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https://www.readbyqxmd.com/read/28959372/a-decision-theoretic-comparison-of-treatments-to-resolve-air-leaks-after-lung-surgery-based-on-nonparametric-modeling
#1
Yanxun Xu, Peter F Thall, Peter Müller, Reza J Mehran
We propose a Bayesian nonparametric utility-based group sequential design for a randomized clinical trial to compare a gel sealant to standard care for resolving air leaks after pulmonary resection. Clinically, resolving air leaks in the days soon after surgery is highly important, since longer resolution time produces undesirable complications that require extended hospitalization. The problem of comparing treatments is complicated by the fact that the resolution time distributions are skewed and multi-modal, so using means is misleading...
2017: Bayesian Analysis
https://www.readbyqxmd.com/read/28934741/successful-management-of-a-positive-air-leak-test-during-laparoscopic-colorectal-surgery
#2
Kazuhito Sasaki, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Tomomichi Kiyomatsu, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Koji Yasuda, Koji Murono, Toshiaki Watanabe
BACKGROUND/AIMS: Anastomotic leakage remains the most serious complications of colorectal surgery. To prevent colorectal anastomotic leakage (CAL), an air leak test (ALT) with intraoperative colonoscopy (IOCS) is performed to detect mechanically insufficient colorectal anastomoses. The approaches to an intraoperative anastomotic air leak (IOAL) have not been fully investigated. This study aimed to clarify the safe management of an IOAL in laparoscopic colorectal surgery. METHODS: One hundred forty-eight consecutive patients who underwent laparoscopic resection with double-stapling technique (DST) anastomosis for left-sided colorectal cancer between April 2015 and June 2016 were included and retrospectively reviewed...
September 22, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28932566/non-intubated-single-incision-video-assisted-thoracic-surgery-a-two-center-cohort-of-188-patients
#3
Man-Ling Wang, Carlos Galvez, Jin-Shing Chen, Jose Navarro-Martinez, Sergio Bolufer, Ming-Hui Hung, Hsao-Hsung Hsu, Ya-Jung Cheng
BACKGROUND: Non-intubated single-incision procedures are slowly expanding because of high experience and skill required, and stricter selection criteria. The aim of this study is to present the first retrospective two-center series in Taiwan and Spain. METHODS: We performed a retrospective analysis of 188 patients undergoing non-intubated single-incision video-assisted thoracic surgery (NI-SI-VATS) procedures between July 2013 to November 2015 in two centers in Taiwan (170 patients) and Spain (18 patients) with two different anesthetic methods...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28927375/effects-of-lubrication-on-air-sealing-performance-of-a-pediatric-cuffed-tracheal-tube
#4
Hiroko Nishioka, Yutaka Usuda, Go Hirabayashi, Koichi Maruyama, Tomio Andoh
BACKGROUND: Lubrication of cuffed tracheal tubes (CTTs) reduces liquid leakage. However, it is not clear how cuff lubrication influences air leakage. We aimed to test the hypothesis that pretreatment with K-Y jelly, a water-soluble lubricant, would improve the air-sealing performance of pediatric CTTs in a model study. METHODS: We placed Parker Flex-Tip™ CTT with 4.0- and 5.0-mm internal diameter (ID) into a tracheal model with 9- and 12-mm ID. The tracheal model was connected to a test lung ventilated in pressure control mode...
September 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28868600/a-pleural-vacuum-relief-device-for-pleural-drain-unit-use-in-the-hyperbaric-environment
#5
Marco Gelsomino, Theo Tsouras, Ian Millar, Andrew Fock
INTRODUCTION: When a standard water-seal pleural drain unit (PDU) is used under hyperbaric conditions there are scenarios where excessive negative intrapleural pressure (IPP) and/or fluid reflux can be induced, risking significant morbidity. We developed and tested a pleural vacuum relief (PVR) device which automatically manages these risks, whilst allowing more rapid hyperbaric pressure change rates. METHODS: The custom-made PVR device consists of a one-way pressure relief valve connected in line with a sterile micro filter selected for its specific flow capacity...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28865448/pediatric-supraglottic-airway-devices-in-clinical-practice-a-prospective-observational-study
#6
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/28863023/evaluation-of-the-augmented-infant-resuscitator-a-monitoring-device-for-neonatal-bag-valve-mask-resuscitation
#7
Desmond J Bennett, Taiga Itagaki, Christopher T Chenelle, Edward A Bittner, Robert M Kacmarek
BACKGROUND: Annually, 6 million newborns require bag-valve-mask resuscitation, and providing live feedback has the potential to improve the quality of resuscitation. The Augmented Infant Resuscitator (AIR), a real-time feedback device, has been designed to identify leaks, obstructions, and inappropriate breath rates during bag-valve-mask resuscitation. However, its function has not been evaluated. METHODS: The resistance of the AIR was measured by attaching it between a ventilator and a ventilator tester...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28759391/case-report-of-a-hypobaric-chamber-fitness-to-fly-test-in-a-child-with-severe-cystic-lung-disease
