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https://www.readbyqxmd.com/read/28938303/optimizing-education-in-difficult-airway-management-meeting-the-challenge
#1
Sheila N Myatra, Rupali S Kalkundre, Jigeeshu V Divatia
PURPOSE OF REVIEW: The last 2 decades have seen a vast change in the science and technology of airway management. As a result, there is an increasing need to equip anesthesiologists with the new knowledge and skills for the safe management of a difficult airway. RECENT FINDINGS: In addition to knowledge and expertise, human factors and nontechnical skills (NTS), including situational awareness, communication and team work, play an important role during difficult airway management and contribute to the outcome...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28905252/human-and-equipment-resources-for-difficult-airway-management-airway-education-programs-and-capnometry-use-in-japanese-emergency-departments-a-nationwide-cross-sectional-study
#2
Yuko Ono, Koichi Tanigawa, Kazuaki Shinohara, Tetsuhiro Yano, Kotaro Sorimachi, Ryota Inokuchi, Jiro Shimada
BACKGROUND: Although human and equipment resources, proper training, and the verification of endotracheal intubation are vital elements of difficult airway management (DAM), their availability in Japanese emergency departments (EDs) has not been determined. How ED type and patient volume affect DAM preparation is also unclear. We conducted the present survey to address this knowledge gaps. METHODS: This nationwide cross-sectional study was conducted from April to September 2016...
September 13, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28879322/difficult-airway-management-in-a-patient-with-a-thin-mandible
#3
Hong-Seok Choi, Jong-Shik Oh, Eun-Jung Kim, Ji-Young Yoon, Ji-Uk Yoon, Cheul-Hong Kim
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28865448/pediatric-supraglottic-airway-devices-in-clinical-practice-a-prospective-observational-study
#4
Maren Kleine-Brueggeney, Anne Gottfried, Sabine Nabecker, Robert Greif, Malte Book, Lorenz Theiler
BACKGROUND: Supraglottic airway devices (SGA) are commonly used in pediatric anesthesia and serve as primary or back-up devices for difficult airway management. Most SGA are marketed without proper clinical evaluation. The purpose of this study was to evaluate the performance of the pediatric LMA Supreme™, Air-Q® and Ambu® Aura-i™. METHODS: This prospective observational study was performed at Bern University Hospital, Switzerland. With ethics committee approval and a waiver for written informed consent 240 children undergoing elective surgery with an ASA class I-III and a weight of 5-30 kg were included...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#5
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
https://www.readbyqxmd.com/read/28781848/successful-difficult-airway-management-of-a-child-with-coffin-siris-syndrome
#6
Ahmet Selim Ozkan, Sedat Akbas, Mehmet Ridvan Yalin, Emine Ozdemir, Zeynep Koylu
Management of airway in patients who have Coffin-Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C-MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#7
REVIEW
Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu, Gui-Zhen Yang
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#8
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#9
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28448320/difficult-airway-management-caused-by-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#10
Courtney L Maxey-Jones, Alec Palmerton, Jocelyn R Farmer, Brian T Bateman
Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#11
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10 - 17% in the general population. Its prevalence in the surgical population seems to be higher. However, a proportion of up to 60% of patients may not have a formal diagnosis at the moment of preoperative visit. OSA is associated with a number of comorbidities and increased perioperative risks. However, most interventions for the perioperative management of OSA patients lack high quality evidence...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#12
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 lifesaving. 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 under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28258332/progress-in-difficult-airway-management
#13
EDITORIAL
Takashi Asai
No abstract text is available yet for this article.
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28203798/videolaryngoscopy-is-not-a-panacea-for-difficult-airway-management
#14
R Rajendram
No abstract text is available yet for this article.
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28178944/two-case-reports-of-unexpected-tracheal-agenesis-in-the-neonate-3-c-s-beyond-algorithms-for-difficult-airway-management
#15
Beate Grass, Leopold Simma, Michael Reinehr, Urs Zimmermann, Claudine Gysin, Georg Henze, Vincenzo Cannizzaro
BACKGROUND: Handling neonates with postnatal respiratory failure due to congenital airway malformations implies knowledge about emergency management of unexpected difficult airway. In these stressful situations both technical and communication skills of the caretakers are essential. CASE PRESENTATION: Two cases with prenatally unknown tracheal agenesis are reported. CONCLUSION: In the presented cases, airway malformation and subsequent difficulties upon endotracheal intubation were not adequately communicated between caretakers...
February 8, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28100946/management-of-young-patients-with-temporomandibular-joint-ankylosis-a-surgical-and-anesthetic-challenge
#16
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
#17
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...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28007521/children-with-challenging-airways-what-about-glidescope-%C3%A2-video-laryngoscopy
#18
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
#19
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
#20
REVIEW
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...
September 2017: Anesthesia and Analgesia
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