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intubation and elderly

Mary P Henman
BACKGROUND: A suicidal person with a do-not-resuscitate (DNR) order presents an ethical dilemma to the emergency physician. Many believe that suicide is an irrational action, and therefore, all suicide attempts must be treated. Others believe a DNR order should be respected even in the setting of a suicide attempt. CASE REPORT: An elderly woman with a known terminal illness presented to the emergency department after a suspected suicide attempt. She had a DNR order during her previous hospitalization...
October 14, 2016: Journal of Emergency Medicine
Roberta Weber Werle, Eduardo Matias Dos Santos Steidl, Renata Mancopes
Purpose: To identify the main factors associated with oropharyngeal dysphagia following cardiac surgery through a systematic review of the literature. Methods: A bibliographic search was conducted in the PubMed and ScienceDirect databases using the following keywords: "cardiac surgery", "deglutition disorders", and "dysphagia". Selection criteria: Articles published in Portuguese, English, or Spanish addressing oropharyngeal dysphagia following cardiac surgery were selected with no time limitation...
September 26, 2016: CoDAS
Nilay Boztas, Sermin Oztekin, Sevda Ozkardes, Mert Akan, Sule Ozbilgin, Ayse Baytok
OBJECTIVE: We compared the effects of three different doses of remifentanil infusion, which were performed for the induction of anesthesia in elder patients, on cardiovascular response. RESEARCH DESIGN AND METHODS: The present study was designed as a randomized, prospective and double-blind study. A total of 90 ASA I-II patients over the age of 65 years were enrolled. The patients were randomly (by lot) assigned to receive one of the three doses of remifentanil infusion (0...
October 17, 2016: Current Medical Research and Opinion
Eriko Miyata, Atsushi Tanaka, Hiroki Emori, Akira Taruya, Shinji Miyai, Nobuo Sakagoshi
OBJECTIVE: Pneumonia after cardiovascular surgery is the leading cause of mortality. Postoperative aspiration pneumonia becomes a critical issue in the management of cardiovascular surgery in the aging society. The aim of this study was to investigate the incidence and risk factors of aspiration pneumonia after cardiovascular surgery for elderly patients. METHODS: This study consisted of 123 elderly patients (>65 years old) who survived their final extubation following cardiovascular surgery at Kinan Hospital...
September 9, 2016: General Thoracic and Cardiovascular Surgery
Pierre-Géraud Claret, Ian G Stiell, Justin W Yan, Catherine M Clement, Brian H Rowe, Lisa A Calder, Jeffrey J Perry
INTRODUCTION: The first aim of this study was to investigate the characteristics for elderly patients with acute heart failure presenting to the emergency department (ED). The second aim was to determine the characteristics of these elderly patients associated with serious adverse events. METHODS: The population was divided into 2 age groups, <80 and ≥80 years. The primary outcome was the occurrence of a serious adverse event, defined as either death from any cause within 30 days of the index ED visit or any of the following events within 14 days of the index ED visit: admission to a monitored unit, intubation, need for noninvasive ventilation, myocardial infarction, major procedure, or, for patients who were discharged after the initial visit, return to the ED resulting in admission to hospital...
August 12, 2016: American Journal of Emergency Medicine
Tetsuya Yumoto, Tatsushi Matsumura, Kohei Tsukahara, Keiji Sato, Toyomu Ugawa, Yoshihito Ujike
INTRODUCTION: Cricothyroidotomy is an emergency procedure that can be used to secure the airway in situations in which intubation and ventilation are not possible. PRESENTATION OF CASE: We describe a case of 79-year-old male presenting with facial trauma combined with massive upper airway bleeding and swelling in which cricothyroidotomy was required to open the airway in an elderly male patient taking antiplatelet agents who suffered a simple ground-level fall. DISCUSSION: Although emergency airway management is often required in patients with Le Fort fractures, mandibular condyle fractures exhibit a significant relationship with ground-level falls, which are not usually associated with emergency airway management...
