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Tracheostomy tube

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https://www.readbyqxmd.com/read/29679678/characterisation-of-40-mg-ml-and-100-mg-ml-tobramycin-formulations-for-aerosol-therapy-with-adult-mechanical-ventilation
#1
Jayesh A Dhanani, Patrician Tang, Steven C Wallis, Suzanne L Parker, Preeti Pandey, John F Fraser, Jeremy Cohen, Adrian Barnett, Jason R Roberts, Hak-Kim Chan
BACKGROUND: Preservative-free tobramycin is commonly used as aerosolized therapy for ventilator associated pneumonia. The comparative delivery profile of the formulations of two different concentrations (100 mg/ml and 40 mg/ml) is unknown. This study aims to evaluate the aerosol characteristics of these tobramycin formulations in a simulated adult mechanical ventilation model. METHODS: Simulated adult mechanical ventilation set up and optimal settings were used in the study...
April 18, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29664694/immediate-use-of-uncuffed-tracheostomy-after-free-flap-reconstruction-of-the-head-and-neck
#2
Priyesh N Patel, Al C Valmadrid, Daniel Y Hong, David O Francis, Michael W Sim, Sarah L Rohde
Objective To determine if immediate postoperative uncuffed tracheostomy placement following oral cavity or oropharyngeal head and neck free flap reconstruction is associated with shorter hospital length of stay and higher inpatient decannulation rates without an increase in respiratory complications, as compared with immediate placement of cuffed tracheostomy. Study Design Retrospective cohort. Setting Tertiary referral center. Subjects and Methods Patients were included if they underwent free flap reconstruction for oral cavity or oropharyngeal squamous cell carcinoma and had an intraoperative tracheostomy placed between 2005 and 2016...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29664213/a-patient-centred-multi-domain-instrument-for-improving-the-clarity-of-outcomes-reporting-and-documentation-in-complex-airway-surgery
#3
S A R Nouraei, K J Heathcote
Laryngotracheal stenosis refers to abnormal narrowing of the central airways from larynx to carina. It is caused by an eclectic group of conditions that include intubation-related airway stenosis, granulomatosis with polyangiitis, tracheal compression or malignancy, and congenital laryngotracheal malformations. A significant proportion of patients with this condition can be satisfactorily treated using a combination of endoscopic and open surgical techniques and when definitive treatment is not possible, most of the remaining patients can be managed with a combination of endoscopic airway maintenance, stents, T-tubes, and/or tracheostomies...
April 17, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29644281/thyrohyoid-membrane-transection-caused-by-a-stab-injury
#4
Dongsub Noh, Kwang Hee Yeo, Hyun Min Cho, Chan Yong Park
Background: The thyrohyoid membrane is located between the hyoid bone and thyroid cartilage. Transection of the thyrohyoid membrane can be fatal. Case presentation: A 54-year-old man presented to the emergency room after attempting to commit suicide by cutting his neck. An endotracheal tube was inserted through the thyrohyoid membrane, which had been cut almost completely. After a tracheostomy, temporary wound closure was performed due to coagulopathy caused by hemorrhagic shock...
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29627795/delayed-extrusion-of-embolic-coils-into-the-airway-after-embolization-of-an-external-carotid-artery-pseudoaneurysm
#5
Zachary Wilseck, Luis Savastano, Neeraj Chaudhary, Aditya S Pandey, Julius Griauzde, Sumanna Sankaran, David Wilkinson, Joseph J Gemmete
Carotid blowout syndrome (CBS) is a known devastating complication of head and neck surgery. The risk of developing CBS increases in the setting of radiation therapy, wound breakdown, or tumor recurrence. Traditionally, the treatment of choice for CBS is surgical ligation of the bleeding artery; however, recently, endovascular occlusion has become a more common option. If a pseudoaneurysm is present, treatment consists of trapping with endovascular coils or occlusion with a liquid embolic agent. Delayed migration of embolization coils into the airway causing acute respiratory distress is a rare occurrence...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29627053/laryngeal-split-and-rib-cartilage-interpositional-grafting-treatment-option-for-glottic-and-subglottic-stenosis-in-adults
#6
REVIEW
Wael Hasan, Patrick Gullane
Optimal management of tracheal stenosis depends on identifying causative factors. Risk factors include high tracheostomy, cricothyroidotomy, prolonged intubation, and proximal migration of an endotracheal tube cuff. Management ranges from conservative observation to endoscopic procedures or open surgical resections. The goal of surgical repair is an adequate airway, decannulation, and normal laryngeal function. For early stage disease, management of refractory conditions is via endoscopic procedures. An understanding of the respiratory function of the glottis and subglottis is essential when an optimum functional reconstruction of the glottic/subglottic area is considered...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29627046/tracheal-injuries-complicating-prolonged-intubation-and-tracheostomy
