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intubation and elderly

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https://www.readbyqxmd.com/read/28286198/in-hospital-mortality-and-post-transplant-complications-in-elderly-multiple-myeloma-patients-undergoing-autologous-hematopoietic-stem-cell-transplantation-a-population-based-study
#1
Larysa Sanchez, Michael Sylvester, Ricardo Parrondo, Veronica Mariotti, Jean Anderson Eloy, Victor T Chang
Autologous hematopoietic stem cell transplantation (auto-HSCT) has improved survival in patients with multiple myeloma (MM) and is increasingly used in elderly patients. The aim of this study was to characterize and compare in-hospital complications and mortality after auto-HSCT in younger (< age 65) vs. elderly (≥ age 65) MM patients utilizing the Nationwide Inpatient Sample (NIS). Over a three-year period (2008-2010), 2209 patients with MM were admitted to U.S. Hospitals for auto-HSCT. The median age was 59 years, with 1650 patients (74...
March 9, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28249306/mini-craniotomy-under-local-anesthesia-to-treat-acute-subdural-hematoma-in-deteriorating-elderly-patients
#2
Alessandro Di Rienzo, Maurizio Iacoangeli, Lorenzo Alvaro, Roberto Colasanti, Lucia Giovanna Maria Di Somma, Niccolo Nocchi, Maurizio Gladi, Massimo Scerrati
Background and Study Aims Surgical treatment for acute subdural hematomas (ASDHs) in elderly patients is still considered unsatisfactory. Series focusing on the use of conventional craniotomy or decompressive craniectomy in such patients report discouraging results. Glasgow Coma Scale (GCS) score at admission seems to be crucial in the decision-making process. Deteriorating patients with a GCS score between 9 and 11 are those who would benefit most from the surgical treatment. Unfortunately, elderly patients often present other comorbidities that greatly increase the risk of severe complications after major neurosurgical procedures under general anesthesia...
March 1, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28243434/spontaneous-thyroid-hemorrhage-on-chronic-anticoagulation-therapy
#3
Kulothungan Gunasekaran, Kelly M Rudd, Swetha Murthi, Scott Kaatz, Nazir Lone
Even though highly vascularized, the thyroid gland rarely has spontaneous bleeding. Bleeding into the thyroid gland can result in potentially lethal acute airway compromise. This case report describes an elderly patient on warfarin for atrial fibrillation, who presented with swelling on the right side of her neck causing acute airway obstruction. An urgent computed tomography of the neck showed an enlarging hemorrhage into the right lobe of the thyroid gland. She was initially intubated for airway protection and her anticoagulation was reversed to stop the bleeding...
January 11, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28239805/comparative-study-efficacy-of-closed-looptarget-controlled-infusion-of-cisatracurium-and-other-administration-methods-for-spinal-surgery-of-elderly-patients
#4
X-D Ma, J Yan, B-Z Dai, D-Q Kong, S-Y Du, B-P Li
OBJECTIVE: To observe the efficacy of traditional administration, continuous pump injection, and closed-loop target controlled infusion of cisatracurium to determine the optimal method of drug administration, and to establish the individualized and rational administration of muscle relaxants in elderly patients. PATIENTS AND METHODS: A total of 150 patients who underwent spinal surgery under tracheal intubation general anesthesia in our hospital from August 2013 to April 2015 were selected...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28184265/effects-of-preanesthetic-dexmedetomidine-on-hemodynamic-responses-to-endotracheal-intubation-in-elderly-patients-undergoing-treatment-for-hypertension-a-randomized-double-blinded-trial
#5
Chan Woo Lee, Miwoon Kim
BACKGROUND: Dexmedetomidine is an alpha-2 adrenergic agonist with sedative, anxiolytic, and analgesic properties. This study was designed to evaluate the inhibitory effects of preoperative administration of 0.5 µg/kg dexmedetomidine on hemodynamic responses caused by endotracheal intubation in elderly patients undergoing treatment for hypertension. METHODS: Forty elderly (≥ 65 years old) patients who had been receiving hypertension treatment, had American Society of Anesthesiologists physical status II, and were scheduled to undergo elective noncardiac surgery were randomly selected and assigned to 2 groups...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28141585/hospital-acquired-pneumonia-due-to-achromobacter-xylosoxidans-in-the-elderly-a-single-center-retrospective-study-in-beijing
#6
Chao Liu, Jun Guo, Weifeng Yan, Yi Jin, Fei Pan, Xiangqun Fang, Long Qin, Changting Liu
INTRODUCTION: Achromobacter xylosoxidans has been reported in several countries; however, hospital-acquired pneumonia (HAP) due to this organism in elderly patients in China remains rare. METHODOLOGY: HAP due to Achromobacter xylosoxidans identified at the General Hospital of the People's Liberation Army in Beijing from January 2008 to October 2011 was studied. Detailed clinical manifestations were collected. To study the clinical risk factors for the imipenem-resistant strain, patients were divided into two groups: imipenem-resistant (21 cases) and imipenem-nonresistant (20 cases)...
