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Tracheostomi

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https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#1
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29664694/immediate-use-of-uncuffed-tracheostomy-after-free-flap-reconstruction-of-the-head-and-neck
#2
Priyesh N Patel, Al C Valmadrid, Daniel Y Hong, David O Francis, Michael W Sim, Sarah L Rohde
Objective To determine if immediate postoperative uncuffed tracheostomy placement following oral cavity or oropharyngeal head and neck free flap reconstruction is associated with shorter hospital length of stay and higher inpatient decannulation rates without an increase in respiratory complications, as compared with immediate placement of cuffed tracheostomy. Study Design Retrospective cohort. Setting Tertiary referral center. Subjects and Methods Patients were included if they underwent free flap reconstruction for oral cavity or oropharyngeal squamous cell carcinoma and had an intraoperative tracheostomy placed between 2005 and 2016...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29664213/a-patient-centred-multi-domain-instrument-for-improving-the-clarity-of-outcomes-reporting-and-documentation-in-complex-airway-surgery
#3
S A R Nouraei, K J Heathcote
Laryngotracheal stenosis refers to abnormal narrowing of the central airways from larynx to carina. It is caused by an eclectic group of conditions that include intubation-related airway stenosis, granulomatosis with polyangiitis, tracheal compression or malignancy, and congenital laryngotracheal malformations. A significant proportion of patients with this condition can be satisfactorily treated using a combination of endoscopic and open surgical techniques and when definitive treatment is not possible, most of the remaining patients can be managed with a combination of endoscopic airway maintenance, stents, T-tubes, and/or tracheostomies...
April 17, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29648486/physicians-attitudes-when-faced-with-life-threatening-events-in-children-with-severe-neurological-disabilities
#4
Benjy Wosinski, Christopher J Newman
PURPOSE: Children with severe neurological disabilities are at an increased risk of acute, life-threatening events. We assessed physicians' attitudes when making decisions in these situations. METHODS: We surveyed physicians in pediatric intensive care, neurology, and rehabilitation units in Swiss hospitals. The questionnaire explored participants' attitudes toward life-threatening situations in two scenarios: a child with profound intellectual and multiple disabilities (PIMD) and an infant with spinal muscular atrophy (SMA) type I...
April 12, 2018: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/29644281/thyrohyoid-membrane-transection-caused-by-a-stab-injury
#5
Dongsub Noh, Kwang Hee Yeo, Hyun Min Cho, Chan Yong Park
Background: The thyrohyoid membrane is located between the hyoid bone and thyroid cartilage. Transection of the thyrohyoid membrane can be fatal. Case presentation: A 54-year-old man presented to the emergency room after attempting to commit suicide by cutting his neck. An endotracheal tube was inserted through the thyrohyoid membrane, which had been cut almost completely. After a tracheostomy, temporary wound closure was performed due to coagulopathy caused by hemorrhagic shock...
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29643913/hair-dye-poisoning-an-early-intervention
#6
Syed Farrukh Umair, Imrana Amin, Ata Urrehman
The use of hair dye has been emerging worldwide however usage of Paraphenylenediamine (PPD) in making hair dye is generally restricted to underdeveloped and developing countries. In particular, prevalence of accidental and suicidal ingestion is more in low socioeconomic areas. The spectra of hair dye toxicity is wide, however, it presents more commonly with severe angioedema of face and neck leading to respiratory failure, rhabdomyolysis complicating into acute kidney injury, myocarditis and acute liver injury...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29629836/use-of-a-tracheal-dilator-for-percutaneous-insertion-of-27f-and-31f-avalon-%C3%A2-dual-lumen-cannulae-for-veno-venous-extracorporeal-membrane-oxygenation-in-adults
#7
Yiorgos Alexandros Cavayas, Caroline Sampson, Hakeem Yusuff, Richard Porter, Susan Dashey, Chris Harvey
Veno-venous extracorporeal membrane oxygenation can be performed either by two cannulae or by a single dual-lumen cannula. The dual-lumen cannulation configuration offers multiple advantages: it avoids the femoral site which may be at greater risk of infection, it improves patient mobility, eases prone positioning and greatly reduces recirculation. The Avalon was the first commercially available dual-lumen cannula for adults. It has gained much popularity, but, for more than a year now, the adult vascular access kit with the 30Fr dilator has been discontinued in the United Kingdom...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29628299/effectiveness-and-safety-of-sclerotherapy-for-treatment-of-low-flow-vascular-malformations-of-the-oropharyngeal-region
#8
Patrick Bourgouin, Frédéric Thomas-Chaussé, Patrick Gilbert, Marie-France Giroux, Sébastien Périgny, Louis Guertin, Josée Dubois, Gilles Soulez
PURPOSE: To evaluate the efficacy and safety of sclerotherapy with sodium tetradecyl sulfate (STS) and bleomycin for treatment of venous malformations (VMs) of the oropharyngeal region. MATERIALS AND METHODS: A retrospective study of 33 patients with 46 VMs of the buccal and pharyngolaryngeal cavity associated with impairment of eating, respiration, or elocution was performed. Individual lesions were divided based on their anterior or posterior location, using the base of the tongue as an anatomic landmark...
