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Tracheostomy tube

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https://www.readbyqxmd.com/read/28078354/-tracheal-laceration-after-dilatational-tracheostomy-a-case-of-succesful-conservative-management
#1
L Eichler, M Simon, S Kluge
During bronchoscopically guided percutaneous dilatational tracheostomy, a 71-year-old woman suffered a long-stretched tear to the posterior tracheal wall. The injury was suspected to be caused by blunt trauma during dilation or cannula insertion, possibly aggravated by vigorous cuff inflation. Since the defect ended just 0.5 cm proximal to the main carina, placing a cuffed endotracheal tube beyond the injury was not an option. However, we decided for a conservative treatment approach by placing a cuffed endotracheal tube under bronchoscopic visualization in direct proximity to the cranial end of the laceration...
January 11, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28072907/symptomatic-treatments-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#2
REVIEW
Louisa Ng, Fary Khan, Carolyn A Young, Mary Galea
BACKGROUND: Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), causes a wide range of symptoms but the evidence base for the effectiveness of the symptomatic treatment therapies is limited. OBJECTIVES: To summarise the evidence from Cochrane Systematic Reviews of all symptomatic treatments for MND. METHODS: We searched the Cochrane Database of Systematic Reviews (CDSR) on 15 November 2016 for systematic reviews of symptomatic treatments for MND...
January 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28070690/reconstruction-of-defects-of-the-trachea
#3
Margot Den Hondt, Jan Jeroen Vranckx
The trachea has a complex anatomy to fulfill its tasks. Its unique fibro-cartilaginous structure maintains an open conduit during respiration, and provides vertical elasticity for deglutition, mobility of the neck and speech. Blood vessels pierce the intercartilaginous ligaments to perfuse the ciliated epithelium, which ensures effective mucociliary clearance. Removal of a tracheal segment affected by benign or malignant disease requires airtight restoration of the continuity of the tube. When direct approximation of both tracheal ends is no longer feasible, a reconstruction is needed...
February 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#4
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28040717/predictors-of-the-use-of-specific-critical-care-therapies-in-patients-with-metastatic-cancer
#5
Kah Poh Loh, Ankit Kansagra, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Mihaela Stefan, Tara Lagu
OBJECTIVE: Understanding which factors are associated with the use of critical care therapies (CCTs) can help with clinical decision-making and goals of care discussion. The goal of this study was to describe the predictors of CCT use (eg, mechanical ventilation, tracheostomy, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, acute use of dialysis) in hospitalized patients with metastatic cancer. METHODS: We used the 2010 California State Inpatient Databases sponsored by the Agency for Healthcare Research and Quality to identify all hospitalizations with a diagnosis of metastatic cancer (patients aged ≥18 years)...
January 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28039250/assessment-of-scoring-systems-to-describe-the-position-of-tracheostomy-tubes-within-the-airway-the-lunar-study
#6
B A McGrath, K Lynch, R Templeton, K Webster, W Simpson, P Alexander, M O Columb
BACKGROUND: Malposition of tracheostomy tubes is difficult to detect at the bedside and may contribute to eventual device misplacement. Endoscopic examination can be undertaken via tracheoscopic (T-view) or trans-laryngeal (L-view) approach, offering more precise detail regarding positioning within the airway. The aims of this study were to evaluate inter-rater agreement between bespoke T and L view scoring systems and subsequently whether T-views could predict L-views. METHODS: Adult intensive care unit patients with percutaneous or surgical tracheostomies were included and paired T and L-views of their tracheostomy tube within the airway were taken on up to four occasions...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28011997/do-salivary-bypass-tubes-lower-the-incidence-of-pharyngocutaneous-fistula-following-total-laryngectomy-a-retrospective-analysis-of-predictive-factors-using-multivariate-analysis
#7
Robert W A Hone, Eqramur Rahman, Gentle Wong, Yvette Annan, Victoria Alexander, Ali Al-Lami, Kiran Varadharajan, Michael Parker, Ricard Simo, Lisa Pitkin, Alasdair Mace, Enyinnaya Ofo, Alistair Balfour, Iain J Nixon
Salivary bypass tubes (SBT) are increasingly used to prevent pharyngocutaneous fistula (PCF) following laryngectomy and pharyngolaryngectomy. There is minimal evidence as to their efficacy and literature is limited. The aim of the study was to determine if SBT prevent PCF. The study was a multicentre retrospective case control series (level of evidence 3b). Patients who underwent laryngectomy or pharyngolaryngectomy for cancer or following cancer treatment between 2011 and 2014 were included in the study...