#7
REVIEW
Joel D Cooper
Respiratory care advances such as the introduction of ventilatory assistance have been associated with postintubation airway stenosis resulting from tracheal injury at the site of the inflatable cuff on endotracheal or tracheostomy tubes. Low-pressure cuffs have significantly reduced this occurrence. Loss of airway stability at the site of a tracheostomy stoma may result in tracheal stenosis. Subglottic stenosis may result from a high tracheostomy site at, or just inferior to, the cricoid arch, or to malposition of an endotracheal tube cuff...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29621756/experience-with-transcordal-silicone-stents-in-adult-laryngotracheal-stenosis-a-bicentric-retrospective-study
#8
Valerian Bourinet, Thibaut Raguin, Marc Fortin, Elsa Chetrit, Julien Guinde, Sophie Laroumagne, Nicolas Fakhry, Philippe Astoul, Christian Debry, Hervé Dutau
BACKGROUND: Benign stenosis involving laryngeal and upper tracheal structures represents a therapeutic challenge. Open surgery and endoscopic management have to be discussed by a multidisciplinary board in order to evaluate the risk and benefit for each patient. OBJECTIVE: The objective of this retrospective study was to report the experience of two French centers with transcordal silicone stents (TSS) in the endoscopic management of benign laryngotracheal stenosis (BLTS) in adults, with focus on efficacy, safety, and tolerability...
April 5, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29616357/preliminary-experience-on-the-safety-and-tolerability-of-mechanical-insufflation-exsufflation-in-subjects-with-artificial-airway
#9
Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela Del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero, Antonio Núñez-Reiz
BACKGROUND: Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. "Mechanical insufflation-exsufflation" exerts positive pressure, followed by an abrupt drop to negative pressure. Potential advantages of this technique are aspiration of distal airway secretions, avoiding trauma, and improving tolerance. METHODS: We applied insufflation of 50 cmH2 O for 3 s and exsufflation of - 45 cmH2 O for 4 s in patients with an endotracheal tube or tracheostomy cannula requiring secretion suctioning...
April 3, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29594157/use-of-nasotracheal-intubation-during-general-anesthesia-in-two-ponies-with-tracheal-collapse
#10
Keila K Ida, Aurélie Sauvage, Alexandra Gougnard, Magda Grauwels, Didier Serteyn, Charlotte Sandersen
Ponies with tracheal collapse may have an increased anesthetic risk due to airway obstruction during induction and recovery. To our knowledge, there are no anesthetic descriptions of these patients, despite a reported 5.6% incidence and 77% mortality rate. Two Shetland ponies with tracheal collapse, a 12-year-old male (pony 1) and a 27-year-old female (pony 2), were referred for right eye enucleation due to a perforating corneal ulcer and severe recurrent uveitis, respectively. Pony 1 was stressed, had lung stridor and hyperthermia, and developed inspiratory dyspnea with handling...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29584610/a-quasi-experimental-study-to-explore-the-effect-of-barrier-cream-on-the-peristomal-skin-of-patients-with-a-tracheostomy
#11
Turkan Karaca, Fatoș Korkmaz
Peristomal skin problems represent one of the most common complications of a tracheostomy. A quasi-experimental study was conducted among patients ages 18 to 65 years hospitalized in a Turkish university hospital ear-nose-throat clinic between August 15, 2013, and December 15, 2013, to compare the effect of using or not using a barrier cream on the peristomal skin with regard to pH, moisture, temperature, color, odor, turgor, infections, and lesions after tracheostomy surgery. Patients were selected using a purposeful sampling method and included if they had not undergone another operation for a complication (eg, pneumothorax, tube misplacement, hemorrhage) within 24 hours following the tracheostomy operation...
March 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29582225/outcomes-in-children-treated-with-pentobarbital-infusion-for-refractory-and-super-refractory-status-epilepticus
#12
Jennifer Erklauer, Jeanine Graf, Mona McPherson, Anne Anderson, Angus Wilfong, Charles G Minard, Laura Loftis
BACKGROUND: Functional neurologic outcome for children with refractory and super-refractory status epilepticus has not been well defined. METHODS: Retrospective chart review including children age 0-17 years who received pentobarbital infusion from 2003 to 2016 for status epilepticus. Outcomes were defined in terms of mortality, need for new medical technology assistance at hospital discharge and functional neurologic outcome determined by pediatric cerebral performance category score (PCPC)...
