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intubation and elderly

Hui-Ying Xu, Guang-Hua Fu, Gui-Sheng Wu
Objective: To investigate the effect of dexmedetomidine at maintenance dose on the postoperative function of elder patients after general anesthesia for laparoscopic ovarian cystectomy. Methods: We enrolled a total of 96 elder patients who were admitted to this hospital for laparoscopic ovarian cystectomy under general anesthesia between March 2015 and March 2017, and divided them into two groups, Group A (n = 48) and B (n = 48). Patients in both groups received the same methods for anesthesia induction and maintenance drugs...
December 2017: Saudi Journal of Biological Sciences
Timothy Johnson, Peter Richman, John R Allegra, Barnet Eskin, James Seger
BACKGROUND: Advances in pharmacologic therapy, non-invasive positive pressure ventilation (NIPPV) and advanced directives may have decreased the intubations of dyspneic elderly (≥65years old) patients in the emergency department (ED). OBJECTIVE: To determine if the percentage of elderly ED patients intubated has decreased in recent years. METHODS: Design: Retrospective multihospital cohort. SETTING: Consecutive ED patients in nine NJ hospitals (1/1/1999 to 9/30/2014)...
February 25, 2018: American Journal of Emergency Medicine
Mitchell S Cappell, Ahmed Edhi, Mitual Amin
RATIONALE: Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation...
January 2018: Medicine (Baltimore)
Caitlin Richardson-Royer, Imran Naqvi, Christopher Riffel, Lawrence Harvey, Domonique Smith, Dagmawe Ayalew, Nasim Motayar, Yaw Amoateng-Adjepong, Constantine A Manthous
Background: Previous studies have demonstrated that video of and scripted information about cardiopulmonary resuscitation (CPR) can be deployed during clinician-patient end-of-life discussions. Few studies, however, examine whether video adds to verbal information-sharing. We hypothesized that video augments script-only decision-making. Methods: Patients aged >65 years admitted to hospital wards were randomized to receive evidence-based information ("script") vs...
2018: International Journal of General Medicine
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
X K Zhang, Q Hu, Q H Chen, W X Wang
We evaluated the effect of continuous perfusion of esmolol on cardiovascular risk during curative laparoscopic surgery for gastrointestinal cancer in elderly patients. Sixty patients with gastrointestinal cancer, aged from 60 to 80 years, were divided into an esmolol group (ES, n = 30) and a control group (NS, n = 30). ES patients were treated with esmolol at a dose of 0.3 mg/kg 3 min before tracheal intubation, and received continuous perfusion of esmolol at a dose of 50 μg/kg/min during operation. In NS, esmolol was replaced by saline...
August 1, 2017: Die Pharmazie
Cédric Dananché, Philippe Vanhems, Anaïs Machut, Martine Aupée, Caroline Bervas, François L'Hériteau, Alain Lepape, Jean-Christophe Lucet, Vincent Stoeckel, Jean-François Timsit, Anne Berger-Carbonne, Anne Savey, Thomas Bénet
OBJECTIVES: To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. DESIGN: Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). SETTINGS: Two-hundred fifty six ICUs in 246 settings in France. PATIENTS: Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network...
February 9, 2018: Critical Care Medicine
Michael S Green, Johann J Mathew, Lia J Michos, Parmis Green, Mansoor M Aman
Introduction: An acquired Tracheoesophageal fistula (TEF) is commonly caused by a malignancy or trauma, with pulmonary infection or aspiration being the presenting symptom. However, in the critical care setting the presentation can be subtle and may present with difficult ventilation. High endotracheal tube cuff pressures can lead to tracheal erosions and thus increasing the chances for developing a TEF. Prolonged intubation in the presence of other risk factors like poor general state of health, episodic hypotension, nasogastric tubes, and repeated intubations can increase the likelihood of developing an acquired TEF...
August 2017: Anesthesiology and Pain Medicine
Alireza Jalali, Ebrahim Nasiri, Mohsen Khoramian, Masood Saghafinia, Hasan Siamian
Introduction: Laryngoscopy and tracheal intubation are known to increase sympathetic activity that may be detrimental to patients with preexisting ischaemic or hypertensive heart disease. Aim: The aim of this study was to compare of intravenous and oropharyngeal spray of lidocaine and high dose of fentanyl on systolic and diastolic blood pressures and heart rate of patients over 65 years during tracheal intubation. Material and Methods: In this clinical trial, 160 patients over 65 yrs who were randomly divided into five groups of 32 patients...
December 2017: Medical Archives
Sarab Sodhi
"Respiratory distress. Four minutes out" crackled the radio. Terrified, I walked over to the resuscitation bay. It was my third day as an intern. An elderly man came in puffing away on BiPAP. His frail chest heaved about forty times a minute. My chief resident nudged me to the head of the bed, and told me to get set to intubate. This article is protected by copyright. All rights reserved.
