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https://www.readbyqxmd.com/read/28100946/management-of-young-patients-with-temporomandibular-joint-ankylosis-a-surgical-and-anesthetic-challenge
#1
REVIEW
Devalina Goswami, Sweta Singh, Ongkila Bhutia, Dalim Baidya, Chhavi Sawhney
Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28099287/anesthetic-outcomes-of-children-with-arthrogryposis-syndromes-no-evidence-of-hyperthermia
#2
Stephen J Gleich, Michael Tien, Darrell R Schroeder, Andrew C Hanson, Randall Flick, Michael E Nemergut
BACKGROUND: Arthrogryposis syndromes are a heterogeneous group of disorders characterized by congenital joint contractures often requiring multiple surgeries during childhood to address skeletal and visceral abnormalities. Previous reports suggest that these children have increased perioperative risk, including hypermetabolic events discrete from malignant hyperthermia, difficult airway management, isolated hyperthermia, and difficult IV line placement. We sought to compare children with arthrogryposis multiplex congenita (AMC) versus the less severe, distal arthrogryposis syndromes (DAS) and to evaluate possible intraoperative hyperthermia of patients with AMC...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28007521/children-with-challenging-airways-what-about-glidescope-%C3%A2-video-laryngoscopy
#3
Chrystelle Sola, Anne-Charlotte Saour, Christine Macq, Sophie Bringuier, Olivier Raux, Christophe Dadure
BACKGROUND: GlideScope® video-laryngoscopy is becoming increasingly used, including in paediatrics. However, to date, very few data are available on efficiency during situations involving difficult intubation. Our objective was to describe the usefulness of the GlideScope® in children with presumed challenging airway criteria. METHODS: In this observational study, all children with predicted criteria of potential difficult intubation and requiring general anaesthesia with tracheal intubation were prospectively enrolled over a 12-month period...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28003694/the-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#4
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often life-saving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with a suboptimal evaluation of the airway and limited oxygen reserves despite adequate pre-oxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxaemia and cardiovascular collapse during TI in the ICU...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27984225/anesthetic-management-of-patients-with-inborn-errors-of-metabolism
#5
Benjamin Kloesel, Robert S Holzman
Inborn errors of metabolism (IEM) are characterized by the body's inability to convert food into energy. The pathogenetic mechanism is based on defects in a variety of cellular enzymes. In addition to impairment of energy generation, accumulation of substrates may occur, which can deposit in tissue and lead to organ dysfunction. IEM can have profound implications for perioperative management, including difficult airway management, cardiac dysfunction, aspiration risk, seizures, and metabolic dysregulation. For the anesthesiologist, comprehensive knowledge is difficult to attain because of the heterogeneity of this group and the low prevalence of specific diseases...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27909609/emergency-difficult-airway-management-in-a-patient-with-severe-epidermolysis-bullosa
#6
Ahmet Selim Özkan, Gülay Erdoğan Kayhan, Sedat Akbaş, Osman Kaçmaz, Mahmut Durmuş
Epidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#7
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27887736/use-of-clarus-video-system-%C3%A2-in-expected-difficult-airway-in-a-patient-with-rett-syndrome
#8
L España Fuente, R E Méndez Redondo, J L González González
Difficult airway management remains one of the key points in our specialty, as the difficulty or impossibility of tracheal intubation is the main cause of morbidity/mortality attributable to anaesthesia. Rett syndrome is a severe and incapacitating neurological disease. We present the case of a 21-year-old girl affected by this syndrome, with significant psychomotor retardation and difficult airway predictors, who was scheduled to have a laparoscopic cholecystectomy under general anaesthesia. We decided on one attempt of Clarus Video System(®) fiberoptic intubation as primary intervention...
January 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27882541/prediction-of-difficult-mask-ventilation-using-a-systematic-assessment-of-risk-factors-vs-existing-practice-a-cluster-randomised-clinical-trial-in-94-006-patients
#9
A K Nørskov, J Wetterslev, C V Rosenstock, A Afshari, G Astrup, J C Jakobsen, J L Thomsen, L H Lundstrøm
We compared implementation of systematic airway assessment with existing practice of airway assessment on prediction of difficult mask ventilation. Twenty-six departments were cluster-randomised to assess eleven risk factors for difficult airway management (intervention) or to continue with their existing airway assessment (control). In both groups, patients predicted as a difficult mask ventilation and/or difficult intubation were registered in the Danish Anaesthesia Database, with a notational summary of airway management...
November 24, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27871545/fiberoptic-guided-intubation-after-insertion-of-the-i-gel-airway-device-in-spontaneously-breathing-patients-with-difficult-airway-predicted-a-prospective-observational-study
#10
Julian Arévalo-Ludeña, Jose Juan Arcas-Bellas, Rafael Alvarez-Rementería, Luis Enrique Muñoz Alameda
STUDY OBJECTIVE: To assess the viability of performing fiberoptic-guided orotracheal intubation through the i-gel airway device previously inserted in spontaneously breathing patients with predicted difficult airway to achieve a patent airway. DESIGN: Prospective observational study. SETTING: Operating room in a tertiary care hospital. PATIENTS: Eighty-five adult patients with at least 3 difficult airway predictors or difficult airway management history were included...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#11
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27816155/respiratory-considerations-including-airway-and-ventilation-issues-in-critical-care-obstetric-patients
#12
REVIEW
Holly Ende, Dirk Varelmann
Critical care management of the obstetric patient can present unique challenges. Parturients who present with respiratory distress can suffer from a multitude of etiologies, and each diagnosis must be pursued as appropriate to the clinical picture. Normal physiologic changes of pregnancy may obscure the presentation and diagnosis, and irrelevant of the cause, pregnancy may complicate the management of hypoxic and hypercarbic respiratory failure in this patient population. In addition to these concerns, both anticipated and unanticipated difficult airway management, including difficulty ventilating and intubating, are more common during pregnancy and may be encountered during endotracheal tube placement...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27796837/emergency-ventilation-with-the-ventrain-%C3%A2-through-an-airway-exchange-catheter-in-a-porcine-model-of-complete-upper-airway-obstruction
#13
Michiel W P de Wolf, Reiner Gottschall, Niels P Preussler, Markus Paxian, Dietmar Enk
PURPOSE: During difficult airway management, oxygen insufflation through airway-exchange and intubating catheters (AEC/IC) can lead to life-threatening hyperinflation. Ventrain(®) was originally designed to facilitate emergency ventilation using active expiration through short, small-bore cannulas. Herein, we studied its efficacy (oxygenation and ventilation) and safety (avoidance of hyperinflation) in a long, small-bore AEC. METHODS: In six anesthetized pigs, the upper airway was obstructed, except for a 100 cm long, 3 mm internal diameter AEC...