January 30, 2017: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#7
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/27924209/postoperative-respiratory-difficulty-due-to-asymptomatic-anterior-cervical-osteophyte-after-brain-tumor-surgery-a-case-report
#8
Hye Won Shin, Joon Chul Jang, Hyong Hwan Lim, Min Kyung Park, Go Eun Bae, Seung Uk Choi, Ji Yong Park
Anterior cervical osteophytes are commonly found in elderly patients, but rarely produce symptoms. When symptoms occur, they can range from mild symptoms of dysphagia, dysphonia, and foreign body sensation to severe symptoms of airway obstruction due to compression of the pharynx or larynx. We report the case of a 59-year-old man who underwent brain tumor surgery, and developed post-operative respiratory difficulty due to progressive pharyngo-laryngeal edema, requiring urgent endotracheal intubation, secondary to the presence of a previously asymptomatic anterior cervical osteophyte...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#9
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27846872/challenges-on-non-invasive-ventilation-to-treat-acute-respiratory-failure-in-the-elderly
#10
REVIEW
Raffaele Scala
Acute respiratory failure is a frequent complication in elderly patients especially if suffering from chronic cardio-pulmonary diseases. Non-invasive mechanical ventilation constitutes a successful therapeutic tool in the elderly as, like in younger patients, it is able to prevent endotracheal intubation in a wide range of acute conditions; moreover, this ventilator technique is largely applied in the elderly in whom invasive mechanical ventilation is considered not appropriated. Furthermore, the integration of new technological devices, ethical issues and environment of treatment are still largely debated in the treatment of acute respiratory failure in the elderly...
November 15, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27798767/practical-management-of-anaesthesia-in-the-elderly
#11
Camilla Strøm, Lars Simon Rasmussen, Jacob Steinmetz
The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient...
October 31, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27751701/suicidal-patients-with-a-do-not-resuscitate-order
#12
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...
January 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27683826/oropharyngeal-dysphagia-and-related-factors-in-post-cardiac-surgery-a-systematic-review
#13
REVIEW
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 2016: CoDAS
https://www.readbyqxmd.com/read/27646937/effects-of-different-doses-of-remifentanil-on-hemodynamic-response-to-anesthesia-induction-in-healthy-elderly-patients
#14
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...
January 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27613432/incidence-and-risk-factors-for-aspiration-pneumonia-after-cardiovascular-surgery-in-elderly-patients
#15
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...
February 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27590209/characteristics-and-outcomes-for-acute-heart-failure-in-elderly-patients-presenting-to-the-ed
#16
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...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27573210/a-case-of-cricothyroidotomy-for-facial-trauma-in-a-patient-taking-antiplatelet-agents-after-a-simple-ground-level-fall
#17
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
https://www.readbyqxmd.com/read/27501655/unknown-pseudocholinesterase-deficiency-in-a-patient-undergoing-tiva-with-planned-motor-evoked-potential-monitoring-a-case-report
#18
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
https://www.readbyqxmd.com/read/27485246/functional-independence-measure-for-elderly-patients-undergoing-aortic-valve-replacement
#19
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)...
January 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27394423/the-plasma-levels-of-brain-derived-neurotrophic-factor-are-positively-associated-with-emergence-agitation-in-the-elderly-after-gastrointestinal-surgery
#20
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
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