December 23, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27996119/bevacizumab-chemotherapy-for-management-of-pulmonary-and-laryngotracheal-papillomatosis-in-a-child
#8
Karen B Zur, Elizabeth Fox
Recurrent laryngeal papillomatosis (RRP) can be a devastating condition for a child to endure, and pulmonary involvement may have terminal consequences. Adjuvant therapies have been trialed and reported over the years; however, these chemotherapy options have not been successful. Bevacizumab (Avastin, Genetech Inc., South San Francisco, CA) is a vascular endothelial factor (VEGF) inhibitor that has shown promise in the management of papillomatosis. Most research has focused on intralesional injections of this antiangiogenic drug...
December 20, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27978885/-two-cases-of-bilateral-pneumothorax-and-pneumomediastinum-caused-by-the-improper-use-of-the-blue-line-ultra%C3%A2-tracheostomy-tube
#9
T B Hu, W Sun, W P Wen
No abstract text is available yet for this article.
December 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/27965430/timing-of-percutaneous-endoscopic-gastrostomy-for-acute-ischemic-stroke-an-observational-study-from-the-us-nationwide-inpatient-sample
#10
Benjamin P George, Adam G Kelly, George P Albert, David Y Hwang, Robert G Holloway
BACKGROUND AND PURPOSE: Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke. METHODS: We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001 to 2011. We defined early PEG placement as 1 to 7 days from admission...
December 13, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27932555/mouthpiece-ventilation-and-complementary-techniques-in-patients-with-neuromuscular-disease-a-brief-clinical-review-and-update
#11
Tiago Pinto, Michelle Chatwin, Paolo Banfi, Joao Carlos Winck, Antonello Nicolini
Noninvasive ventilatory support (NVS) is sometimes reported as suboptimal in patients with neuromuscular disease (NMD). The reasons for this include inadequate ventilator settings and/or lack of interface tolerance. NVS has been used for many years in patients with NMD disorders as a viable alternative to continuous ventilatory support via a tracheostomy tube. The mouthpiece ventilation (MPV) is a ventilatory mode that is used as daytime ventilatory support in combination with other ventilatory modalities and interfaces for nocturnal NVS...
December 8, 2016: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/27924286/submental-intubation-in-patients-with-complex-maxillofacial-injuries
#12
Yuseon Cheong, Seong Sik Kang, Minsoo Kim, Hee Jeong Son, Jaewoo Park, Jeong-Mo Kim
Airway management in patients with complex maxillofacial injuries is a challenge to anesthesiologists. Submental intubation is a useful technique that is less invasive than tracheostomy in securing the airways where orotracheal and nasotracheal intubation cannot be performed. This procedure avoids the use of tracheostomy and bypasses its associated morbidities. A flexible and kink-resistant reinforced endotracheal tube with detachable universal connector is commonly used for submental intubation. Herein, we report cases involving submental intubation using a reinforced endotracheal tube with a non-detachable universal connector in patients with complex maxillofacial injuries...
September 2016: Journal of Lifestyle Medicine
https://www.readbyqxmd.com/read/27903130/risk-factors-and-mortality-in-the-carbapenem-resistant-klebsiella-pneumoniae-infection-case-control-study
#13
Fethiye Akgul, Ilkay Bozkurt, Mustafa Sunbul, Saban Esen, Hakan Leblebicioglu
Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been known as a nosocomial pathogen, both for the last 10 years in Turkey and for 20 years worldwide. Due to limited treatment options and high mortality rates, despite improvements in the field of medicine at the present time, CRKP is still a big threat for public health. This study was carried out between the dates of January 2010 and September 2014. Patients ≥18 who were hospitalized for at least 72 h and who also had CRKP growth were included in the study as a case group...