April 6, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29627795/delayed-extrusion-of-embolic-coils-into-the-airway-after-embolization-of-an-external-carotid-artery-pseudoaneurysm
#9
Zachary Wilseck, Luis Savastano, Neeraj Chaudhary, Aditya S Pandey, Julius Griauzde, Sumanna Sankaran, David 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...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29627422/predictors-of-failure-in-infant-mandibular-distraction-osteogenesis
#10
Jeffrey A Hammoudeh, Artur Fahradyan, Colin Brady, Michaela Tsuha, Beina Azadgoli, Sally Ward, Mark M Urata
PURPOSE: Mandibular distraction osteogenesis (MDO) has been shown to be successful in treating upper airway obstruction caused by micrognathia in pediatric patients. The purpose of this study was to assess the success rate of MDO and possible predictors of failure. PATIENTS AND METHODS: The records of all neonates and infants who underwent MDO from 2008 to 2015 were retrospectively reviewed. Procedural failure was defined as patient death or the need for tracheostomy postoperatively...
March 15, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29627053/laryngeal-split-and-rib-cartilage-interpositional-grafting-treatment-option-for-glottic-and-subglottic-stenosis-in-adults
#11
REVIEW
Wael Hasan, Patrick Gullane
Optimal management of tracheal stenosis depends on identifying causative factors. Risk factors include high tracheostomy, cricothyroidotomy, prolonged intubation, and proximal migration of an endotracheal tube cuff. Management ranges from conservative observation to endoscopic procedures or open surgical resections. The goal of surgical repair is an adequate airway, decannulation, and normal laryngeal function. For early stage disease, management of refractory conditions is via endoscopic procedures. An understanding of the respiratory function of the glottis and subglottis is essential when an optimum functional reconstruction of the glottic/subglottic area is considered...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29627046/tracheal-injuries-complicating-prolonged-intubation-and-tracheostomy
#12
REVIEW
Joel D Cooper
Respiratory care advances such as the introduction of ventilatory assistance have been associated with postintubation airway stenosis resulting from tracheal injury at the site of the inflatable cuff on endotracheal or tracheostomy tubes. Low-pressure cuffs have significantly reduced this occurrence. Loss of airway stability at the site of a tracheostomy stoma may result in tracheal stenosis. Subglottic stenosis may result from a high tracheostomy site at, or just inferior to, the cricoid arch, or to malposition of an endotracheal tube cuff...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29627044/fundamental-and-practical-aspects-of-airway-anatomy-from-glottis-to-segmental-bronchus
#13
REVIEW
Reza J Mehran
The surgical anatomy of the airways from the glottis to segmental bronchi is reviewed with a focused review on pertinent anatomic findings surrounding common surgical procedures. The knowledge of the anatomy of the trachea while performing tracheostomy, tracheal and sleeve carinal resection, and bronchoplastic procedures is addressed. Pertinent anatomic relationships as evident on common computed tomographic imagery are emphasized.
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29621756/experience-with-transcordal-silicone-stents-in-adult-laryngotracheal-stenosis-a-bicentric-retrospective-study
#14
Valerian Bourinet, Thibaut Raguin, Marc Fortin, Elsa Chetrit, Julien Guinde, Sophie Laroumagne, Nicolas Fakhry, Philippe Astoul, Christian Debry, Hervé Dutau
BACKGROUND: Benign stenosis involving laryngeal and upper tracheal structures represents a therapeutic challenge. Open surgery and endoscopic management have to be discussed by a multidisciplinary board in order to evaluate the risk and benefit for each patient. OBJECTIVE: The objective of this retrospective study was to report the experience of two French centers with transcordal silicone stents (TSS) in the endoscopic management of benign laryngotracheal stenosis (BLTS) in adults, with focus on efficacy, safety, and tolerability...