January 30, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Tomohisa Yamamoto, Tatsushige Iwamoto, Seishi Kimura, Shinichi Nakao
BACKGROUND: Postoperative cognitive dysfunction (POCD) is likely to occur in elderly people, who often suffer from cerebral hypoperfusion and white matter lesions even in the absence of cerebral infarctions. METHODS: Thirty-two adult male rats were randomly assigned to one of four groups: the cerebral normoperfusion + normotension group (n = 8), cerebral normoperfusion + hypotension group (n = 8), chronic cerebral hypoperfusion (CCH) + normotension group (n = 8), and CCH + hypotension group (n = 8)...
January 25, 2018: Journal of Anesthesia
Kyawzaw Lin, Jamil Shah, Emmanuel Ofori, Vahe Shahnazarian, Madhavi Reddy
Esophageal cancer is the eighth-most common cause of cancer-related mortality worldwide. The most common presenting symptom in advanced distal esophageal cancer is the sensation of sticking food, but it may sometimes present with bleeding and related complications, or asymptomatic leukocytosis. We present the case of a 77-year-old afebrile man with chronic alcoholism and a dilated thoracic esophagus with painful, progressive, and persistent dysphagia and leukocytosis of unknown origin. A 77-year-old man with a past medical history of hypertension and colonic cancer status post right hemicolectomy (surveillance negative) presented to the emergency department with painful, progressive, persistent, and worsening dysphagia for the past three weeks...
November 16, 2017: Curēus
Bin Wang, Siyuan Li, Xipeng Cao, Xinghui Dou, Jingzhu Li, Ling Wang, Mingshan Wang, Yanlin Bi
BACKGROUND: Postoperative cognitive dysfunction (POCD) has received considerable attention as one of the main postoperative complications. The underlying mechanism of POCD in elderly subjects has not been fully elucidated to date. The central nervous system (CNS) is isolated from the bloodstream by the blood brain barrier (BBB) that consists of endothelial cells, capillary blood vessels and the tight junctions. The tight junctions carry out significant biological functions that are associated with the CNS and the blood circulation...
October 9, 2017: Current Neurovascular Research
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
Ahmet Yüksel, Irem Iris Kan, Atıf Yolgösteren, Yusuf Velioğlu, Mustafa Çagdaş Çayır, Orçun Gürbüz, Gencehan Kumtepe, Serkan Akarsu, Murat Biçer, Mustafa Tok, Işık Şenkaya
Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender...
May 2017: Brazilian Journal of Cardiovascular Surgery
Mariana N Meireles, Magda Mh Viveiros, Roberta Lfs Meneghin, Alicia Galindo-Ferreiro, Mariângela Ea Marques, Silvana A Schellini
To evaluate the dacryocystectomy (DCT) outcomes for chronic dacryocystitis in an elderly population over 70 years old. A retrospective chart review was performed for patients over 70 years old who were diagnosed with chronic dacryocystitis and underwent DCT at the Botucatu School of Medicine, UNESP, Brazil, from 2007 to July 2014. Data were collected about patient demographics, age, gender, previous nasal, or ophthalmic diseases, symptoms related to the lacrimal drainage system preoperatively and postoperatively, signs of enlargement of the lacrimal sac (regurgitation of secretion), and histopathologic evaluation...
December 2017: Orbit
Shinya Kanazawa, Yutaka Oda, Chika Maeda, Ryu Okutani
PURPOSE: We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia. METHODS: One hundred and twenty young (20-30 years), middle-aged (31-65 years), and elderly (66-80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation...
October 2017: Journal of Anesthesia
Wendy Gerstein, Ziyang Liu
BACKGROUND: A significant percentage of elderly patients suffer from both polypharmacy and visual impairment. This combination can increase the risk of an adverse event related to medication. This case highlights an unusual, but potentially deadly, medication adverse event. CASE PRESENTATION: A 77-year-old male, visually impaired, ingested a pill desiccant, believing it was the ampicillin/sulbactam tablet he was prescribed for an infected diabetic foot ulcer. He presented to the emergency room with inability to swallow, and imaging revealed the pill desiccant lodged in his upper esophagus...
July 28, 2017: BMC Geriatrics
Xiuman Li, Lixiang Wang
OBJECTIVE: To investigate the effect of external abdominal aorta compression on circulation during anesthetic induction in elderly patients. METHODS: A prospective randomized controlled trial was conducted. Patients with age of 60-75 years old, requiring a general anesthesia for non-abdominal surgery, and with II-III class of American Society of Anesthesiologists (ASA) physical status classification, and admitted to General Hospital of Chinese People's Armed Police Forces from January to April in 2017 were enrolled...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
G Hirlekar, T Karlsson, S Aune, A Ravn-Fischer, P Albertsson, J Herlitz, B Libungan
BACKGROUND: There have been few studies of the outcome in elderly patients who have suffered in-hospital cardiac arrest (IHCA) and the association between cardiac arrest characteristics and survival. AIM: The aim of this large observational study was to investigate the survival and neurological outcome in the elderly after IHCA, and to identify which factors were associated with survival. METHODS: We investigated elderly IHCA patients (≥70years of age) who were registered in the Swedish Cardiopulmonary Resuscitation Registry 2007-2015...
September 2017: Resuscitation
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