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https://www.readbyqxmd.com/read/29666093/bougie-associated-bronchial-injury-complicated-by-a-nephropleural-fistula-after-percutaneous-nephrolithotomy-a-tale-of-two-complications
#1
Aparna Pande, Rashmi Ramachandran, Vimi Rewari
We present a case of bronchial injury following bougie-assisted endotracheal intubation in a patient with difficult airway scheduled to undergo right percutaneous nephrolithotomy under general anaesthesia. The patient developed pleuritic pain along with right pleural effusion on the third postoperative day which was diagnosed by the anaesthesiologist who was following up the patient for airway trauma-associated complications. However, the patient was diagnosed to have a nephropleural fistula, a rare complication of supracostal access to percutaneous nephrolithotomy, which was managed successfully...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29662817/concomitant-avulsion-injury-of-the-subclavian-vessels-and-the-main-bronchus-caused-by-blunt-trauma
#2
Dongsub Noh, Chan-Kyu Lee, Jung Joo Hwang, Hyun Min Cho
Concomitant rupture of the subclavian vessels and the left main bronchus caused by blunt trauma is a serious condition. Moreover, the diagnosis of a tracheobronchial injury with rupture of the subclavian vessels can be difficult. This report describes the case of a 33-year-old man who suffered from blunt trauma that resulted in the rupture of the left subclavian artery and vein. The patient underwent an operation for vascular control. On postoperative day 3, the left main bronchus was found to be transected on a computed tomography scan and bronchoscopy...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29661388/degree-of-obesity-is-not-associated-with-more-than-one-intubation-attempt-a-large-centre-experience
#3
W Saasouh, K Laffey, A Turan, R Avitsian, A Zura, J You, N M Zimmerman, L Szarpak, D I Sessler, K Ruetzler
BACKGROUND: The role of obesity as a risk factor for difficult intubation remains controversial. We primarily assessed the association between body mass index (BMI) and difficult tracheal intubation. METHODS: We analysed electronic records of more than 67 000 adults having elective non-cardiac surgery requiring tracheal intubation at the Cleveland Clinic between 2011 and 2015. The association between BMI and difficult intubation, defined as more than one intubation attempt, was assessed using multivariable logistic regression adjusting for pre-specified confounders...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29657097/single-cell-transcriptomic-profiling-of-pluripotent-stem-cell-derived-scgb3a2-airway-epithelium
#4
Katherine B McCauley, Konstantinos-Dionysios Alysandratos, Anjali Jacob, Finn Hawkins, Ignacio S Caballero, Marall Vedaie, Wenli Yang, Katherine J Slovik, Michael Morley, Gianni Carraro, Seunghyi Kook, Susan H Guttentag, Barry R Stripp, Edward E Morrisey, Darrell N Kotton
Lung epithelial lineages have been difficult to maintain in pure form in vitro, and lineage-specific reporters have proven invaluable for monitoring their emergence from cultured pluripotent stem cells (PSCs). However, reporter constructs for tracking proximal airway lineages generated from PSCs have not been previously available, limiting the characterization of these cells. Here, we engineer mouse and human PSC lines carrying airway secretory lineage reporters that facilitate the tracking, purification, and profiling of this lung subtype...
April 9, 2018: Stem Cell Reports
https://www.readbyqxmd.com/read/29656528/the-role-of-scalpel-bougie-cricothyroidotomy-in-managing-emergency-front-of-neck-airway-access-a-review-and-technical-update-for-ent-surgeons
#5
N D McNiven, J P Pracy, B A McGrath, A K Robson
In October 2016 an editorial was published jointly in Clinical Otolaryngology and the British Journal of Anaesthesia concerning the appropriate management of the difficult airway in a situation of 'Can't Intubate Can't Oxygenate' (CICO).1 It highlighted the importance of joint working between surgeons and anaesthetists and also made a case for the wider use of the scalpel-bougie cricothyroidotomy technique in securing a Front of Neck Airway (FONA), especially in an emergency. This article is protected by copyright...
April 15, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29652577/lung-cancers-associated-with-cystic-airspaces-underrecognized-features-of-early-disease
#6
Sarah Sheard, Joanna Moser, Charlie Sayer, Konstantinos Stefanidis, Anand Devaraj, Ioannis Vlahos
Early lung cancers associated with cystic airspaces are increasingly being recognized as a cause of delayed diagnoses-owing to data gathered from screening trials and encounters in routine clinical practice as more patients undergo serial imaging. Several morphologic subtypes of cancers associated with cystic airspaces exist and can exhibit variable patterns of progression as the solid elements of the tumor grow. Current understanding of the pathogenesis of these malignancies is limited, and the numbers of cases reported in the literature are small...
