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https://www.readbyqxmd.com/read/28449498/trans-tracheostomy-repair-of-tracheo-esophageal-fistula-under-endoscopic-view-in-a-75-year-old-woman
#1
Francesco Paolo Caronia, Alfonso Reginelli, Mario Santini, Roberto Alfano, Sebastiano Trovato, Ettore Arrigo, Alfonso Fiorelli
Tracheo-esophageal fistula is a life-threatening condition for fatal pulmonary complications. Surgery is the treatment of choice. Unfortunately, the most of patients are unfit for surgery and in these cases there is no a standardized management. Herein, we reported a clinical case of a 75-year-old-woman with a tracheoesophageal fistula related to tracheostomy. The fistula was localized 3.5 cm below the vocal folds and extended 3 cm distally. The patient's poor clinical condition contraindicated surgery while the characteristics of fistula prevented any successfully endoscopic repair with standard methods as application of fibrin glue, clipping, or stenting...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445377/first-lower-two-thirds-osteomyocutaneous-facial-allograft-perfused-by-a-unilateral-facial-artery-outcomes-and-vascularization-at-1-year-after-transplantation
#2
Sebastian Fischer, Thomas C Lee, Nicco Krezdorn, Muayyad Alhefzi, Maximilian Kueckelhaus, Ericka M Bueno, Bohdan Pomahac
BACKGROUND: Facial allotransplantation provides a unique opportunity to restore facial form and function in severely disfigured patients. Using a single unilateral facial artery for vascularization can significantly reduce surgical duration and thus facilitate the practice of face transplantation. METHODS: A 33-year-old man with a history of high-energy ballistic trauma received a facial allograft comprising the lower two-thirds of the face, including maxilla and mandible...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28439690/association-of-endotracheal-tube-repositioning-and-acute-laryngeal-lesions-during-mechanical-ventilation-in-children
#3
Denise Manica, Catia de Souza Saleh Netto, Cláudia Schweiger, Leo Sekine, Larissa Valency Enéas, Denise Rotta Pereira, Gabriel Kuhl, Paulo Roberto Antonacci Carvalho, Paulo José Cauduro Marostica
The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care. All patients underwent flexible fiber-optic laryngoscopy (FFL) not later than 8 h after extubation...
April 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28436022/ventilation-via-the-2-4%C3%A2-mm-internal-diameter-tritube-%C3%A2-with-cuff%C3%A2-new-possibilities-in-airway-management
#4
REVIEW
M S Kristensen, M W P de Wolf, L S Rasmussen
BACKGROUND: A small tube may facilitate tracheal intubation and improve surgical access. We describe our initial experience with the Tritube(®) that is a novel cuffed endotracheal tube with a 2.4 mm internal diameter. METHODS: The Tritube(®) was used in seven adult Ear-Nose-and Throat surgical patients with airway narrowing or whose surgical access was facilitated by this small-bore endotracheal tube. Ventilation through Tritube(®) is performed with the manually operated Ventrain(®) -ventilator that allows active suctioning during expiration, therefore facilitating normoventilation through small diameter airways...
April 23, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#5
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28414605/use-of-a-novel-surgical-approach-for-treatment-of-complete-bilateral-membranous-choanal-atresia-in-an-alpaca-cria
#6
Karine Pader, Patrick M Burns, Anne-Claire Brisville, Marjolaine Rousseau, Laurent Blond, Geoffrey Truchetti, Hélène Lardé, Catherine Lapointe, David Francoz
CASE DESCRIPTION A 4-hour-old 6.3-kg (13.9-lb) female alpaca cria was evaluated because of severe respiratory distress and difficulty nursing since birth. CLINICAL FINDINGS The cria had open-mouth breathing and cyanotic membranes, with no airflow evident from either nostril. Supplemental oxygen was delivered, and the patient was anesthetized and intubated orotracheally; a CT evaluation of the head confirmed bilateral membranous obstruction of the nasal cavities, consistent with complete bilateral choanal atresia...
