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endotracheal intubation complications

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https://www.readbyqxmd.com/read/29666093/bougie-associated-bronchial-injury-complicated-by-a-nephropleural-fistula-after-percutaneous-nephrolithotomy-a-tale-of-two-complications
#1
Aparna Pande, Rashmi Ramachandran, Vimi Rewari
We present a case of bronchial injury following bougie-assisted endotracheal intubation in a patient with difficult airway scheduled to undergo right percutaneous nephrolithotomy under general anaesthesia. The patient developed pleuritic pain along with right pleural effusion on the third postoperative day which was diagnosed by the anaesthesiologist who was following up the patient for airway trauma-associated complications. However, the patient was diagnosed to have a nephropleural fistula, a rare complication of supracostal access to percutaneous nephrolithotomy, which was managed successfully...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29649932/optimal-tube-length-of-orotracheal-intubation-for-mice
#2
Nobuyuki Nosaka, Timothy R Crother, Shuang Chen, Moshe Arditi, Kenichi Shimada
Endotracheal tube (ETT) management is an essential technique in handling mice with mechanical ventilators. Malposition into bronchi causes not only lethal complications for them but also less efficient mechanical ventilation. However, in general, it is difficult to know whether the ETT is placed with appropriate depth into the trachea of mice. We measured the distance from incisors to the bifurcation of trachea of multiple mice, and created a new estimation formula to obtain the suitable ETT length for mice with a body weight range from 17 g to 25 g: length (mm) = 0...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29643913/hair-dye-poisoning-an-early-intervention
#3
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/29643623/effect-of-dexmedetomidine-infusion-on-hemodynamic-responses-in-microsurgery-of-larynx
#4
Shakuntala Basantwani, Mayuresh Patil, Balasaheb Govardhane, Jyoti Magar, Bharati Tendolkar
Background and Aims: Microlaryngeal surgery is a frequently performed ear, nose, and throat procedure used to diagnose and treat laryngeal disorders. Suspension laryngoscopy causes prolonged stimulation of the deep pressure receptors of the larynx leading to adverse circulatory responses and consequently cardiac complications. In this study, dexmedetomidine infusion was used to assess its effectiveness for attenuation of this hemodynamic stress response. Material and Methods: Sixty patients undergoing elective microlaryngeal surgery randomly received either dexmedetomidine 1 μg/kg over 10 min followed by continuous infusion of 0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628599/temporomandibular-joint-ankylosis-a-pediatric-difficult-airway-management
#5
Anoop Sharma, Deepak Dwivedi, Ram Murti Sharma
Intubating a pediatric patient with temporomandibular joint ankylosis is a daunting task, and it becomes more challenging with limited mouth opening. Fiberoptic nasotracheal intubation technique is considered a gold standard. We describe an improvised technique of securing airway in the absence of appropriate-sized fiberoptic scope. The endotracheal tube inserted in the left nostril for maintaining depth of anesthesia was advanced under vision by the fiberoptic scope inserted into the right nostril, and with external laryngeal manipulation, the airway was secured with no complications...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628574/effects-of-intravenous-and-inhaled-nebulized-lignocaine-on-the-hemodynamic-response-of-endotracheal-intubation-patients-a-randomized-clinical-trial
#6
Abolfazl Jokar, Maryam Babaei, Sahar Pourmatin, Majid Taheri, Amir Almasi-Hashiani, Arash Yazdanbakhsh
Background: Endotracheal intubation is one of the most common measures in the Intensive Care Unit (ICU) which plays an important role in airway management of the critically ill patients. Aims: The study aimed to evaluate the effects of lignocaine spray on hemodynamic response of endotracheal intubation patients. Settings and Design: This study is a randomized clinical trial on a study population comprising patients admitted to the ICU. Subjects and Methods: The patients were divided into three groups using a permuted block randomization...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628155/-vocal-cord-paralysis-after-endotracheal-intubation-an-uncommon-complication-of-general-anesthesia
#7
Claudia Hurtado Nazal, Andrea Araneda Vilches, Carolina Vergara Marín, Karen García Contreras, Carla Napolitano Valenzuela, Pedro Badía Ventí
BACKGROUND: General anesthesia is a safe, frequent procedure in clinical practice. Although it is very unusual in procedures not related to head and or neck surgery, vocal cord paralysis is a serious and important complication. Incidence has been associated with patient age and comorbidities, as well as the position of the endotracheal tube and cuff. It can become a dangerous scenario because it predisposes aspiration. OBJECTIVES: To present a case and analyze the risk factors associated with increased risk of vocal cord paralysis described in the literature...