October 2016: Pathogens and Global Health
https://www.readbyqxmd.com/read/27899532/long-term-management-for-ventilator-assisted-children-in-hong-kong-2-decades-experience
#14
Shuk-Kuen Chau, Ada Wing-Yan Yung, So-Lun Lee
BACKGROUND: The population of children receiving long-term mechanical ventilation is growing worldwide, but only limited data exist in Asian regions. The objective of the study was to review the management of these children in Hong Kong over the past 2 decades. METHODS: This was a retrospective cohort study. Hospital records from subjects receiving mechanical ventilation for >3 months were retrieved. Demographic characteristics and medical information of subjects (≤21 y old) under the care of the ventilator program at the Duchess of Kent Children's Hospital between 1997 and 2015 were reviewed...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27876258/normal-saline-instillation-before-suctioning-a-meta-analysis-of-randomized-controlled-trials
#15
Chia-Hui Wang, Jui-Chen Tsai, Shu-Fen Chen, Chien-Ling Su, Lawrence Chen, Chao-Chun Lin, Ka-Wai Tam
BACKGROUND: For airway management of intensive care unit (ICU) patients who are intubated, a 5-10-mL bolus of sterile normal saline (NS) solution is commonly instilled into an endotracheal or tracheostomy tube before suctioning. However, NS instillation has been associated with adverse events such as dyspnea, increasing heart rate, decreasing of oxygenation, blood pressure, and other vital parameters. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the necessity of NS instillation before suctioning in ICU patients...
November 18, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27872994/outcomes-of-tracheostomy-in-children-requiring-surgery-for-congenital-heart-disease
#16
Laura A Ortmann, Winston M Manimtim, Charisse I Lachica
Outcomes after discharge in children requiring tracheostomy after cardiac surgery have not been fully described. A retrospective, single-center study was performed on all children <18 years of age requiring both tracheostomy and surgery for congenital heart disease from January 2002 to May 2015. Forty-six tracheostomies were placed after surgery and four before. Single-ventricle anatomy was present in 12 (33%) patients. Incidence of tracheostomy after heart surgery increased from 0.8% the first half of the study period to 2% the second half...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27865477/tracheostomy-among-infants-with-hypoplastic-left-heart-syndrome-undergoing-cardiac-operations-a-multicenter-analysis
#17
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27864126/the-use-of-life-sustaining-procedures-in-the-last-month-of-life-is-associated-with-more-depressive-symptoms-in-surviving-spouses
#18
Katherine A Ornstein, Melissa D Aldridge, Melissa M Garrido, Rebecca Gorges, Evan Bollens-Lund, Albert L Siu, Kenneth M Langa, Amy S Kelley
CONTEXT: Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression. OBJECTIVES: The objective of this study was to determine the association between patients' use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses. METHODS: We used data from the Health and Retirement Study, a longitudinal survey of U...
November 15, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27852959/percutaneous-dilatational-tracheostomy-in-ankylosing-spondylitis-bechterew-disease-is-feasible-and-not-associated-with-higher-complication-rates
#19
Uwe Hamsen, Oliver Kamp, Chris Kaczmarek, Mirko Aach, Christian Waydhas, Thomas A Schildhauer, Oliver Jansen
BACKGROUND: Ankylosing spondylitis (AS) is a common disease with an incidence of approximately 0.5% in Europe, causing severe limitations of axial spine mobility and cervical kyphosis. Deformities of the cervical spine and the temporomandibular joints could increase the risk of complications while performing an intubation or tracheostomy. The percutaneous dilatational tracheostomy (PDT) is a standard procedure in intensive care medicine. However, the combination of cervical kyphosis and osteoporosis makes patient positioning challenging...
November 15, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27837046/c1-esterase-inhibitor-berinert-for-ace-inhibitor-induced-angioedema-two-case-reports
#20
Maria Leibfried, Alexandra Kovary
OBJECTIVE: To describe 2 cases of angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema treated with C1 esterase inhibitor (human) [Berinert]. SUMMARY: Case 1 is a 60-year-old Caucasian male with angioedema from lisinopril. He was initially treated with a conventional regimen of an antihistamine, methylprednisolone, epinephrine, and fresh frozen plasma. When symptoms did not resolve, intravenous C1 peptide esterase inhibitor (C1INH) was administered, with clinical improvement...
November 11, 2016: Journal of Pharmacy Practice
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