May 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28410258/behavioral-disturbance-causing-sudden-respiratory-distress-in-a-3-year-old-after-tracheocutaneous-fistula-closure-a-case-report
#7
Rhashedah A Ekeoduru, Hassan M Aijazi, Amy D Graham-Carlson
A 3-year-old boy underwent tracheostomy at age 5 months for respiratory failure. The tracheostomy tube was removed a year later but a tracheocutaneous fistula developed requiring fistulectomy and primary skin closure. After an initial uneventful course in the postanesthesia care unit, the patient became agitated, began to scream, and suddenly developed rapidly progressing subcutaneous emphysema over his chest, face, and abdomen. Orotracheal intubation was emergently performed and chest radiograph revealed pneumothorax and pneumomediastinum...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28405997/tracheoesophageal-fistula-following-endotracheal-intubation-for-organophosphorus-poisoning
#8
Shailaja V Rao, Ajay K Boralkar, Prabhakar S Jirvankar, Mangala V Sonavani, Varsha Rotte Kaginalkar, Chimu Chinte
Tracheoesophageal fistula (TEF) is an abnormal communication between the trachea and esophagus. Iatrogenic TEF can be due to endotracheal intubation, rigid bronchoscopy or tracheostomy. Tracheostomy tube cuff volumes and pressures require constant monitoring to avoid tracheal injury. Acquired TEF which occurs after prolonged intubation, usually develops after 15-200 days of mechanical ventilation. We report a case of a large TEF secondary to endotracheal intubation for organophosphorus poison-induced respiratory failure...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28391268/a-modified-tracheal-transaction-approach-for-the-repair-of-nonmalignant-tracheoesophageal-fistulas-a-report-of-5-cases
#9
Jie Liu, Wei Wu, Shaoyan Liu, Zhengang Xu, Jian Wang, Baowei Li
BACKGROUND: A postintubation tracheoesophageal fistula is a rare complication of a tracheotomy. Surgical repair is the only viable option for these patients, but the repair techniques presented in the literature vary. METHODS: We used a modified tracheal transaction approach to repair 5 cases of nonmalignant tracheoesophageal fistulas. The procedure was performed with a low cervical collar incision, and the trachea was transected directly. All the procedures were only carried out in the surgical field created by tracheostomy and paratracheal and esophageal dissection was no longer necessary...
April 8, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28390614/coblation-of-suprastomal-granulomas-in-tracheostomy-dependent-children
#10
C Scott Brown, Marisa A Ryan, Vaibhav H Ramprasad, Anatoli F Karas, Eileen M Raynor
OBJECTIVE: Suprastomal granulomas pose a persistent challenge for tracheostomy-dependent children. They can limit phonation, cause difficulty with tracheostomy tube changes and prevent decannulation. We describe the use of the coblator for radiofrequency plasma ablation of suprastomal granulomas in five consecutive children from September 2012 to January 2016. METHOD: Retrospective case series at a tertiary medical center. RESULTS: The suprastomal granuloma could be removed with the coblator in all 5 cases...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28377879/membranous-tracheal-stenosis-in-a-patient-with-anorexia-nervosa-and-self-induced-vomiting-challenges-in-securing-the-airway
#11
Motohiro Nakamura, Masaki Hisamura, Masayuki Hashimoto, Makoto Sawano, Midori Joshita, Takahiro Toi, Yoshitaka Asano, Hideyo Matsueda, Fumihito Arima, Hidenori Oi, Takehiro Kitawaki, Yoji Ando, Kenji Koshimizu
We report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy and placement of a tracheostomy tube failed to secure her respiratory tract and ventilation continued to deteriorate...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28358930/association-of-transoral-robotic-surgery-with-short-term-and-long-term-outcomes-and-costs-of-care-in-oropharyngeal-cancer-surgery
#12
Kevin Motz, Hsien-Yen Chang, Harry Quon, Jeremy Richmon, David W Eisele, Christine G Gourin
Importance: The treatment of oropharyngeal cancer has undergone a paradigm shift in the past 2 decades, with an increase in the use of nonoperative treatment owing to poor functional outcomes associated with traditional surgical approaches. Transoral robotic surgery (TORS) allows surgical resection of oropharyngeal cancer (OPC) with less morbidity through a minimally invasive approach. Objective: To investigate the relationship among TORS and short- and long-term outcomes and costs in surgically treated patients with OPC...
