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review emergent endotracheal intubation complications

David T Wong, Amanda J Yee, Siaw May Leong, Frances Chung
PURPOSE: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. The objective of this narrative review is to examine the utilization of apneic oxygenation within the operating room, intensive care unit (ICU), emergency department, and pre-hospital settings and to determine its efficacy compared with controls...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Yoann Ammar, Juliette Vella-Boucaud, Claire Launois, Hervé Vallerand, Sandra Dury, François Lebargy, Gaëtan Deslee, Jeanne-Marie Perotin
Obstructive fibrinous tracheal pseudomembrane (OFTP) is a rare and potentially severe complication of endotracheal intubation characterized by a tubular pseudomembrane that obstructs the trachea and induces clinical symptoms of airway obstruction after extubation. In this report, we reviewed and summarized all published cases of OFTP (n = 58) between 1981 and 2015. Twenty-three of 52 patients were men, and the mean age was 36 ± 22 years. Intubation was emergent in 41 of 53 cases. OFTP was revealed by acute symptoms in 19 of 39 cases and led to acute respiratory failure in 13 of 39 cases...
June 1, 2016: Anesthesia and Analgesia
Lei Tan, Da-Hui Sun, Tiecheng Yu, Linxiang Wang, Dong Zhu, Yan-Hui Li
Migration of orthopedic fixation wires into the ascending aorta though a rare occurrence can have devastating consequences. Therefore, prompt recognition, with immediate and cautious retrieval of the implant is paramount in averting these complications.We present a case of a 5-year-old boy with the intra-aortic migration of a K-wire used for the treatment of a right clavicle fracture. He was transferred to us with a history of syncope, chest pain, and shortness of breath 7 days after K-wire placement, which was performed at another hospital...
May 2016: Medicine (Baltimore)
Rashmi Ramachandran, Vimi Rewari, Ankur Sharma, Rajeev Kumar, Anjan Trikha
INTRODUCTION: Minimal invasive approaches to pheochromocytoma (PCC) and paraganglioma (PGL) removal may be complicated by the hemodynamic disturbances that are associated with the catecholamine secretion from the tumour. The anaesthetic and perioperative monitoring techniques need to be customized to handle these complications effectively. This retrospective analysis was undertaken to review the perioperative management of these patients handled by the same anaesthetic and surgical team...
May 10, 2016: Current Hypertension Reviews
Eric F Reichman, Brenda J Lanan
There are numerous immediate and delayed complications associated with endotracheal intubation. Tracheal rupture is a rare complication whose diagnosis is often delayed. This can result in significant morbidity and mortality. We present a case of therapeutic misadventure resulting in a significant tracheal rupture in a child intubated by helicopter emergency medical services after a near-drowning. This is followed by a review of endotracheal intubation related tracheal rupture.
November 2015: Pediatric Emergency Care
Fanceng Ji, Peihe Nie, Fuxia Yi, Limin Zhang
OBJECTIVE: Although the placement of esophageal self-expandable stents (SES) can effectively relieve dysphagia after radiotherapy in patients with esophageal cancer (EC), it may induce severe esophageal complications. This article reports a case of emergency endotracheal intubation in an EC patient who suddenly developed severe dyspnea two months after SES placement. METHODS: Electronic bronchoscopy of the patient's airway confirmed the diagnosis of esophagotracheal fistula, tracheal stenosis and tracheal rupture...
2015: International Journal of Clinical and Experimental Pathology
Hossein Hassanian-Moghaddam, Kambiz Soltaninejad, Shahin Shadnia, Ali Kabir, Mitra Movahedi, Amirhossein Mirafzal
This was a retrospective chart review to evaluate various risk factors associated with in-hospital mortality and intubation risk in acute methadone overdose. All patients admitted to an academic hospital in Tehran, Iran, during a 10-year period (2000-2009) constituted the study sample. Exclusion criteria were significant comorbidities and age under 18 years. Outcome variables were in-hospital mortality and being intubated during admission. A total of 802 patients were enrolled in the study. There were 15 (1...
