND METHODS: A total of 60 patients were divided in 3 random groups undergoing percutaneous tracheostomy by using landmark method, ultrasonography-guided out-of-plane method, and ultrasonography-guided in-plane method...
December 7, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#13
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224771/revision-repair-of-type-iv-laryngotracheoesophageal-cleft-using-multiple-long-tapered-engaging-grafts
#14
Evan J Propst
An 8 year-old female with esophageal atresia and a type IV laryngotracheoesophageal cleft underwent tracheostomy, gastric pull-up and fundoplication with G-tube insertion at birth. She remained nil per os due to aspiration. The trachealis was separated from the esophagus that was reapproximated and clavicular periosteum was placed. A long posterior costal cartilage graft that engaged behind the cricoid plate and tapered inferiorly was inserted. A second thin cartilage graft was sutured to it distally to extend the length of the repair...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29224749/supraglottoplasty-for-laryngomalacia-the-experience-from-concepcion-chile
#15
Sahba Sedaghat, Felipe Fredes, Mario Tapia
OBJECTIVE: To review the clinical manifestations and outcomes of supraglottoplasty in patients with moderate to severe laryngomalacia at Guillermo Grant Benavente Hospital between January 2015 and January 2017. METHODS: Retrospective study of patients with laryngomalacia who underwent CO2 laser supraglottoplasty at a tertiary referral center. A review of medical records of these patients was performed. Epidemiological data along with symptoms, comorbidities, morphological type of laryngomalacia, synchronous airway lesions, surgery outcomes and satisfaction of parents after the procedure were recorded...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29223743/early-vs-late-tracheostomy-in-intensive-care-settings-impact-on-icu-and-hospital-costs
#16
Brent Herritt, Dipayan Chaudhuri, Kednapa Thavorn, Dalibor Kubelik, Kwadwo Kyeremanteng
INTRODUCTION: Up to 12% of the 800,000 patients who undergo mechanical ventilation in the United States every year require tracheostomies. A recent systematic review showed that early tracheostomy was associated with better outcomes: more ventilator-free days, shorter ICU stays, less sedation and reduced long-term mortality. However, the financial impact of early tracheostomies remain unknown. OBJECTIVES: To conduct a cost-analysis on the timing of tracheostomy in mechanically ventilated patients...
December 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29223064/patient-characteristics-incidence-technique-outcomes-and-early-prediction-of-tracheostomy-in-the-state-of-victoria-australia
#17
Andrew Casamento, Michael Bailey, Ray Robbins, David Pilcher, Stephen Warrillow, Angaj Ghosh, Rinaldo Bellomo
BACKGROUND: Tracheostomy is a relatively common procedure in Intensive Care Unit (ICU) patients. AIMS: To study the patient characteristics, incidence, technique, outcomes and prediction of tracheostomy in the State of Victoria, Australia. METHODS: We used data from the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD) and the Victorian Admitted Episode Dataset (VAED) to identify and match patients who had received a tracheostomy from 2004 to 2014...
December 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment%C3%A2-relational-potential-revisited
#18
Aaron Wightman, Jennifer Cobelli Kett, Benjamin Wilfond
One of the most challenging situations for pediatric clinicians is responding to parental requests for life-sustaining medical therapies for a child with profound neurodevelopmental disabilities. These therapies (e.g. intravenous medications and fluids, gastrostomy tube feeds, dialysis, tracheostomy, and/or mechanical ventilation) offer the possibility for the child to live, at home or in a facility, for months or years as opposed to experiencing their imminent death. While relatively rare, the tension surrounding these requests can be exceptionally high, as illustrated by the cases of Baby K, Baby Joseph, Jahi McMath, Charlie Gard, and many others from our own experience...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29218130/neonatal-stridor-in-familial-congenital-laryngeal-paralysis-plott-syndrome-%C3%A2-a-case-study-in-an-omani-family
#19
Emad Sadek Shatla, Gowda Parameshwara Prashanth, Rodney Aguiar, Ganji Shivalingam, Adeel Ahmed Al Haq
Stridor presenting soon after birth due to bilateral abductor vocal cord paralysis (VCP) is rare. We report a family with bilateral VCP affecting four male members in two generations and hence suggesting X-linked recessive inheritance. Severe stridor in the neonatal period requires meticulous airway evaluation, and tracheostomy in 35-70% cases. The current trend is towards conservative management and tracheostomy is avoided unless respiratory distress is severe or life-threatening. Neonatal VCP can be an isolated finding, or it can be familial with or without syndromic features...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29217087/evolution-of-simplified-frozen-elephant-trunk-repair-for-acute-debakey-type-i-dissection-midterm-outcomes
#20
Eric E Roselli, Jay J Idrees, Faisal G Bakaeen, Michael Z Tong, Edward G Soltesz, Stephanie Mick, Douglas R Johnston, Mathew J Eagleton, Venu Menon, Lars G Svensson
BACKGROUND: A modified technique for frozen elephant trunk (FET) repair of acute DeBakey type I dissection has evolved. Procedural modifications are described and midterm outcomes evaluated. METHODS: From 2009 to 2016, 72 patients with DeBakey type I dissection underwent emergency simplified FET. Mean age was 59 ± 15 years. Presentation included malperfusion (n = 22, 31%), rupture (n = 12, 16%), and aortic insufficiency (n = 42, 58%). Concomitant procedures included valve replacement (n = 9), root replacement (n = 11; valve sparing n = 6), cusp repair (n = 11), and valve resuspension (n = 21)...
December 4, 2017: Annals of Thoracic Surgery
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