April 13, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29644445/-perioperative-onset-of-sarcoidosis-rare-differential-diagnosis-of-a-difficult-airway
#7
G Jansen, A Nowak
Sarcoidosis is a rare multisystemic chronic inflammatory condition. Typically, there is a big discrepancy between the patient's subjectively perceived symptoms and the presence of clinical signs. Due to the high number of potential sites of onset (e. g. larynx, lungs, heart, liver, kidneys) the affected organs may show functional restrictions that are relevant for decisions related to anesthesia. Therefore, an anesthetists working in a clinical setting should be familiar with the special needs of this patient collective...
April 11, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29644040/a-rare-case-of-a-lingual-mass-in-a-neonate
#8
Laura Leach, Nico Jonas
A large lingual cyst was noted on the 22-week antenatal ultrasound, which grew in proportion to the foetus on serial imaging. An elective c-section was performed in view of possible airway obstruction, and the neonate initially required oxygen to maintain saturations. Aged 1 month, the baby developed significant breastfeeding difficulties secondary to rapid cyst and secondary tongue enlargement, completely filling the oral cavity. Fifteen millilitres of fluid were aspirated in clinic, resulting in reduction of tongue size and immediate improvement in feeding...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29643625/formulation-of-a-multivariate-predictive-model-for-difficult-intubation-a-double-blinded-prospective-study
#9
Anoop Kanwal Chhina, Richa Jain, Parshotam Lal Gautam, Jony Garg, Nidhi Singh, Anju Grewal
Background and Aims: Various models were devised for prediction of difficult intubation but have low positive predictive value, sensitivity and specificity. We aimed to predict difficult intubation from various airway predictive indices, in isolation and combination, and to formulate a multivariate model that can aid in accurate prediction of difficult intubation. Material and Methods: A prospective double blinded study was conducted on 500 adult patients scheduled for elective surgery under general anaesthesia...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643559/appropriate-angled-tip-front-width-facilitates-tracheal-tube-introducer-placement-in-difficult-to-displace-epiglottis-situations
#10
Amitabh Dutta, Manish Gupta, Prabhat Kumar Choudhary, Jayashree Sood
Tracheal tube introducers (TTIs) are a useful aid to a conventional laryngoscopy-intubation method of upper airway access in adults. However, even when TTIs are used, successful tracheal intubation is not guaranteed. Apart from suboptimal practice proficiency and unavailability of the complete repertoire of TTI, the physical attributes of the TTI have a role to play. Our report on the management of two cases highlights the importance of selecting a TTI with appropriate angled tip characteristics to facilitate successful guided intubation...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628864/fixed-cervical-flexion-deformity-difficult-airway
#11
Kadarapura Nanjundaiah Gopalakrishna, Shetty Prajwal, Kamath Sriganesh, Bhumireddy Suneel Reddy
No abstract text is available yet for this article.
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628843/point-of-care-ultrasound-in-the-airway-assessment-a-correlation-of-ultrasonography-guided-parameters-to-the-cormack-lehane-classification
#12
Shelly Rana, Versha Verma, Shyam Bhandari, Shalini Sharma, Vishal Koundal, Sudarshan Kumar Chaudhary
Background and Aim: The sonographic assessment of airway in the preoperative period has encouraging results in predicting difficult laryngoscopy. Materials and Methods: The prospective, observational study was conducted on 120 patients scheduled for elective surgery requiring general anesthesia and tracheal intubation. The depth of the pre-epiglottic space (Pre-E), the distance from the epiglottis to the midpoint of the distance between the vocal cords (E-VC) was measured sonographically...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628833/efficacy-and-safety-of-dexmedetomidine-infusion-for-patients-undergoing-awake-craniotomy-an-observational-study
#13
Charu Mahajan, Girija Prasad Rath, Gyaninder Pal Singh, Nitasha Mishra, Suman Sokhal, Parmod Kumar Bithal
Background: The goal of awake craniotomy is to maintain adequate sedation, analgesia, respiratory, and hemodynamic stability and also to provide a cooperative patient for neurologic testing. An observational study carried out to evaluate the efficacy of dexmedetomidine sedation for awake craniotomy. Materials and Methods: Adult patients with age >18 year who underwent awake craniotomy for intracranial tumor surgery were enrolled. Those who were uncooperative and had difficult airway were excluded from the study...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628599/temporomandibular-joint-ankylosis-a-pediatric-difficult-airway-management
#14
Anoop Sharma, Deepak Dwivedi, Ram Murti Sharma
