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"difficult airway management"

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
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
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)...
August 30, 2016: American Journal of Emergency Medicine
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...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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
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
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
Carlos E Pompilio, Paolo Pelosi, Melina G Castro
The increasing number of bariatric/metabolic operations as important alternatives for the treatment of obesity and type 2 diabetes brought several concerns about the intensive care of patients undergoing those procedures. Intensive Care Unit admission criteria are needed in order to better allocate resources and avoid unnecessary interventions. Furthermore, well-established protocols, helpful in many clinical situations, are not directly applicable to obese patients. Indeed, difficult airway management, mechanical ventilation, fluid therapy protocols, prophylaxis, and treatment of venous thromboembolic events have unique aspects that should be taken into consideration...
September 2016: Current Atherosclerosis Reports
T Saito, S T H Chew, W L Liu, K K Thinn, T Asai, L K Ti
BACKGROUND: The aim of this study was to propose and validate a new clinical score to predict difficult ventilation through a supraglottic airway device. METHODS: The score was proposed from our previously reported derivation data, and we prospectively validated the score in 5532 patients from November 2013 to April 2014. Predictive accuracy of the score was compared by the area under the receiver operating characteristic (ROC) curve (AUC). We assigned point values to each of the identified four risk factors: male, age >45 yr, short thyromental distance, and limited neck movement, their sum composing the score...
September 2016: British Journal of Anaesthesia
Ahmet Selim Özkan, Serdar Nazif Nasır
Difficult airway is defined as having the patient's mask ventilation or difficult tracheal intubation of an experienced anaesthesiologist. A number of reasons, such as congenital or acquired anatomical anomalies, can cause difficult intubation and difficult ventilation. Keeping all equipment ready for airway management of patients will reduce mortality and complications. In this case, it is intended that the submission of difficult airway management who encountered in mandibular reconstruction for mandible bone defect repairing with reconstruction plates before at the field conditions in Somalia...
October 2015: Turkish Journal of Anaesthesiology and Reanimation
Vladimir Dolinaj, Sanja Milošev, Dušanka Janjević
Laryngeal chondrosarcoma is a rare mesenchymal tumor, most frequently affecting cricoid cartilage. The objective of this report is to present successful video laryngoscope usage in a patient with anticipated difficult airway who refused awake fiberoptic endotracheal intubation (AFOI). A 59-year-old male patient was admitted in our hospital due to difficulty breathing and swallowing. On clinical examination performed by ENT surgeon, preoperative endoscopic airway examination (PEAE) could not be performed properly due to the patient's uncooperativeness...
March 2016: Acta Clinica Croatica
Bibiana Vitković, Morena Milić
Goldenhar syndrome, also known as oculoauriculovertebral dysplasia, is a rare congenital condition characterized by facial, cranial, vertebral, ocular, auricular and cardiac abnormalities. This syndrome is associated with hemifacial microsomia due to inadequate growth of the mandible and vertebral anomaly of the cervical part of the spine. For anesthesiologists, airway management is of great interest because of facial and oral abnormalities such as mandibular hypoplasia and limitation of neck movement. Considering different conditions of Goldenhar syndrome, every patient should be preoperatively evaluated in order to make the plan for the anticipated difficult airway management...
March 2016: Acta Clinica Croatica
Tatjana Stopar Pintaric
Airway anesthesia is pivotal for successful awake intubation provided either topically or by blocks. Airway blocks are considered technically more difficult to perform and carry a higher risk of complications. However, in experienced hands, they can be useful as they provide excellent intubating conditions. For complete upper airway anesthesia, bilateral glossopharyngeal and superior laryngeal nerve blocks with translaryngeal injection are required. Superior laryngeal nerve block and translaryngeal injection can be performed easily, safely and with a high success rate in patients with normal anatomy...
March 2016: Acta Clinica Croatica
Branka Maldini, Iljaz Hodžović, Tatjana Goranović, Jasna Mesarić
Despite the lack of uniformity and the need of further investigation, video laryngoscopy continues to gain popularity both inside and outside the operating room. It has quickly become a first line strategy for potential and/or encountered difficult intubation. It is well established that video laryngoscope improves laryngeal view as compared with direct laryngoscopy in patients with suspected difficult intubation and simulated difficult airway scenarios. For novices and experienced anesthesiologists alike, video laryngoscopy is easy to use and the skills involved are easy to master...
March 2016: Acta Clinica Croatica
Nevena Kalezić, Vera Sabljak, Ksenija Stevanović, Biljana Milicić, Dejan Marković, Anka Tošković, Marina Stojanović, Vladan Živaljević
Difficult tracheal intubation (DI) is more common in thyroid than in other surgical branches due to thyromegaly. Proper preoperative airway evaluation is necessary in order to reduce the potential numerous complications. The study examined the incidence of DI in thyroid surgery and the influence of tracheal dislocation and other risk factors on DI. A prospective study was conducted on 2379 patients who underwent thyroidectomy at the Center for Endocrine Surgery, Clinical Center of Serbia, from 2007 to 2012...
March 2016: Acta Clinica Croatica
Rudrashish Haldar, Ankur Khandelwal, Raghavendra Vagyannavar, Shashi Srivastava
No abstract text is available yet for this article.
June 2, 2016: Journal of Neurosurgical Anesthesiology
Michell Gulabani, Akhilesh Gupta, Neerja Gaur Bannerjee, Rajesh Sood, Prashant Dass
An 11-year-old male child, known case of down's syndrome with congenital oesophageal stricture was posted for oesophageal dilatation. Preoperative airway assessment revealed a high arched palate, receding mandible and Mallampati Score of 2. During surgery, after loss of consciousness which was described as loss of eyelash reflex and adequate jaw relaxation, direct laryngoscopy and endotracheal intubation was attempted with a cuffed endotracheal tube number 5.0mm ID (internal diameter). The endotracheal tube could not be negotiated smoothly, so 5...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Yuko Ono, Koichi Tanigawa, Kazuaki Shinohara, Tetsuhiro Yano, Kotaro Sorimachi, Lubna Sato, Ryota Inokuchi, Jiro Shimada, Choichiro Tase
PURPOSE: The availability of difficult airway management (DAM) resources and the extent of capnometry use in Japanese intensive care units (ICUs) remained unclear. The purpose of this study was to clarify whether: (1) DAM resources were adequate, and (2) capnometry was routinely applied in Japanese ICUs. METHODS: This nationwide cross-sectional study was conducted from September 2015 to February 2016. All ICUs received a mailed questionnaire about their DAM resources and use of capnometry...
August 2016: Journal of Anesthesia
Anders Kehlet Nørskov
Difficulties with airway management in relation to general anaesthesia have been a challenge for the anaesthesiologist since the birth of anaesthesia. Massive landmark improvements have been made and general anaesthesia is now regarded as a safe procedure. However, rare, difficult airway management still occurs and it prompts increased risk of morbidity and mortality - especially when not anticipated. Several preoperative risk factors for airway difficulties have been identified, yet none have convincing diagnostic accuracy as stand alone tests...
May 2016: Danish Medical Journal
Behrad Ziapour
BACKGROUND: To describe the successful management of a patient with severe dyspnea and hypoxia due to tracheal stenosis by the application of a novel bridging technique-anterograde tracheal catheterization-prior to tracheostomy. CASE PRESENTATION: A 55-year-old woman entered the Emergency Department with severe dyspnea, tachypnea, and stridor and a pulse oximetry reading of 60 %. An attempt at intubation failed because of tracheal stenosis discovered 3-4 cm distal to the vocal cords, which had been formed as a complication of intubation the previous month...
2016: Journal of Cardiothoracic Surgery
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