#8
Sarah Loo, Andrew Campbell, Julian Vyas, Naveen Pillarisetti
Patients with severe cystic lung disease are considered to be at risk for cyst rupture during air travel because of the possibility of increase in cyst size and impaired equilibration of pressure between the cysts and other parts of the lung. This may have clinically devastating consequences for the patient but may also result in significant costs for emergency alteration of flight schedule. We report the use of a hypobaric chamber to simulate cabin pressure changes encountered on a commercial flight to assess the safety to fly of a child with severe cystic lung disease secondary to Langerhans cell histiocytosis...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28747940/surgical-treatment-for-pulmonary-aspergilloma-early-and-long-term-results
#9
Mariusz Kasprzyk, Kornel Pieczyński, Krystian Mania, Piotr Gabryel, Cezary Piwkowski, Wojciech Dyszkiewicz
INTRODUCTION: Pulmonary aspergilloma is a difficult therapeutic problem due to the low effectiveness of conservative treatment and high surgical morbidity. AIM: To analyze the early and late results of surgical treatment for pulmonary aspergilloma. MATERIAL AND METHODS: From 2005 to 2015, 49 patients were treated surgically for pulmonary aspergilloma. Symptoms occurred in 85.7% of cases, including recurrent hemoptysis in 53%. A history of immunosuppressive therapy or chemotherapy was noted in 24...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28744781/lung-function-in-pregnancy-in-langerhans-cell-histiocytosis
#10
Elżbieta Radzikowska, Elżbieta Wiatr, Monika Franczuk, Iwona Bestry, Kazimierz Roszkowski-Śliż
Pulmonary Langerhans cell histiocytosis (LCH) is a rare disease, affecting usually young people. The course of the disease is variable. In some pulmonary LCH patients a severe lung destruction and progression in spite of chemotherapy is observed, but in others just a cessation of smoking induces a regression of the disease. In the present study we seek to determine the influence of pregnancy on pulmonary function in LCH patients, an unchartered area of research. We addressed the issue by investigating eight pregnant women out of the 45 women hospitalized with the diagnosis of pulmonary LCH in the period from 2000 to 2015...
July 26, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28734991/endoscopic-full-thickness-resection-using-suture-loop-needle-t-tag-tissue-anchors-in-the-porcine-stomach-with-video
#11
Akira Dobashi, Elizabeth Rajan, Mary A Knipschield, Christopher J Gostout
BACKGROUND AND AIMS: Endoscopic full-thickness resection (EFTR) is still challenging, and a reliable technique is desirable. The aim of this study was to evaluate the feasibility of controlled EFTR using a pseudopolyp made from suture loop needle T-tag (SLNT) tissue anchors in ex vivo porcine stomachs. METHODS: Five pig stomachs were used. Two concentric circumferential border mucosal incisions were made to facilitate isolating a target lesion for full-thickness excision and pseudopolyp formation...
July 20, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28658880/ultrasonographic-estimation-of-endotracheal-tube-size-in-paediatric-patients-and-its-comparison-with-physical-indices-based-formulae-a-prospective-study
#12
Jagadish G Sutagatti, Ranjana Raja, Madhuri S Kurdi
INTRODUCTION: Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. AIM: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. The secondary outcome was to assess the number of times the tube was changed based on air leak test for USG estimated tube size...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28655952/a-novel-technique-for-insertion-of-proseal%C3%A2-laryngeal-mask-airway-comparison-of-the-stylet-tool-with-the-introducer-tool-in-a-prospective-randomised-study
#13
Sheila Nainan Myatra, Vijaykumar Khandale, Friedrich Pühringer, Sushan Gupta, Sohan Lal Solanki, Jigeeshu V Divatia
BACKGROUND AND AIMS: The ProSeal™ laryngeal mask airway (PLMA) has a soft cuff which tends to fold on itself during insertion, resulting in reduced first-attempt success rate. We compared the standard introducer technique of PLMA insertion with a novel method to prevent folding of the cuff using a Rüsch™ Stylet. METHODS: This randomised superiority trial included 120 American Society of Anesthesiologists I-II patients between 18 and 80 years, undergoing elective surgeries under general anaesthesia using a PLMA for airway management...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28648052/anticancer-therapeutic-alginate-based-tissue-sealants-for-lung-repair
#14
Spencer L Fenn, Patrick N Charron, Rachael A Oldinski
Injury to the connective tissue that lines the lung, the pleura, or the lung itself can occur from many causes including trauma or surgery, as well as lung diseases or cancers. To address current limitations for patching lung injuries, to stop air or fluid leaks, an adherent hydrogel sealant patch system was developed, based on methacrylated alginate (AMA) and AMA dialdehyde (AMA-DA) blends, which is capable of sealing damaged tissues and sustaining physiological pressures. Methacrylation of alginate hydroxyl groups rendered the polysaccharide capable of photo-cross-linking when mixed with an eosin Y-based photoinitiator system and exposed to visible green light...