April 5, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29621014/laryngoscopy-and-bronchoscopy-in-an-infant-with-a-congenital-laryngeal-web-complicated-by-bilateral-pneumothoraces-a-case-report
#15
Michelle M LeRiger, Marcellene H Franzen, Ryan K Sewell, Greta L Duncan-Wiebe
Neonates with laryngeal webs pose unique challenges to the anesthesiologist. We present a 2-day-old neonate with aphonia and stridor who underwent microdirect laryngoscopy. Intraoperatively, a Cohen type 4 laryngeal web was diagnosed not immediately amenable to resection. Therefore, the decision was made for endotracheal intubation and subsequent tracheostomy. After endotracheal intubation, there was acute respiratory compromise and oxygen desaturation that improved moderately after urgent tracheostomy. A chest radiograph revealed a large pneumothorax...
March 31, 2018: A&A practice
https://www.readbyqxmd.com/read/29619238/pelizaeus-merzbacher-disease-can-be-a-differential-diagnosis-in-males-presenting-with-severe-neonatal-respiratory-distress-and-hypotonia
#16
Ayako Ueda, Hiroko Shimbo, Yukari Yada, Yasunori Koike, Takanori Yamagata, Hitoshi Osaka
Pelizaeus-Merzbacher disease (PMD; MIM #312080) is a rare X-linked recessive disorder. A male neonate presented with severe respiratory distress that required tracheostomy. After the appearance of nystagmus, PMD was suspected as a diagnosis for the patient, and a missense mutation, p.Phe51Val, was identified in PLP1 , the gene responsible for PMD. PMD can be a differential diagnosis in a male neonate presenting severe respiratory distress.
2018: Human Genome Variation
https://www.readbyqxmd.com/read/29619100/comparative-study-between-peristomal-patches-in-patients-with-definitive-tracheostomy
#17
Liset Lansaat, Bertram de Kleijn, Frans Hilgers, Bernard van der Laan, Michiel van den Brekel
Introduction  To prevent or diminish pulmonary problems in laryngectomized patients, continuous use of a heat and moisture exchanger (HME) is recommended. Therefore, automatic speaking valves are also often combined with an HME to enable hands-free speech. In order to keep these devices in place, most commonly, peristomal patches are used. Objective  This prospective clinical 2 × 2 crossover study aims at assessing the added value of a new patch for HME application, the Provox StabiliBase OptiDerm (SBO)...
April 2018: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29616357/preliminary-experience-on-the-safety-and-tolerability-of-mechanical-insufflation-exsufflation-in-subjects-with-artificial-airway
#18
Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela Del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero, Antonio Núñez-Reiz
BACKGROUND: Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. "Mechanical insufflation-exsufflation" exerts positive pressure, followed by an abrupt drop to negative pressure. Potential advantages of this technique are aspiration of distal airway secretions, avoiding trauma, and improving tolerance. METHODS: We applied insufflation of 50 cmH2 O for 3 s and exsufflation of - 45 cmH2 O for 4 s in patients with an endotracheal tube or tracheostomy cannula requiring secretion suctioning...
April 3, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29607174/effect-of-a-passive-exhalation-port-on-tracheostomy-ventilation-in-amyotrophic-lateral-sclerosis-patients-a-randomized-controlled-trial
#19
Andrea Vianello, Giovanna Arcaro, Beatrice Molena, Silvia Iovino, Federico Gallan, Cristian Turato, Rosario Marchese-Ragona
Background: Amyotrophic lateral sclerosis (ALS) patients often require long-term tracheostomy ventilation (LT-TV) because of progressive ventilatory failure. Although widely used for non-invasive ventilation (NIV), passive exhalation port systems have not been gaining popularity for TV because of the possibility of carbon dioxide (CO2 ) rebreathing. The current study set out to investigate the effect of a Whisper Swivel connector in comparison to an active exhalation valve on gas exchange and symptoms in ALS patients requiring LT-TV...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29606641/is-transcatheter-aortic-valve-replacement-better-than-surgical-aortic-valve-replacement-in-patients-with-chronic-obstructive-pulmonary-disease-a-nationwide-inpatient-sample-analysis
#20
Tomo Ando, Oluwole Adegbala, Emmanuel Akintoye, Said Ashraf, Mohit Pahuja, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso, Theodore Schreiber
BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients are at increased risk of respiratory related complications after cardiac surgery. It is unclear whether transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in favorable outcomes among COPD patients. METHODS AND RESULTS: Patients were identified from the Nationwide Inpatient Sample database from 2011 to 2014. Patients with age ≥60, COPD, and either went transarterial TAVR or SAVR were included in the analysis...
April 1, 2018: Journal of the American Heart Association
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