March 30, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28350680/airway-and-feeding-outcomes-of-mandibular-distraction-tongue-lip-adhesion-and-conservative-management-in-pierre-robin-sequence-a-prospective-study
#13
Ibrahim Khansa, Courtney Hall, Lauren L Madhoun, Mark Splaingard, Adriane Baylis, Richard E Kirschner, Gregory D Pearson
BACKGROUND: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28342626/understanding-the-health-care-utilization-of-children-who-require-medical-technology-a-descriptive-study-of-children-who-require-tracheostomies
#14
Regena Spratling
Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28341025/standardizing-care-and-parental-training-to-improve-training-duration-referral-frequency-and-length-of-stay-our-quality-improvement-project-experience
#15
Concettina Tina Tolomeo, Nili E Major, Mary V Szondy, Alia Bazzy-Asaad
OBJECTIVES: At our institution, there is a six bed Pediatric Respiratory Care Unit for technology dependent infants and children with a tracheostomy tube. A lack of consistency in patient care and parent/guardian education prompted our group to critically evaluate the services we provided by revisiting our teaching protocol and instituting a new model of care in the Unit. The aims of this quality improvement (QI) project were to standardize care and skills proficiency training to parents of infants with a tracheostomy tube in preparation for discharge to home...
January 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#16
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#17
Jeffrey S Raskin, Daniel Hansen, Arvind Mohan, I-Wen Pan, Daniel J Curry, Sandi Lam
PURPOSE: Preoperative antibiosis contributes up to one third of total antibiotic use in major hospitals. Choice of antibiotic is not uniformly standardized, and polypharmacy regimens may be used without knowing the effect on rates of surgical site infection, nonsurgical infections, or antibiotic resistance. Careful examination of trends in surgical prophylaxis is warranted. In this study, we aimed to examine our institution's experience with vagus nerve stimulator (VNS) implantation, focusing on association between perioperative antibiotic practices and postoperative infectious outcomes...
March 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28286390/early-postoperative-malignant-subcutaneous-emphysema-report-and-review
#18
N K Sahoo, Shivinder Singh, I D Roy, Amit Bhandari
BACKGROUND: Subcutaneous emphysema is defined as presence of air or gas in subcutaneous tissue layer. It may be localized or generalized due to various aetiological factors. Although SE and pneumomediastinum are self-limiting conditions, life-threatening complications may develop. Escape of air into both pleural cavity causing bilateral pneumothorax and tension pneumothorax can be termed as malignant emphysema. PURPOSE: To report a case of malignant generalized subcutaneous emphysema in early postoperative phase following palatoplasty...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28282230/nebulized-adrenaline-in-the-postoperative-management-of-brachycephalic-obstructive-airway-syndrome-in-a-pug
#19
Jenny Ellis, Elizabeth Ann Leece
Brachycephalic obstructive airway syndrome is a common problem in certain breeds, and may necessitate surgical procedures, such as rhinoplasty, palatoplasty, laryngeal sacculectomy, and/or arytenoid laryngoplasty, to improve the quality of life. However, laryngeal edema may necessitate the use of temporary tracheostomy tubes postoperatively to maintain a patent airway. This case demonstrates that administration of nebulized adrenaline in the immediate postoperative period where upper airway obstruction is life threatening can be used to reduce edema, therefore avoiding the need for tracheostomy...
March 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28275475/surgery-and-perioperative-management-for-post-intubation-tracheoesophageal-fistula-case-series-analysis
#20
Francesco Puma, Jacopo Vannucci, Stefano Santoprete, Moira Urbani, Lucio Cagini, Marco Andolfi, Rossella Potenza, Niccolò Daddi
BACKGROUND: Post-intubation tracheoesophageal fistula (PITEF) is an often mistreated, severe condition. This case series reviewed for both the choice and timing of surgical technique and outcome PITEF patients. METHODS: This case series reviewed ten consecutive patients who had undergone esophageal defect repair and airway resection/reconstruction between 2000 and 2014. All cases were examined for patients: general condition, medical history, preparation to surgery, diagnostic work-up, timing of surgery and procedure, fistula size and site, ventilation type, nutrition, post-operative course and complications...
February 2017: Journal of Thoracic Disease
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