January 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27697130/lack-of-national-consensus-in-preoperative-airway-assessment
#14
Anders K Nørskov, Charlotte V Rosenstock, Lars H Lundstrøm
INTRODUCTION: Difficult airway management is associated with an increased risk of morbidity and mortality. Several preoperative risk factors associated with airway management difficulties have been proposed; however, no clear guideline for airway assessments exists. We therefore hypothesised that Danish airway assessment was lacking uniformity. We aimed to examine whether multivariable risk assessment tools and predictors for difficult intubation and mask ventilation were used systematically...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27637970/supraglottic-jet-oxygenation-and-ventilation-assisted-fibre-optic-bronchoscope-intubation-in-patients-with-difficult-airways
#15
Caineng Wu, Jianqi Wei, Qingyun Cen, Xuefan Sha, Qingxiang Cai, Wuhua Ma, Ying Cao
A difficult airway may lead to hypoxia and brain damage. The WEI Nasal Jet Tube (WNJ) is a new nasal pharyngeal tube that applies supraglottic jet oxygenation and ventilation (SJOV) for patients during tracheal intubation without the need for mask ventilation. We evaluated the effectiveness and safety of SJOV-assisted fibre-optic bronchoscopy (FOB) using the WNJ in the management of difficult tracheal intubations. A total of 50 adult patients with Cormack-Lehane grade ≥3 and general anesthesia with tracheal intubation were randomly assigned to either the laryngeal mask airway (LMA) or WNJ groups...
September 14, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27629490/is-retrograde-intubation-more-successful-than-direct-laryngoscopic-technique-in-difficult-endotracheal-intubation
#16
Pitsucha Sanguanwit, Thavinee Trainarongsakul, Noppanan Kaewsawang, Kittisak Sawanyawisuth, Yuwares Sitthichanbuncha
BACKGROUND: Difficult airway intubation is an emergency condition both at the emergency department (ED) and in out-of-hospital situations. Retrograde intubation (RI) is another option for difficult airway management. There are limited data regarding the successful rate of RI compared with direct laryngoscopy (DL) intubation, the commonly used method in the ED. METHODS: This study was a randomized, controlled trial. Participants were randomly assigned to either the RI or the DL technique to attempt intubation on a difficult airway mannequin (Cormack and Lehane grades 3-4)...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27576447/association-between-off-hour-presentation-and-endotracheal-intubation-related-adverse-events-in-trauma-patients-with-a-predicted-difficult-airway-a-historical-cohort-study-at-a-community-emergency-department-in-japan
#17
Yuko Ono, Takuya Sugiyama, Yasuyuki Chida, Tetsuya Sato, Hiroaki Kikuchi, Daiji Suzuki, Masakazu Ikeda, Koichi Tanigawa, Kazuaki Shinohara
BACKGROUND: A reduction in medical staff such as occurs in hospitals during nights and weekends (off hours) is associated with a worse outcome in patients with several unanticipated critical conditions. Although difficult airway management (DAM) requires the simultaneous assistance of several appropriately trained medical caregivers, data are scarce regarding the association between off-hour presentation and endotracheal intubation (ETI)-related adverse events, especially in the trauma population...
August 30, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27555208/vivasight-a-new-era-in-the-evolution-of-tracheal-tubes
#18
REVIEW
Ayten Saracoglu, Kemal T Saracoglu
STUDY OBJECTIVE: To evaluate the available data describing the use of single and double lumen VivaSight tubes. DESIGN: Systematic review. SETTING: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications. PATIENTS: Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27555177/redesigning-an-airway-cart-using-lean-methodology
#19
Wade A Weigel
STUDY OBJECTIVE: Use lean methodology to create a more efficient difficult airway management equipment transport and setup. DESIGN: The 5S steps of sort, set in order, sweep, standardize, and sustain were used to create a redesigned airway cart. The 5S steps provided the framework to separate the needed from unneeded equipment, logical equipment placement on the cart, and a plan to maintain improvements. Simulations were utilized to compare the revised airway cart to the previous airway equipment storage...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27468737/emergency-surgical-airway-management-in-denmark-a-cohort-study-of-452-461-patients-registered-in-the-danish-anaesthesia-database
#20
C V Rosenstock, A K Nørskov, J Wetterslev, L H Lundstrøm
BACKGROUND: The emergency surgical airway (ESA) is the final option in difficult airway management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed airway management. METHODS: We extracted a cohort of 452 461 adult patients undergoing general anaesthesia and tracheal intubation from the DAD from June 1, 2008 to March 15, 2014. Difficult airway management involving an ESA was retrieved for analysis and compared with hospitals files...
September 2016: British Journal of Anaesthesia
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