March 2016: Basic & Clinical Pharmacology & Toxicology
Mark E Oppenlander, Forrest D Hsu, Patrick Bolton, Nicholas Theodore
Although exceedingly rare, catastrophic neurological decline may result from endotracheal intubation of patients with preexisting cervical spine disease. The authors report on 2 cases of quadriplegia resulting from emergent endotracheal intubation in the intensive care unit. A 68-year-old man with ankylosing spondylitis became quadriplegic after emergent intubation. A new C6-7 fracturedislocation was identified, and the patient underwent emergent open reduction and C4-T2 posterior fixation and fusion. The patient remained quadriplegic and ultimately died of pneumonia 1 year later...
May 2015: Journal of Neurosurgery. Spine
Luis F Lara, Andrew Ukleja, Ronnie Pimentel, Roger J Charles
BACKGROUND AND STUDY AIMS: Adverse events associated with overtube-assisted enteroscopy are similar to those with routine endoscopy. Our endoscopy quality program identified a number of respiratory adverse events resulting in emergency resuscitation efforts. The aim is to report all adverse events identified by quality monitoring and outcomes of adverse events associated with overtube-assisted enteroscopy. METHODS: A retrospective study used data prospectively obtained from consecutive patients undergoing overtube-assisted enteroscopy between December 2008 and July 2012...
November 2014: Endoscopy
John Donatelli, Ayushi Gupta, Ramya Santhosh, Todd R Hazelton, Leelakrishna Nallamshetty, Alvaro Macias, Carlos A Rojas
Artificial airway devices are commonly used to provide adequate ventilation and/or oxygenation in multiple clinical settings, both emergent and nonemergent. These frequently used devices include laryngeal mask airway, esophageal-tracheal combitube, endotracheal tube, and tracheostomy tube and are associated with various acute and late complications. Clinically, this may vary from mild discomfort to a potentially life-threatening situation. Radiologically, these devices and their acute and late complications have characteristic imaging findings which can be detected primarily on radiographs and computed tomography...
April 2015: Emergency Radiology
Gustavo Noleto, Iuri Santana Neville, Wagner Malagó Tavares, Felippe Saad, Fernando Campos Pinto, Manoel Jacobsen Teixeira, Wellingson Silva Paiva
Cerebrospinal fluid over-drainage is a common complication of ventriculoperitoneal devices. In terms of haemorrhage, subdural haematomas are usually more frequent lesions than epidural hematomas, which, more rarely, may also be seen after ventricular shunt procedures and may lead to rapid neurological decline and even death unless a surgical procedure can be promptly performed. This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosis of normal pressure hydrocephalus submitted to a ventriculoperitoneal shunt with a high fixed pressure valve...
2014: International Journal of Clinical and Experimental Medicine
Jonathan D Mathers, Thomas M Breen, Jonathan H Smith
OBJECTIVES: To perform a retrospective, anesthesia case note review of patients with Fraser syndrome. AIM: To identify the perioperative and postoperative anesthetic management and complications in this patient group. BACKGROUND: Fraser syndrome is a rare, autosomal recessively inherited disorder characterized by cryptophthalmos, cutaneous syndactyly, and ambiguous genitalia. It also has variable association with cardiac, laryngeal, tracheal, and gastrointestinal abnormalities...
December 2014: Paediatric Anaesthesia
Clint T Allen, Chia-Jung Lee, Tanya K Meyer, Allen D Hillel, Albert L Merati
PURPOSE: To compare post-operative complication rates between inpatient and outpatient endoscopic airway surgery in patients with laryngotracheal stenosis. Secondary objectives included characterization of a cohort of patients with this disease. METHODS: Retrospective review of patients with laryngotracheal stenosis in a tertiary care laryngology practice over a 5-year period. RESULTS: Ninety-one patients underwent 223 endoscopic airway surgeries...
November 2014: American Journal of Otolaryngology
V Darlong, Puneet Khanna, Dalim Kumar Baidya, Chandralekha, Ravindra Pandey, Jyotsna Punj, Rakesh Kumar, Kapil Sikka
Cochlear implant is a commonly performed surgery for hearing loss in pre-school and school children. However, data on anesthesia management and anesthesia-related complications are sparse. We retrospectively reviewed the data of our institute from January, 2007 to December, 2012. Medical records and anesthesia charts of all the patients who had undergone cochlear implant under general anesthesia between this period were reviewed. Information related to the demographic profile, preoperative evaluation, anesthetic techniques, and perioperative complications were collected and analyzed...
