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Endotracheal intubation

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https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#1
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
April 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28424763/airway-problems-in-neonates-a-review-of-the-current-investigation-and-management-strategies
#2
REVIEW
Quen Mok
Airway problems in the neonatal population are often life threatening and raise challenging issues in diagnosis and management. The airway problems can result from congenital or acquired lesions and can be broadly classified into those causing obstruction or those due to an abnormal "communication" in the airway. Many different investigations are now available to identify the diagnosis and quantify the severity of the problem, and these tests can be simple or invasive. Bronchography and bronchoscopy are essential to determine the extent and severity of the airway problem and to plan treatment strategy...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28422820/comparison-of-the-etview-single-lumen-and-macintosh-laryngoscopes-for-endotracheal-intubation-in-an-airway-manikin-with-immobilized-cervical-spine-by-novice-paramedics-a-randomized-crossover-manikin-trial
#3
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Barak Cohen, Kurt Ruetzler, Lukasz Szarpak
CONTEXT: Management of the airway of a trauma victim is considered challenging. Various approaches have been described to achieve airway control in this setup; many of them include video-assited viewing of the larynx during intubation. ETView Single Lumen (SL) is a novice single-use endotracheal tube equiped with a video camera and a light source at its distal tip. Its use was previously described in seeral clinical and training setups. OBJECTIVE: The aim was to evaluate the efficacy of the VivaSight SL compared with classic direct laryngoscopy performed with a Macintosh blade in a manikin-simulated trauma setup presenting various degrees of airway challenge when performed by inexperienced physicians...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#4
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28413075/abrasion-and-blunt-tissue-trauma-study-of-a-novel-flexible-robotic-system-in-the-porcine-model
#5
Michael Z Lerner, Michael Tricoli, Marshall Strome
OBJECTIVES: The objective of this study was to determine if a flexible robotic system caused increased tissue reaction when accessing the oropharynx and hypopharynx compared to intubation controls in only 2 scenarios: high speed tissue impact and multiple unit insertions and retractions. The data obtained were submitted as part of the entirety of information submitted for FDA approval. METHODS: This study consisted of 5 groups of Yorkshire pigs (2 animals per group)...
April 11, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28411000/meconium-aspiration-or-respiratory-distress-associated-with%C3%A2-meconium-stained-amniotic-fluid
#6
REVIEW
Nestor E Vain, Daniel G Batton
The designation meconium aspiration syndrome (MAS) reflects a spectrum of disorders in infants born with meconium-stained amniotic fluid, ranging from mild tachypnea to severe respiratory distress and significant mortality. The frequency of MAS is highest among infants with post-term gestation, thick meconium, and birth asphyxia. Pulmonary hypertension is an important component in severe cases. Prenatal hypopharyngeal suctioning and postnatal endotracheal intubation and suctioning of vigorous infants are not effective...
April 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28410880/the-effect-of-user-experience-and-inflation-technique-on-endotracheal-tube-cuff-pressure-using-a-feline-airway-simulator
#7
Donna M White, José I Redondo, Alastair R Mair, Fernando Martinez-Taboada
OBJECTIVE: The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator. STUDY DESIGN: Prospective, experimental clinical study. METHODS: Participants included veterinary students at the beginning (group S1) and end (group S2) of their 2-week anaesthesia rotation and veterinary anaesthetists (group A). The feline airway simulator was designed to simulate an average size feline trachea, intubated with a 4...
February 24, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28410264/esophageal-atresia-tracheoesophageal-fistula-repair-complicated-by-tracheomalacia-a-case-report-of-successful-management-of-respiratory-distress-using-caudal-morphine
#8
Joanna M Dion, Anthony M-H Ho, Andrea Winthrop, Michael P Flavin
We report a case of severe respiratory distress in a neonate who was not endotracheally intubated soon after esophageal atresia/tracheoesophageal fistula (EA/TEF) repair. In this serious situation, any form of emergency respiratory support or definitive airway management may compromise the esophageal anastomosis and fistula repair. The cause of respiratory distress in the early postoperative period after EA/TEF is multifactorial, and in this case, included symptomatic tracheomalacia, which is commonly associated with EA/TEF...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28410262/life-saving-esophageal-intubation-in-neonate-with-undiagnosed-tracheal-agenesis-a-case-report
#9
Christopher Sattler, Franklin Chiao, David Stein, Denise Murphy
A 3-day-old, 2.2-kg former 34-week premature infant with imperforate anus required loop ileostomy surgery. At delivery, the child had respiratory distress. Endotracheal intubation was "confirmed" by detection of exhaled carbon dioxide with a Pedi-Cap (Covidien, Dublin, Ireland) and subsequent chest x-ray. On arrival to the operating room, the pulse oximeter reading was 100% despite a large leak around the endotracheal tube and high-airway pressures. Packing the throat reduced the leak and increased the tidal volume...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28409758/improving-neonatal-intubation-safety-a-journey-of-a-thousand-miles
#10
T Sawyer, E E Foglia, L Dupree Hatch, A Moussa, A Ades, L Johnston, A Nishisaki
Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is extremely difficult, and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28408368/neonatal-airway-challenging-endotracheal-intubation-in-infants-with-tracheal-malformations-at-birth
#11
Arpan Agarwal, Masakazu Nakao, Victor Samuel Rajadurai, Suresh Chandran
Intubating newborn infants can be exacting. We describe two cases of endotracheal intubations in infants born with tracheal malformations. A male infant aged 30 weeks required intubation at birth for respiratory distress. Repeated attempts at intubation failed to achieve an optimal endotracheal tube position as the tube could not advance beyond the vocal cords. Hence ventilation continued with suboptimal air entry in the lungs. Bronchoscopy and CT scan confirmed tracheal stenosis. Slide tracheoplasty was successfully executed on day 78 of life...