2016: International Journal of Surgery Case Reports
Candace Binkley
Pseudocholinesterase abnormalities are a genetic cause of aberrant metabolism of the depolarizing muscle relaxant succinylcholine. This article examines a case where succinylcholine was chosen to facilitate intubation due to its ultra short duration and the request of the surgeon to monitor motor evoked potentials. Following succinylcholine administration the neurophysiologist was unable to obtain motor evoked potentials. This case study highlights the intraoperative and postoperative management of an elderly patient with an unknown pseudocholinesterase deficiency...
June 2016: AANA Journal
Masaaki Ryomoto, Masataka Mitsuno, Mitsuhiro Yamamura, Hiroe Tanaka, Shinya Fukui, Tetsuya Kajiyama, Ayaka Satou, Yuji Miyamoto, Domen Kazuhisa
OBJECTIVE: This study aimed to evaluate the efficacy of the Functional Independence Measure to assess preoperative frailty for elderly patients undergoing surgical aortic valve replacement. METHODS: Eighty-five patients >65 years who survived elective isolated aortic valve replacement from January 2008 to October 2015 were included. The mean age at the operation was 78 ± 6 years old (n = 28 males, n = 57 females). The patients were divided into two groups according to their status at discharge: impossible to discharge home or hospitalization for >30 days (compromised group, n = 8), or unaffected (unaffected group, n = 77)...
August 2, 2016: General Thoracic and Cardiovascular Surgery
Xi Mei, Jianbin Tong
AIMS: To explore the association between plasma concentrations of brain-derived neurotrophic factor (BDNF) and the occurrence of emergence agitation (EA) in the elderly after gastrointestinal surgery. METHODS: Seventy-two patients were recruited, who received gastrointestinal surgery and general anesthesia. BDNF level of blood was detected by ELISA before anesthesia (baseline), 10 min after tracheal intubation before the start of surgery, at skin closure, 10 min after tracheal extubation, and 24 h postoperatively...
October 2016: Journal of Anesthesia
Yusuke Okuma, Yukio Hosomi, Satoshi Takahashi, Yoshiro Nakahara, Kageaki Watanabe, Makoto Nagamata, Yusuke Takagi, Shinichiro Mikura
INTRODUCTION: The objective of this clinical trial was to explore the efficacy and tolerability of first-line chemotherapy with nanoparticle albumin-bound paclitaxel (nab-paclitaxel), a novel agent that uses a drug delivery system, plus carboplatin, in elderly Japanese patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: In this phase II, single-arm, open-label, single-institutional study, we aimed to enroll 37 elderly patients, aged more than 70 years, with advanced NSCLC of performance status 0 or 1...
August 2016: Cancer Chemotherapy and Pharmacology
Wei-guo Ni, Qing-feng Hu, Ke Xu, Ying-hua Zhang, Shuai Ding, Sheng-qiang Liu, Chen Xin
OBJECTIVE: To observe effects of Ligustrazine on serum S100p protein and neuron-specific enolase (NSE) in elderly patients undergoing orthopedics operations. METHODS: Totally 60 patients undergoing selective total hip replacement, 65-80 years old, who were in line with American Society of Anesthesiologists (ASA) grade I or II, were randomly assigned to the Ligustrazine group (Group L) and the normal saline control group (Group S). The right internal jugular vein catheters were placedcephalad and ensured theirs tips in jugular venous bulbs after anesthesia induction and tracheal intubation...
April 2016: Chinese Journal of Integrated Traditional and Western Medicine
Muhammet Onur Hanedan, İlker Mataracı, Mehmet Ali Yürük, Tanıl Özer, Ufuk Sayar, Ali Kemal Arslan, Uğur Ziyrek, Murat Yücel
BACKGROUND: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation...
