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https://www.readbyqxmd.com/read/29141315/-clinical-efficacy-of-one-lung-ventilation-in-treatment-of-children-postoperatively-intractable-atelectasis
#1
J M Huo, K Bai, Y Q Fu, C J Liu, F Xu
Objective: To investigate the effect of fiberoptic bronchoscope-guided one-lung ventilation (OLV) on treatment of intractable atelectasis in children. Method: This retrospective cohort study was conducted in Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University from December 2014 to May 2017. Six patients with intractable atelectasis of left lung were included. Three cases were male and three female with the age from 1.5 to 11.0 years. The endotracheal tube was intubated to the left main bronchus for OLV by the guidance of fiberoptic bronchoscopy...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29135753/prevention-of-neonatal-unplanned-extubations-in-the-neonatal-intensive-care-unit-a-best-practice-implementation-project
#2
Xiaojing Hu, Yuxia Zhang, Yun Cao, Guoying Huang, Yan Hu, Alexa McArthur
BACKGROUND: Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. OBJECTIVES: The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29126451/acceleration-sensors-in-abdominal-wall-position-as-a-non-invasive-approach-to-detect-early-breathing-alterations-induced-by-intolerance-of-increased-airway-resistance
#3
Thomas Breuer, Christian S Bruells, Rolf Rossaint, Henning Steffen, Catherine Disselhorst-Klug, Michael Czaplik, Norbert Zoremba
BACKGROUND: Early detection of respiratory overload is crucial to mechanically ventilated patients, especially during phases of spontaneous breathing. Although a diversity of methods and indices has been established, there is no highly specific approach to predict respiratory failure. This study aimed to evaluate acceleration sensors in abdominal and thoracic wall positions to detect alterations in breathing excursions in a setting of gradual increasing airway resistance. METHODS: Twenty-nine healthy volunteers were committed to a standardized protocol of a two-minutes step-down spontaneous breathing on a 5 mm, 4 mm and then 3 mm orally placed endotracheal tube...
November 10, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29124521/successful-peritoneal-dialysis-using-a-percutaneous-tube-for-peritoneal-drainage-in-an-extremely-low-birth-weight-infant-a-case-report
#4
Satoshi Yokoyama, Takayuki Nukada, Yuka Ikeda, Shigeto Hara, Akira Yoshida
BACKGROUND: Peritoneal dialysis (PD) for acute kidney injury (AKI) of newborns has been performed safely. AKI occurs in 8 to 24% of extremely low birth weight (ELBW) infants. Although PD has only been used occasionally in ELBW infants, prognosis is poor for ELBW infants with AKI. Several reports have described successful PD in these infants, but no guideline-based evidence concerning indications for renal replacement therapy in ELBW infants are currently available. Here, we report on our experience with PD in an ELBW infant with AKI resulting from septic shock...
November 9, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29123846/two-cases-of-cryptogenic-life-threatening-hemoptysis-identification-and-management-of-bleeding-point
#5
Kazunori Okuda, Jun Tanaka, Jun Okamoto, Fumihisa Kishi, Junichiro Nakagawa, Hiroshi Hino, Satoru Chujoh, Kazuhisa Shimadzu, Masafumi Kishimoto, Noboru Kato, Shigeru Shiono
Cases: Case 1: A 63-year-old woman was referred for coughing blood. Although cardiorespiratory dynamics were stabilized by artificial respiration under sedation, severely poor ventilation developed from asphyxia associated with massive respiratory tract hemorrhage. One-lung ventilation was temporarily secured by endotracheal tube insertion into the left main bronchus just prior to cardiopulmonary arrest.Case 2: A 72-year-old man was referred for massive hemoptysis after coughing, then intubated and placed on a respirator...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121081/intraoperative-ventilatory-leak-predicts-prolonged-air-leak-after-lung-resection-a-retrospective-observational-study
#6
Won Ho Kim, Hyung-Chul Lee, Ho-Geol Ryu, Hyun-Kyu Yoon, Chul-Woo Jung
Prolonged air leak (PAL), defined as air leak more than 5 days after lung resection, has been associated with various adverse outcomes. However, studies on intraoperative risk factors for PAL are not sufficient. We investigated whether the intraoperative ventilatory leak (VL) can predict PAL. A retrospective study of 1060 patients with chest tubes after lung resection was conducted. Tidal volume data were retrieved from the electronic anesthesia records. Ventilatory leak (%) was calculated as [(inspiratory tidal volume-expiratory tidal volume)/ inspiratory tidal volume × 100] and was measured after restart of two-lung ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/29119549/a-prototype-small-bore-ventilation-catheter-with-a-cuff-cuff-inflation-optimizes-ventilation-with-the-ventrain
#7
M W P de Wolf, T van der Beek, A E Hamaekers, M Theunissen, D Enk
BACKGROUND: Ventilation through small-diameter tubes typically precludes use of a cuff as this will impede the necessary passive outflow of gas alongside the tube's outer surface. Ventrain assists expiration and enables oxygenation and normoventilation through small-bore cannulas or catheters, particularly in obstructed airways. A small-bore ventilation catheter (SBVC; 40 cm long, 2.2 mm inner diameter) with a separate pressure monitoring lumen and a cuff was developed. Efficacy of oxygenation and ventilation with Ventrain through this catheter was investigated in sealed and open airways in a porcine cross-over study...