July 19, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28610883/the-validation-of-a-no-drain-policy-after-thoracoscopic-major-lung-resection
#15
Junichi Murakami, Kazuhiro Ueda, Toshiki Tanaka, Taiga Kobayashi, Yoshie Kunihiro, Kimikazu Hamano
BACKGROUND: The omission of postoperative chest tube drainage may contribute to early recovery after thoracoscopic major lung resection; however, a validation study is necessary before the dissemination of a selective drain policy. METHODS: A total of 162 patients who underwent thoracoscopic anatomical lung resection for lung tumors were enrolled in this study. Alveolar air leaks were sealed with a combination of bioabsorbable mesh and fibrin glue. The chest tube was removed just after the removal of the tracheal tube in selected patients in whom complete pneumostasis was obtained...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28584349/comparison-of-actual-and-ideal-body-weight-for-selection-of-appropriate-size-of-proseal%C3%A2-laryngeal-mask-airway-in-overweight-and-obese-patients-a-prospective-randomised-study
#16
Sohan Lal Solanki, Jeson R Doctor, Kamlesh K Shekhawat, Sheila Nainan Myatra, Malini Joshi, Jigeeshu V Divatia
BACKGROUND AND AIMS: The ProSeal™ laryngeal mask airway (PLMA) has advantages of providing better cuff seal and the presence of a gastric drain tube. The manufacturer recommends actual body weight (ABW) for size selection. Pharyngeal area reduces with increase in body mass index (BMI); hence, in overweight patients, PLMA selected on ABW may not fit well. We hypothesised that the ideal body weight (IBW) would be more appropriate in size selection of PLMA. METHODS: This randomised, single-blind study included 124 patients of 20-60 years and American Society of Anesthesiologists Class I-II, with BMI >25...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28567102/neonatal-respiratory-distress-syndrome-chest-x-ray-or-lung-ultrasound-a-systematic-review
#17
REVIEW
Matthew Hiles, Anne-Marie Culpan, Catriona Watts, Theresa Munyombwe, Stephen Wolstenhulme
BACKGROUND AND AIM: Neonatal respiratory distress syndrome is a leading cause of morbidity in preterm new-born babies (<37 weeks gestation age). The current diagnostic reference standard includes clinical testing and chest radiography with associated exposure to ionising radiation. The aim of this review was to compare the diagnostic accuracy of lung ultrasound against the reference standard in symptomatic neonates of ≤42 weeks gestation age. METHODS: A systematic search of literature published between 1990 and 2016 identified 803 potentially relevant studies...
May 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/28511075/using-endoscopy-to-minimize-the-extent-of-resection-in-the-management-of-giant-gists-of-the-stomach
#18
Hishaam Ismael, Yury Ragoza, Steven Cox
INTRODUCTION: The stomach is the most common site for GISTs. Wide local resection to achieve negative margins is the standard of care. Giants GISTs requiring extensive resection are usually managed with neo-adjuvant therapy followed by partial or total gastrectomy. PRESENTATION OF CASE: We present a case report of a giant GIST on the lesser curvature of the stomach. Neo-adjuvant therapy was administered. Intra-operative endoscopy was used to reduce the extent of gastric resection...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28444366/intraoperative-air-leak-measured-after-lobectomy-is-associated-with-postoperative-duration-of-air-leak
#19
Alessandro Brunelli, Michele Salati, Cecilia Pompili, Paolo Gentili, Armando Sabbatini
OBJECTIVES: To verify the association between the air leak objectively measured intraoperatively (IAL) using the ventilator and the air leak duration after pulmonary lobectomy. METHODS: Prospective analysis on 111 patients submitted to pulmonary lobectomy (33 by video-assisted thoracic surgery). After resection, objective assessment of air leak (in milliliter per minute) was performed before closure of the chest by measuring the difference between a fixed inspired and expired volume, using a tidal volume of 8 ml/kg, a respiratory rate of 10 and a positive-end expiratory pressure of 5 cmH 2 O...
April 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28414119/efficacy-of-the-fissureless-technique-on-decreasing-the-incidence-of-prolonged-air-leak-after-pulmonary-lobectomy-a-systematic-review-and-meta-analysis
#20
REVIEW
Shuang-Jiang Li, Kun Zhou, Yong-Jiang Li, Peng-Fei Li, Yan-Ming Wu, Lun-Xu Liu, Guo-Wei Che
OBJECTIVE: The objective of our study was to evaluate the efficacy and safety of fissureless technique in pulmonary lobectomy by applying a meta-analysis of the current evidence. METHODS: We searched the PubMed, EMBASE and the Web of Science databases to recognize the eligible articles. The relative risk (RR) and weighted mean difference (WMD) with the corresponding 95% confidence interval (CI) served as the summarized estimates for dichotomous variables and continuous variables, respectively...
June 2017: International Journal of Surgery
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