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https://www.readbyqxmd.com/read/28229065/foreign-body-aspiration-in-adults-two-unusual-foreign-bodies-knife-and-tube-tracheostomy
#1
Seyed Mozafar Hashemi, Mohsen Kolahdouzan, Shahab Shahabi, Hamid Talebzadeh, Mohammad Taghi Rezaei
INTRODUCTION: Foreign body aspiration is usually a serious condition that is most common among the pediatric population, and rare in adults. In adults, aspiration may be tolerated for a long time. CASE REPORTS: Our first case is a 38-year-old man who presented with a 2-day history of swallowing a foreign body. He was completely asymptomatic. Chest X-ray revealed the presence of 5-cm foreign object in the right main bronchus. Rigid bronchoscopy was performed and a knife was removed from the right main bronchus...
January 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28217065/unsuspected-subglottic-web-in-a-child-managed-for-severe-respiratory-obstruction
#2
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28195000/prevention-of-tracheostomy-related-hospital-acquired-pressure-ulcers
#3
Thomas R O'Toole, Natalie Jacobs, Brian Hondorp, Laura Crawford, Lisa R Boudreau, Jill Jeffe, Brian Stein, Phillip LoSavio
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28177326/supracricoid-laryngectomy-for-recurrent-laryngeal-cancer-after-chemoradiotherapy-a-systematic-review-and-meta-analysis
#4
C A Leone, P Capasso, D Topazio, G Russo
Residual or recurrent laryngeal cancer after irradiation is a difficult clinical problem with a rate that ranges from 13% to 36% of cases. Supracricoid laryngectomy (SCL) with cricohyoidopexy (CHP) or cricohyoidoepiglottopexy (CHEP) provide reliable oncological and functional results for selected primary and recurrent patients with glottic and supraglottic carcinomas. We conducted a systematic review and meta-analysis to assess the oncological and functional outcomes of patients treated with open partial horizontal laryngectomy types IIa and IIb (CHEP, CHP) in terms of the recurrence of squamocellular cancer of the larynx after radiotherapy failure...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28163526/a-novel-method-of-fixation-of-tracheostomy-tube-in-cervical-spine-surgeries-with-posterior-approach
#5
Devendra Gupta, Ankur Khandelwal, Rudrashish Haldar
No abstract text is available yet for this article.
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28157753/discussing-life-sustaining-therapy-with-surrogate-decision-makers
#6
David Y Hwang
Clinicians caring for patients with severe stroke in intensive care units often grapple with requests from surrogate decision makers for life-prolonging treatment that members of the care team may believe to be futile. An example is a surrogate decision maker's request to place a tracheostomy and feeding tube in a patient who, in the clinical judgment of the neurocritical care team, is very unlikely to recover interactive capacity. This article presents a case, discusses definitions of medical futility, and summarizes recommended steps for mediating conflict regarding potentially inappropriate treatment...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28149569/how-should-this-patient-with-repeated-aspiration-pneumonia-be-managed-and-treated-a-proposal-of-the-percutaneous-endoscopic-gastrostomy-and-tracheostomy-penlight-procedure
#7
REVIEW
Zhongheng Zhang, Jason Akulian, Yucai Hong, Ning Liu, Yuhao Chen
Cerebrovascular accident (CVA) is commonly seen among the elderly with a substantial proportion of patients suffering from long-term dysphagia and/or an inability to protect their airway. This potentially imposes on them an increased risk of malnutrition and aspiration pneumonia. In this article, we present a patient with malnutrition and dysphagia secondary to CVA. We propose a procedure for which we will name the Percutaneous ENdoscopIc Gastrostomy and Tracheostomy (PENlIGhT) procedure for placement of percutaneous endoscopic gastrostomy (PEG) and tracheostomy tube (TT) at the same time...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28139937/risk-factors-for-tracheostomy-requirement-in-extremely-low-birth-weight-infants
#8
Orly L Levit, Veronika Shabanova, Alia Bazzy-Asaad, Matthew J Bizzarro, Vineet Bhandari
AIM: To identify variables that affect the risk for tracheostomy in a population of extremely low birth weight (ELBW) infants. METHODS: A retrospective matched case-control study was conducted. ELBW infants with a tracheostomy were compared with controls without tracheostomy. Data collection included demographics, detailed information about each intubation and extubation attempt, the use of steroids and the presence of comorbidities. Statistical analyses include conditional logistic regression and Poisson regression for clustered observations...
January 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28114156/a-case-report-establishing-a-definitive-airway-in-a-trauma-patient-with-a-king-laryngeal-tube-in-situ-in-the-presence-of-a-closed-head-injury-and-difficult-airway-between-the-devil-and-the-deep-blue-sea
#9
Yuri Koumpan, John Murdoch, Jason A Beyea, Michael Kahn, Jaime Colbeck
Airway management in trauma is a crucial skill, because patients are at risk of aspiration, hypoxia, and hypoventilation, all of which may be fatal in the setting of increased intracranial pressure. The King Laryngeal Tube reusable supraglottic airway (King Systems, Noblesville, IN) allows for temporary management of a difficult airway but poses a challenge when an attempt is made to exchange the device for an endotracheal tube, often managed by emergency tracheostomy. We describe a novel fiberoptic, video laryngoscope-assisted approach to intubation in a difficult trauma airway with an in situ King Laryngeal Tube...
January 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28112532/percutaneous-dilatational-tracheostomy-via-griggs-technique
#10
Hasan Ali Karimpour, Kamran Vafaii, Maryam Chalechale, Saeed Mohammadi, Rasool Kaviannezhad
BACKGROUND: Tracheostomy is considered the airway management of choice for patients who need prolonged mechanical ventilation support. Percutaneous Dilatational Tracheotomy (PDT) is a technique that can be performed easily and rapidly at bedside and is particularly useful in the intensive care setting. The Griggs percutaneous tracheotomy is unique in its utilization of a guide wire dilator forceps. OBJECTIVE: We aimed to describe the early perioperative and late postoperative complications of PDT using the Griggs technique in patients in the intensive care unit (ICU)...
January 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28112014/laryngotracheal-stenosis
#11
Shekhar K Gadkaree, Vinciya Pandian, Simon Best, Kevin M Motz, Clint Allen, Young Kim, Lee Akst, Alexander T Hillel
Objective Laryngotracheal stenosis (LTS) is a fibrotic process that narrows the upper airway and has a significant impact on breathing and phonation. Iatrogenic injury from endotracheal and/or tracheostomy tubes is the most common etiology. This study investigates differences in LTS etiologies as they relate to tracheostomy dependence and dilation interval. Study Design Case series with chart review. Setting Single-center tertiary care facility. Subjects and Methods Review of adult patients with LTS was performed between 2004 and 2015...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28078354/-tracheal-laceration-after-dilatational-tracheostomy-a-case-of-succesful-conservative-management
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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