November 8, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29114417/an-alternative-lung-isolation-technique-in-paediatric-pulmonary-alveolar-proteinosis
#8
Tümay Umuroğlu, Merve Altıntaş, Tural Abdullayev, Gürsu Kıyan, Hilmi Ö Ayanoğlu
Lung isolation during the lung lavage of children with pulmonary alveolar proteinosis (PAP) poses challenges to anaesthesiologists. There is no established technique in the management of lung lavage in children; each described technique has its own advantages and disadvantages. We described a patient (2.5-year-old) with PAP, who has undergone left lung lavage. While his lung was isolated by a Fogarty catheter, lavage was performed via a feeding tube, and the right lung was ventilated with a rigid bronchoscope...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29114411/clinical-comparison-of-i-gel-supraglottic-airway-device-and-cuffed-endotracheal-tube-for-pressure-controlled-ventilation-during-routine-surgical-procedures
#9
Ankur Dhanda, Shalendra Singh, Anju R Bhalotra, Siddharth Chavali
Objective: Recently, there has been a trend favouring the use of supraglottic airway devices over endotracheal tubes (ETT) during short surgical procedures. In this study, we are going to assess the suitability of one such supraglottic airway device, i-gel, for pressure-controlled ventilation (PCV) during routine surgical procedures. Methods: The airway management for 60 patients was done with either i-gel (Group I) or cuffed tracheal tube (Group E) for this prospective, randomised, double-blinded study...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29109835/anterior-submandibular-approach-for-transmylohyoid-endotracheal-intubation-a-reappraisal-with-prospective-study-in-206-cases-of-craniomaxillofacial-fractures
#10
Nitin Bhola, Anendd Jadhav, Atul Kala, Rahul Deshmukh, Umesh Bhutekar, G S V Prasad
Despite a paradigm shift in anesthesia and trauma airway management, the craniomaxillofacial fracture (CMF) patients continue to pose a challenge. A prospective study was planned between April 2007 and March 2015 to investigate the safety, efficacy, utility, and complications of anterior submandibular approach for transmylohyoid intubation (TMI) in CMFs using an armored endotracheal tube (ETT). Out of 1,207 maxillofacial trauma cases reported, this study recruited 206 patients (152 males and 54 females) aged between 21 and 60 years...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29098448/incidence-of-airway-complications-in-patients-using-endotracheal-tubes-with-continuous-aspiration-of-subglottic-secretions
#11
Jordi Vallés, Susana Millán, Emili Díaz, Eva Castanyer, Xavier Gallardo, Ignacio Martín-Loeches, Marta Andreu, Mario Prenafeta, Paula Saludes, Jorge Lema, Montse Batlle, Néstor Bacelar, Antoni Artigas
BACKGROUND: Continuous aspiration of subglottic secretions is effective in preventing ventilator-associated pneumonia, but it involves a risk of mucosal damage. The main objective of our study was to determine the incidence of airway complications related to continuous aspiration of subglottic secretions. METHODS: In consecutive adult patients with continuous aspiration of subglottic secretions, we prospectively recorded clinical airway complications during the period after extubation...
November 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29092869/testing-placement-of-gastric-feeding-tubes-in-infants
#12
Norma A Metheny, Ann Pawluszka, Melanie Lulic, Leslie J Hinyard, Kathleen L Meert
BACKGROUND: Inadvertent positioning of a nasogastric tube in the lung can cause serious complications, so identifying methods to detect improperly inserted tubes is imperative. OBJECTIVES: To compare the sensitivity, specificity, and negative and positive predictive values of 4 pH cut points (< 4.0, < 4.5, < 5.0, and < 5.5) in differentiating gastric and tracheal aspirates under various treatment conditions and to explore the utility of a pepsin assay for distinguishing between gastric and tracheal aspirates...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29089699/tracheostomy-in-patients-who-need-mechanical-ventilation-early-or-late-surgical-or-percutaneous-a-prospective-study-in-iran
#13
Hamidreza Hemmati, Mohammad Forozeshfard, Babak Hosseinzadeh, Sahar Hemmati, Majid Mirmohammadkhani, Razieh Bandari
Tracheostomy can be performed surgically or by percutaneous (percutaneous dilatory tracheostomy, PDT) methods, and it may be used early or late. In a 3-month follow-up, all patients who underwent tracheostomy in Semnan in 2013 were evaluated for complications of tracheostomy considering the method used and the timing of operation. A total of 55 patients underwent tracheostomy (26 cases surgery, 29 cases PDT, 30 cases early, and 25 cases late based on 14 days reference). The mean durations of operation were 19...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29080710/conservative-management-in-traumatic-pneumothoraces-an-observational-study
#14
Steven P Walker, Shaney L Barratt, Julian Thompson, Nick A Maskell
BACKGROUND: Traumatic pneumothoraces are a common consequence of major trauma. Despite this, there is a paucity of literature regarding their optimal management, including the role of conservative treatment. The aim of this study was to assess the treatment, complications and outcomes of traumatic pneumothoraces in patients presenting to a Major Trauma Centre. METHODS: The prospectively collected Trauma Audit and Research Network (TARN) database was used to identify all patients presenting with traumatic pneumothoraces to a UK Major Trauma Centre from April 2012 to December 2016...