June 2016: Korean Journal of Thoracic and Cardiovascular Surgery
J E Romo Gonzales, J Silva Obregón, C Martin Dal Gesso, P Gallardo Culebradas, S Saboya Sanchez, M Torralba
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Suchi Chang, Jindong Shi, Cuiping Fu, Xu Wu, Shanqun Li
BACKGROUND: COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Kouhei Ishikawa, Kei Jitsuiki, Hiromichi Ohsaka, Toshihiko Yoshizawa, Mariko Obinata, Kazuhiko Omori, Yasumasa Oode, Motoki Takahashi, Youichi Yanagawa
OBJECTIVE: This is the first report to show the use of doctor helicopters in a mass casualty event induced by electrocution. METHODS: We performed a narrative review. RESULTS: Two children obtained electrocution burns by breaking an electric fence. Five adults also received electrocution burns. Emergency medical technicians at the scene requested additional dispatch of an ambulance and the doctor helicopter. Two adult men with cardiopulmonary arrest were transported by 2 ambulances to a nearby hospital...
May 2016: Air Medical Journal
Dominik T Steck, Christine Choi, Suneeta Gollapudy, Paul S Pagel
INTRODUCTION: Sporadic inclusion body myositis (IBM) is an inflammatory myopathy characterized by progressive asymmetric extremity weakness, oropharyngeal dysphagia, and the potential for exaggerated sensitivity to neuromuscular blockers and respiratory compromise. The authors describe their management of a patient with IBM undergoing urgent orthopedic surgery. CASE PRESENTATION: An 81-year-old man with IBM suffered a left intertrochanteric femoral fracture after falling down stairs...
April 2016: Anesthesiology and Pain Medicine
Ines Maria Grazia Piroddi, Cornelius Barlascini, Antonio Esquinas, Fulvio Braido, Paolo Banfi, Antonello Nicolini
The treatment of acute respiratory failure with non-invasive ventilation (NIV) as a first-line therapy is increasingly common in intensive care units. The reduced invasiveness of NIV leads to better outcomes than endotracheal intubation in carefully selected groups of patients. Furthermore, the use of NIV as a palliative treatment for respiratory failure and dyspnea has become increasingly common. NIV also has an impact on the use of "do not intubate" orders. In the present narrative review, we explore the use and outcome of NIV in elderly patients...
May 23, 2016: Geriatrics & Gerontology International
Marco Moscarelli, Sam Emmanuel, Thanos Athanasiou, Giuseppe Speziale, Khalil Fattouch, Roberto Casula
BACKGROUND: Minimal access valve surgery, both mitral and aortic, may be related to improvement in specific post-operative outcomes, therefore may be beneficial for the subgroup of the elderly referred for valve surgery. METHODS: A systematic literature review identified several different studies, of which 6 fulfilled criteria for meta-analysis. Outcomes for a total of 1347 patients (675 conventional standard sternotomy and 672 minimally invasive valve surgery) were assessed with a meta-analysis using random effects modeling...
September 2016: International Journal of Surgery
Alberto Zangrillo, Patrizio Mazzone, Carmine D Votta, Nicola Villari, Paolo Della Bella, Fabrizio Monaco
PURPOSE: Left atrial appendage (LAA) closure is an interventional procedure increasingly used to prevent stroke in patients with permanent atrial fibrillation and contraindications to anticoagulation therapy. As this procedure requires a relatively immobile patient and performance of continuous and prolonged transesophageal echocardiography (TEE), it is usually performed under general anesthesia. In this case series, we describe the feasibility of prolonged TEE for percutaneous LAA closure using a new noninvasive ventilation device that can avoid the need for endotracheal intubation and general anesthesia...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Nao Umei, Kazuaki Atagi, Hideo Okuno, Seino Usuke, Yasuhiro Otsuka, Atsushi Ujiro, Hideki Shimaoka
OBJECTIVES: This study identified respiratory and haemodynamic parameters affected by limited mobilisation therapy in elderly, critically ill, intubated patients in an intensive care unit. METHODS: Over 18 months, we retrospectively assessed physiological changes during 43 mobilisation therapy sessions in 23 patients requiring mechanical ventilation for >48h. We compared heart rate, mean arterial blood pressure, respiratory rate, partial pressure of oxygen in arterial blood/inspired fraction of oxygen and lactate before and after mobilisation therapy, which entailed sitting on the edge of a hospital bed without back support...
August 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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