April 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28408081/-nondepolarizing-muscle-relaxant-improves-direct-laryngoscopy-view-with-no-effect-on-face-mask-ventilation
#12
Marwan S Rizk, Salah M Zeineldine, Mohamad F El-Khatib, Vanda G Yazbeck-Karam, Sophie D Ayoub, Pierre K Bou-Khalil, Elie Abi-Nader, Marc M Ghabach, Chakib M Ayoub
BACKGROUND: Difficult or impossible face mask ventilation complicated with difficult tracheal intubation during anesthesia induction occurs in 0.4% of adult anesthesia cases, possibly leading to life-threatening complications. Because of such catastrophes, muscle relaxants have been recommended to be administered after confirming adequate face mask ventilation without a solid scientific validation of this principal. METHODS: In this observational study, the ease of ventilation and the scores of direct laryngoscopy views before and after administration of cisatracurium were assessed in ninety young healthy adults, without anesthetic risks and without foreseen difficult intubation and who were scheduled for general elective surgeries...
April 10, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28405997/tracheoesophageal-fistula-following-endotracheal-intubation-for-organophosphorus-poisoning
#13
Shailaja V Rao, Ajay K Boralkar, Prabhakar S Jirvankar, Mangala V Sonavani, Varsha Rotte Kaginalkar, Chimu Chinte
Tracheoesophageal fistula (TEF) is an abnormal communication between the trachea and esophagus. Iatrogenic TEF can be due to endotracheal intubation, rigid bronchoscopy or tracheostomy. Tracheostomy tube cuff volumes and pressures require constant monitoring to avoid tracheal injury. Acquired TEF which occurs after prolonged intubation, usually develops after 15-200 days of mechanical ventilation. We report a case of a large TEF secondary to endotracheal intubation for organophosphorus poison-induced respiratory failure...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28405036/rapidity-and-efficacy-of-ultrasonographic-sliding-lung-sign-and-auscultation-in-confirming-endotracheal-intubation-in-overweight-and-obese-patients
#14
Sunil Rajan, Jayasankar Surendran, Jerry Paul, Lakshmi Kumar
BACKGROUND AND AIMS: Obese individuals are predisposed to difficult airway and intubation. They usually yield confusing or misleading auscultatory findings. We aimed to assess the rapidity and efficacy of ultrasonographic (USG) sliding lung sign for confirming endotracheal intubation in normal as well as overweight and obese surgical patients. METHODS: This prospective, observational study was performed in forty surgical patients. Twenty patients with body mass index (BMI) <25 were recruited to Group A, whereas twenty patients with BMI ≥25 constituted Group B...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#15
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#16
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28401613/implementing-augmentative-and-alternative-communication-in-critical-care-settings-perspectives-of-healthcare-professionals
#17
Charlotte Handberg, Anna Katarina Voss
AIM: The aim of the current study was to describe the perspectives of healthcare professionals caring for intubated patients on implementing Augmentative and Alternative Communication (AAC) in critical care settings. BACKGROUND: Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalization and rehabilitation...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28392636/subcutaneous-emphysema-after-shoulder-arthroscopy-a-case-report-and-review-of-the-literature
#18
Els S M Van Nieuwenhuyse, Bart Kerens, Jan Moens, Gunther Kiekens
INTRODUCTION: Subcutaneous emphysema (SE) and pneumomediastinum are rare complications after shoulder arthroscopy. CASE REPORT: A case is presented in which SE was seen after arthroscopic cuff repair. DISCUSSION: A review of current literature shows that SE after shoulder arthroscopy can be due to loco-regional anaesthesiology, endotracheal intubation, gas-forming infection, postoperative mobilisation or the arthroscopic procedure itself. During the procedure air can be sucked into the subacromial space due to suction and subsequently transferred into subcutaneous tissue by the positive pressure of the infusion pump...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28390643/a-46-year-old-man-with-dyspnea-hypoxemia-and-radiographic-asymmetry-after-redo-bilateral-lung-transplantation
#19
Sofya Tokman, Michael A Smith, A Samad Hashimi, Ashraf Omar
A 46-year-old man underwent redo bilateral sequential lung transplantation for rapidly progressive bronchiolitis obliterans syndrome that developed 3.5 years after initial transplantation. In the operating room, he was sedated and intubated with a dual lumen endotracheal tube with subsequent single right-lung ventilation and left allograft implantation. His pulmonary arterial pressure became elevated with reperfusion of the newly implanted left lung, which required initiation of cardiopulmonary bypass to facilitate implantation of the right lung...
April 2017: Chest
https://www.readbyqxmd.com/read/28387188/deep-sedation-technique-for-dental-rehabilitation-of-a-patient-with-klippel-feil-syndrome
#20
Halima Abukabbos, Michael Mahla, Abi O Adewumi
Klippel-Feil syndrome (KFS) is a congenital anomaly characterized by a defect in the formation or segmentation of the cervical vertebrae, resulting in their fusion. The clinical triad of the syndrome consists of short neck, low posterior hairline, and limited neck movement, although fewer than 50 percent of patients demonstrate all three clinical features. The short neck and its immobility and instability present a significant challenge for endotracheal intubation. The purpose of this paper is to describe the management of a 13-year-old patient with KFS, extensive dental caries, and restricted mouth opening using a deep sedation technique in the operating room, which allowed successful completion of dental treatment...
January 15, 2017: Journal of Dentistry for Children
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