April 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29627046/tracheal-injuries-complicating-prolonged-intubation-and-tracheostomy
#8
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/29622329/pediatric-emergency-noninvasive-ventilation
#9
REVIEW
Chad D Viscusi, Garrett S Pacheco
Noninvasive ventilation (NIV) has emerged as a powerful tool for the pediatric emergency management of acute respiratory failure (ARF). This therapy is safe and well tolerated and seems to frequently prevent both the need for invasive mechanical ventilation and the associated risks/complications. Although NIV can be the primary treatment of ARF resulting from multiple respiratory disease states, it must be meticulously monitored and, when unsuccessful, may aid in preoxygenation for prompt endotracheal intubation and invasive mechanical ventilation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29621014/laryngoscopy-and-bronchoscopy-in-an-infant-with-a-congenital-laryngeal-web-complicated-by-bilateral-pneumothoraces-a-case-report
#10
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/29616357/preliminary-experience-on-the-safety-and-tolerability-of-mechanical-insufflation-exsufflation-in-subjects-with-artificial-airway
#11
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/29616352/efast-for-the-diagnosis-of-a-perioperative-complication-during-percutaneous-nephrolithotomy
#12
Achyut Sharma, Prajjwal Bhattarai, Apurb Sharma
A 29-year-old patient with normal preanesthetic evaluation was planned for percutaneous nephrolithotomy (PCNL) for right nephrolithiasis with right pyelolithiasis. Surgery was performed under general anesthesia with endotracheal intubation with muscle relaxation. At the conclusion of surgery, when the patient was turned over to supine position, tense abdomen was noted. Immediately extended focused assessment with sonography in trauma (eFAST) was done in which both right and left quadrants of abdomen including pericardial and suprapubic region, right and left thoracic, and both lung basis were examined...
April 3, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29615093/continuous-versus-intermittent-endotracheal-cuff-pressure-control-for-the-prevention-of-ventilator-associated-respiratory-infections-in-vietnam-study-protocol-for-a-randomised-controlled-trial
#13
Vu Quoc Dat, Ronald B Geskus, Marcel Wolbers, Huynh Thi Loan, Lam Minh Yen, Nguyen Thien Binh, Le Thanh Chien, Nguyen Thi Hoang Mai, Nguyen Hoan Phu, Nguyen Phu Huong Lan, Nguyen Van Hao, Hoang Bao Long, Tran Phuong Thuy, Nguyen Van Kinh, Nguyen Vu Trung, Vu Dinh Phu, Nguyen Trung Cap, Dao Tuyet Trinh, James Campbell, Evelyne Kestelyn, Heiman F L Wertheim, Duncan Wyncoll, Guy Edward Thwaites, H Rogier van Doorn, C Louise Thwaites, Behzad Nadjm
BACKGROUND: Ventilator-associated respiratory infection (VARI) comprises ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). Although their diagnostic criteria vary, together these are the most common hospital-acquired infections in intensive care units (ICUs) worldwide, responsible for a large proportion of antibiotic use within ICUs. Evidence-based strategies for the prevention of VARI in resource-limited settings are lacking. Preventing the leakage of oropharyngeal secretions into the lung using continuous endotracheal cuff pressure control is a promising strategy...