Intubating a pediatric patient with temporomandibular joint ankylosis is a daunting task, and it becomes more challenging with limited mouth opening. Fiberoptic nasotracheal intubation technique is considered a gold standard. We describe an improvised technique of securing airway in the absence of appropriate-sized fiberoptic scope. The endotracheal tube inserted in the left nostril for maintaining depth of anesthesia was advanced under vision by the fiberoptic scope inserted into the right nostril, and with external laryngeal manipulation, the airway was secured with no complications...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628567/comparison-of-upper-lip-bite-test-and-ratio-of-height-to-thyromental-distance-with-other-airway-assessment-tests-for-predicting-difficult-endotracheal-intubation
#15
D Shobha, Maitri Adiga, D Devika Rani, Sudheesh Kannan, S S Nethra
Background and Aims: Unanticipated difficult intubation or the failed intubation in operating room and in emergency department is an imperative source of anesthesia-related patient's mortality. The aim of this study is to compare the predictive value of upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) with other commonly used preoperative airway assessment tests for predicting difficult intubation in Indian population. Materials and Methods: In this prospective, single-blinded observational study, 260 adult patients of either sex, belonging to American Society of Anesthesiologists physical Status I and II undergoing elective surgical procedure under general anesthesia were included in the study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628546/hemodynamic-responses-and-safety-of-sedation-following-premedication-with-dexmedetomidine-and-fentanyl-during-fiberoptic-assisted-intubation-in-patients-with-predicted-difficult-airway
#16
Sunil Rajan, Rittick Talukdar, Pulak Tosh, Jerry Paul, Bindu K Vasu, Lakshmi Kumar
Background: Awake fiberoptic intubation (AFOI) is the gold standard for the management of predicted difficult airway, and inappropriate sedation is a major cause leading to its failure. Aims: The primary objective was to compare the heart rate (HR) changes that accompany AFOI following sedation with dexmedetomidine and fentanyl. Secondary objectives included comparison of changes in blood pressure, patient comfort, ease of intubation, and degree of sedation. Settings and Designs: This prospective double-blinded randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628333/multidisciplinary-difficult-airway-course-an-essential-educational-component-of-a-hospital-wide-difficult-airway-response-program
#17
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29619784/comparison-between-lignocaine-nebulization-and-airway-nerve-block-for-awake-fiberoptic-bronchoscopy-guided-nasotracheal-intubation-a-single-blind-randomized-prospective-study
#18
Pooja Rawat Mathur, Neena Jain, Aji Kumar, Beena Thada, Veena Mathur, Deepak Garg
BACKGROUND: The preferred management strategy for difficult airways is awake fiberoptic bronchoscopy-guided intubation, which requires effective airway anesthesia to ensure patient comfort and acceptance. This randomized single-blind prospective study was conducted to compare lignocaine nebulization and airway nerve block for airway anesthesia prior to awake fiberoptic bronchoscopy-guided intubation. METHODS: Sixty adult patients scheduled for surgical procedures under general anesthesia were randomly allocated to two groups...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29619557/performance-and-skill-retention-of-five-supraglottic-airway-devices-for-the-pediatric-difficult-airway-in-a-manikin
#19
Johannes Kulnig, Lisa Füreder, Nicole Harrison, Michael Frass, Oliver Robak
Supraglottic airway devices (SADs) have been introduced to assist medical professionals in emergency situations with limited experience in securing airways via conventional endotracheal intubation (ETI). Literature on the use of SADs for securing an airway during pediatric critical settings is scarce, and there is a lack of studies comparing different SADs to each other and to conventional ETI. We conducted a study comparing five different SADs to ETI with regard to success rate, time to first ventilation, and personal rating in a pediatric manikin under simulated physiologic and pathologic airway conditions in 41 pediatricians of varying clinical experience and training...
April 5, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29618189/cervical-collar-makes-difficult-airway-a-simulation-study-using-the-lemon-criteria
#20
Moonsu Yuk, Woonhyung Yeo, Kangeui Lee, Jungin Ko, Taejin Park
OBJECTIVE: Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and after cervical collar application to investigate the causes of a difficult airway. METHODS: This simulation study was performed in 76 healthy volunteers. We measured the mouth opening, modified Mallampati classification, and neck extension before and after cervical collar application...
March 2018: Clinical and Experimental Emergency Medicine
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