March 26, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29551223/quality-of-life-improves-for-tracheostomy-patients-with-return-of-voice-a-mixed-methods-evaluation-of-the-patient-experience-across-the-care-continuum
#13
Amy L Freeman-Sanderson, Leanne Togher, Mark Elkins, Belinda Kenny
OBJECTIVES: A tracheostomy tube can profoundly impact ability to communicate. The impact of this on patients' self-esteem and quality of life in the care continuum from the intensive care unit to after decannulation has not been reported. Therefore, the aim was to investigate the patient-reported experience regarding change in communication function, communication-related self-esteem and quality of life. RESEARCH DESIGN: A mixed methods approach was utilised. Quantitative data were obtained using validated measures of self-esteem related to communication-related quality of life and general health...
March 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29549460/success-rates-of-pre-hospital-difficult-airway-management-a-quality-control-study-evaluating-an-in-hospital-training-program
#14
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29549119/the-case-for-early-use-of-rapid-whole-genome-sequencing-in-management-of-critically-ill-infants-late-diagnosis-of-coffin-siris-syndrome-in-an-infant-with-left-congenital-diaphragmatic-hernia-congenital-heart-disease-and-recurrent-infections
#15
Nathaly M Sweeney, Shareef A Nahas, Shimul Chowdhury, Miguel Del Campo, Marilyn C Jones, David P Dimmock, Stephen F Kingsmore, Rcigm Investigators
Congenital diaphragmatic hernia (CDH) results from incomplete formation of the diaphragm leading to herniation of abdominal organs into the thoracic cavity. CDH is associated with pulmonary hypoplasia, congenital heart disease and pulmonary hypertension. Genetically, it is associated with aneuploidies, chromosomal copy number variants, and single gene mutations. CDH is the most expensive non-cardiac congenital defect: Management frequently requires implementation of Extracorporeal Membrane Oxygenation (ECMO), which increases management expenditures 2...
March 16, 2018: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29544581/percutaneous-tracheostomy-by-physician-intensivists
#16
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29543970/analysis-of-vocal-fold-motion-impairment-in-neonates-undergoing-congenital-heart-surgery
#17
Stephanie Elyse Ambrose, Julina Ongkasuwan, Kavita Dedhia, Gillian Ruth Diercks, Samantha Anne, Subhadra Shashidharan, Nikhila Raol
Importance: Vocal fold motion impairment (VFMI) is a known risk factor following congenital heart surgery (CHS). The impact of this diagnosis on utilization and outcomes is unknown. Objective: To evaluate the cost, postprocedure length of stay (PPLOS), and outcomes for neonates with VFMI after CHS. Design, Setting, and Participants: A cross-sectional analysis of the 2012 Kids' Inpatient Database (KID) of neonates who underwent CHS was carried out...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29543641/percutaneous-dilatational-tracheostomy-using-tube-exchanger
#18
Ohad Ronen, Alexander Gurevich, Shimon Ivry, Edward Altman, Evgeni Kukuev
We describe a modified technique for percutaneous dilatational tracheostomy using a 15F tube exchanger or Eschmann catheter. A retrospective review of 1180 procedures using this modified technique demonstrated it to be effective with a failure rate of only 0.25% (3 patients). Moreover, it provides an additional safeguard with the ability to rapidly reintroduce the endotracheal tube into the trachea guided by the exchange catheter in the event of accidental extubation during the procedure. This technique needs no additional special devices or equipment (eg, a bronchoscope)...
March 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29543311/unusual-case-of-central-alveolar-hypoventilation
#19
Hadil Ak AlOtair, Abdulaziz H Alzeer, Mohammed A Abdou, Shaden O Qasrawi
Central alveolar hypoventilation is rarely encountered. This case report describes a young woman who was recently diagnosed with hypertension and ischemic heart disease. She presented to the emergency room with hypercapnic respiratory failure, for which she was mechanically ventilated. This was preceded by an acute upper respiratory tract infection. She was initially suspected to have Guillain-Barré syndrome, but further investigations ruled out neuromuscular or autoimmune disorders. Sleep-related hypoventilation was suspected after she experienced recurrent apneas at night that resulted in re-intubation...
March 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29521796/a-selective-placement-strategy-for-surgical-feeding-tubes-benefits-trauma-patients
#20
Joseph Marcotte, Joshua Hazelton, Chirag Arya, Michael Dalton, Amber Batool, John Gaughan, Linh Nguyen, John Porter, Nicole Fox
BACKGROUND: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement...
March 8, 2018: Journal of Trauma and Acute Care Surgery
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