October 25, 2017: Chest
https://www.readbyqxmd.com/read/29078668/anaesthesiology-for-uniportal-vats-double-lumen-single-lumen-and-tubeless
#15
REVIEW
Ze-Rui Zhao, Rainbow W H Lau, Calvin S H Ng
The advent of one-lung ventilation (OLV) technique provides immobilized surgical field which is fundamental in minimally invasive thoracic surgery. Mainstem methods of achieving lung separation are either via a double-lumen endotracheal tube or placing a bronchial blocker (BB) through a single-lumen endotracheal tube. More recently, the use of non-intubated thoracic surgery (NITS) has been investigated intensively, attempting to minimise the complications that follow general anaesthesia. The aim of this review is to describe the mechanism of these techniques briefly and outlines the advantages and drawbacks of them with the comparison...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29073915/emt-led-laryngeal-tube-vs-face-mask-ventilation-during-cardiopulmonary-resuscitation-a-multicenter-prospective-randomized-trial
#16
Anna Fiala, Wolfgang Lederer, Agnes Neumayr, Tamara Egger, Sabrina Neururer, Ernst Toferer, Michael Baubin, Peter Paal
BACKGROUND: Laryngeal tube (LT) application by rescue personnel as an alternate airway during the early stages of out-of-hospital cardiac arrest (OHCA) is still subject of debate. We evaluated ease of handling and efficacy of ventilation administered by emergency medical technicians (EMTs) using LT and bag-valve-mask (BVM) during cardiopulmonary resuscitation of patients with OHCA. METHODS: An open prospective randomized multicenter study was conducted at six emergency medical services centers over 18 months...
October 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29071770/the-child-s-behavior-during-inhalational-induction-and-its-impact-on-the-anesthesiologist-s-sevoflurane-exposure
#17
Jennifer Herzog-Niescery, Heike Vogelsang, Martin Bellgardt, Nikolaj Matthias Botteck, Hans-Martin Seipp, Horst Bartz, Thomas Peter Weber, Philipp Gude
BACKGROUND: Sevoflurane is commonly used for inhalational inductions in children, but the personnel's exposure to it is potentially harmful. Guidance to reduce gas pollution refers mainly to technical aspects, but the impact of the child's behavior has not yet been studied. AIMS: The purpose of this study was to determine how child behavior, according to the Frankl Behavioral Scale, affects the amount of waste sevoflurane in anesthesiologists' breathing zones. METHODS: Sixty-eight children aged 36-96 months undergoing elective ENT surgery were recruited for this prospective, observational investigation...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29068269/prone-position-for-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#18
Laveena Munshi, Lorenzo Del Sorbo, Neill K J Adhikari, Carol L Hodgson, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Jordi Mancebo, Antonio Pesenti, V Marco Ranieri, Eddy Fan
RATIONALE: The application of prone positioning for acute respiratory distress syndrome (ARDS) has evolved, with recent trials focusing on patients with more severe ARDS, and applying prone ventilation for more prolonged periods. OBJECTIVES: This review evaluates the effect of prone positioning on 28-day mortality (primary outcome) compared with conventional mechanical ventilation in the supine position for adults with ARDS. METHODS: We updated the literature search from a systematic review published in 2010, searching MEDLINE, EMBASE, and CENTRAL (through to August 2016)...
October 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29063711/role-of-ultrasound-measuring-position-and-ventilation-pressure-in-determining-correct-tube-size-in-children
#19
Christoph Schramm, Luzie S Eisleben, Jens Kessler, Katrin Jensen, Konstanze Plaschke
BACKGROUND: Ultrasound measurements of the airway are useful for determining correctly sized, uncuffed endotracheal tubes in children. AIMS: The primary objective of this study was to evaluate the influence of ventilation pressure on the sonographically measured tracheal diameter at different levels. METHODS: A total of 100 patients (under 7 years) were enrolled in this study. Six sonographic measurements of minimal transverse diameters at 3 locations (vocal chords, cricoid cartilage, and proximal trachea) and at 2 different ventilation pressures (0 and 15 mbar) were performed before the intubation procedure...
October 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29059833/two-parameter-leak-estimation-in-non-invasive-ventilation
#20
Francesco Vicario, Samiya Alkhairy, Roberto Buizza, William A Truschel
In this paper we present a method for the estimation of leaks in non-invasive ventilation. Accurate estimation of leaks is a key component of a ventilator, since it determines the ventilator performance in terms of patient-ventilator synchrony and air volume delivery. In particular, in non-invasive ventilation, the patient flow is significantly different from the flow measured at the ventilator outlet. This is mostly due to the vent orifice along the tube that is used for exhalation, but also to the non-intentional leaks that occur elsewhere in the circuit (e...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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