April 4, 2018: Trials
https://www.readbyqxmd.com/read/29580592/benchmarking-the-applicability-of-four-methods-of-endotracheal-tube-cuff-inflation-for-optimal-sealing-a-randomized-trial
#14
Georgia G Tsaousi, Chryssa Pourzitaki, Dimitra Chlorou, Konstantinos Papapostolou, Dimitrios G Vasilakos
PURPOSE: To assess the comparable applicability of four methods of endotracheal tube cuff (ETTc) inflation on the basis of optimal level of intracuff pressure and presence of intubation-related complications. DESIGN: Double-blind, randomized trial. METHODS: A total of 139 adult surgical patients scheduled to undergo nitrous oxide-free general anesthesia were assigned into one of four groups according to the method used for ETTc inflation. The cuff pressure and air volume applied in each method, and laryngotracheal complications were recorded...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#15
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29576821/video-versus-direct-laryngoscopy-on-successful-first-pass-endotracheal-intubation-in-icu-patients
#16
Yong-Xia Gao, Yan-Bo Song, Ze-Juan Gu, Jin-Song Zhang, Xu-Feng Chen, Hao Sun, Zhen Lu
BACKGROUND: Airway management in intensive care unit (ICU) patients is challenging. The aim of this study was to compare the rate of successful first-pass intubation in the ICU by using the direct laryngoscopy (DL) and that by using the video laryngoscopy (VL). METHODS: A randomized, non-blinded trial comparing first-pass success rate of intubation between VL and DL was performed. Patients were recruited in the period from August 2014 to August 2016. All physicians working at ICU received hands-on training in the use of the video and direct laryngoscope...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29572436/pulmonary-artery-rupture-management-with-a-single-lumen-endotracheal-tube-old-tricks-that-should-be-revisited
#17
Thanuja Neerukonda, William J Gibson, Travis Abicht, Andrew Sauer, Brigid C Flynn
BACKGROUND Pulmonary artery rupture can be a lethal complication of a pulmonary artery catheter (PAC). Different techniques have been used to manage PAC-induced pulmonary artery rupture, including double lumen endotracheal tube (DLT), bronchial blockers, pulmonary artery embolization, thoracotomy with hematoma evacuation, and extracorporeal life support for ventilation (ECLS). Single lumen endotracheal tube (ETT) is not frequently reported in the literature despite its advantages. CASE REPORT The authors present a case of PAC-induced pulmonary artery rupture successfully managed with a single lumen ETT...
March 24, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29568855/prevailing-practices-in-airway-management-a-prospective-single-centre-observational-study-of-endotracheal-intubation
#18
Geraldine Pei Chin Cheong, Anusha Kannan, Kwong Fah Koh, Kumaresh Venkatesan, Edwin Seet
INTRODUCTION: Airway management during anaesthesia has potential difficulties and risks. We aimed to investigate the utility of routine airway assessment for predicting difficult tracheal intubation, review the prevailing practice of videolaryngoscope use amongst anaesthetists in a teaching hospital and determine the incidence of intraoperative and postoperative airway-related complications. METHODS: A prospective observational study of 1,654 patients undergoing general anaesthesia with endotracheal intubation over a seven-month period was performed...
March 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/29543640/anesthesia-for-percutaneous-pulmonary-valve-implantation-a-case-series
#19
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29542326/sedation-with-propofol-in-digestive-endoscopy-administered-by-gastroenterologists-experience-in-a-venezuelan-hospital
#20
Ramón E Ruiz-Curiel, Ydaly Bonilla H, Alberto Baptista, Manuel Bronstein
OBJECTIVES: propofol is a rapid acting hypnotic that is becoming the drug of choice for sedation in digestive endoscopy worldwide. There is some controversy with regard to the use of propofol by physicians who are not anesthesiologists. We present our experience of the administration of propofol by endoscopist and nursing personnel. METHODS: this was a retrospective study of sedation in endoscopy. Propofol was exclusively used and administered by the endoscopist who performed the procedure and the nursing staff...
April 2018: Revista Española de Enfermedades Digestivas
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