February 2015: Journal of Anesthesia
Reinhard Strametz, Christoph Pachler, Johanna F Kramer, Christian Byhahn, Andrea Siebenhofer, Tobias Weberschock
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adult patients on intensive care units (ICUs) who require long-term ventilation. PDT is generally associated with relevant life-threatening complications (e.g. cuff rupture leading to possible hypoxia or aspiration, puncture of the oesophagus, accidental extubation, mediastinitis, pneumothorax, emphysema). The patient's airway can be secured with an endotracheal tube (ETT) or a laryngeal mask airway (LMA)...
2014: Cochrane Database of Systematic Reviews
Seung-Hwa Lee, Duck-Joo Lee, Kwang-Min Kim, Kyu-Nam Kim, Sang-Wook Seo, Young-Kyu Park, Sung-Min Cho, Young-Ah Choi, Jung-Un Lee, Dong-Ryul Lee
From the endoscopists' point of view, although the main focus of upper gastrointestinal endoscopic examination is the esophagus, stomach, and duodenum (usually bulb and 2nd portion including ampulla of Vater), the portions of the upper airway may also be observed during insertion and withdrawal of the endoscope, such as pharynx and larynx. Thus, a variety of pathologic lesions of the upper airway can be encountered during upper endoscopy. Among these lesions, an epiglottic cyst is relatively uncommon. The cyst has no malignant potential and mostly remains asymptomatic in adults...
May 2014: Korean Journal of Family Medicine
Victoria Reynolds, Suzanne Meldrum, Karen Simmer, Shyan Vijayasekaran, Noel French
INTRODUCTION: Intubation is a known risk factor for dysphonia yet is essential in the perinatal care of many very preterm infants. Children born preterm, who are frequently resuscitated with endotracheal intubation, may be at risk of dysphonia at school age and beyond. OBJECTIVES: To identify and describe the evidence pertaining to long-term voice outcomes and risk factors for developing dysphonia in preterm children. RESULTS: In addition to case studies and series, three larger-scale studies have reported on dysphonia and voice outcomes in preterm children...
2014: Neonatology
V Helmstaedter, R Tellkamp, B Schwab, T Lenarz, M Durisin
BACKGROUND: High-frequency jet ventilation (HFJV) through thin catheters creates more room for surgical procedures in laryngotracheal surgery, while few contraindications exist. In contrast, the anaesthesiologist has to cope with reduced monitoring and numerous contraindications. Therefore, every participating discipline has to thoroughly know the method. We report our experiences with HFJV and focus on relevant points, which contribute to a safe and cooperative procedure. MATERIAL AND METHODS: We performed a retrospective chart review for patients, who were operated for benign laryngotracheal lesions using HFJV at the Hannover Medical School, Department of Otorhino-Laryngology between June 2012 and February 2013...
July 2014: Laryngo- Rhino- Otologie
Jannet J Lee-Jayaram, Loren G Yamamoto
Securing the pediatric airway in the emergency setting is an uncommon event that is complicated by anatomic, physiologic, and environmental factors. Even more uncommonly, practitioners are faced with the added complication of a difficult airway, and the question of what alternatives to traditional endotracheal intubation are available and most useful may arise. Timely and effective intervention determines the patient's clinical outcome. The purpose of this review was to detail specific alternative airway management strategies and tools for use in the pediatric emergency department...
March 2014: Pediatric Emergency Care
Go-Woon Kim, Younsuck Koh, Chae-Man Lim, Myongja Han, Jiyoung An, Sang-Bum Hong
PURPOSE: Emergency endotracheal intubation (EEI) is a complex process that leads to various complications. Previous studies mainly demonstrated that the Medical Emergency Team (MET) intervention reduced the incidence of cardiac arrest, however, the impact of a MET on airway management has not been investigated in detail. Our purpose was to confirm the impact of a MET on airway management and compare the incidence of complications of EEI before and after MET intervention in a general ward...
January 2014: Yonsei Medical Journal
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