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https://www.readbyqxmd.com/read/28101365/comments-to-role-of-upper-airway-ultrasound-in-airway-management
#1
Wan-Ching Lien
Tracheal ultrasound can be an alternative diagnostic tool in airway management, besides traditional confirmatory methods such as capnography and auscultation. The standard image is a hyperechoic air-mucosa (A-M) interface with a reverberation artifact posteriorly (comet-tail artifact). If the second A-M interface appears, which we call a "double-tract sign," esophageal intubation is considered.
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28100714/the-dynamics-of-the-pulmonary-microbiome-during-mechanical-ventilation-in-the-intensive-care-unit-and-the-association-with-occurrence-of-pneumonia
#2
Tetyana Zakharkina, Ignacio Martin-Loeches, Sébastien Matamoros, Pedro Povoa, Antoni Torres, Janine B Kastelijn, Jorrit J Hofstra, B de Wever, Menno de Jong, Marcus J Schultz, Peter J Sterk, Antonio Artigas, Lieuwe D J Bos
RATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included...
January 18, 2017: Thorax
https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#3
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098589/can-mandibular-condylar-mobility-sonography-measurements-predict-difficult-laryngoscopy
#4
Weidong Yao, Yumei Zhou, Bin Wang, Tao Yu, Zhongbing Shen, Hao Wu, Xiaoju Jin, Yuanhai Li
BACKGROUND: Limited mandibular condylar mobility plays an important role in difficult laryngoscopy. Indirect assessment methods, such as mouth opening, have been proven to be useful predictors of difficult laryngoscopy. Sonography is a new direct assessment method for the limited mandibular condylar mobility. However, whether this method could be used in predicting difficult laryngoscopy still remains unknown. This study aimed to observe its ability to predict difficult laryngoscopy. METHODS: Adult patients who were administered tracheal intubations for elective surgery under general anesthesia were enrolled in the study...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097852/laryngotracheal-edema-due-to-thermal-injury-a-complication-after-thyroidectomy-in-children
#5
Pinar Kendigelen, Ayse C Tutuncu, Gulruh Ashyralyyeva, Senol Emreb, Seval Urkmez, Tughan Utkua, Guner Kaya
Postoperative respiratory insufficiency is a serious complication of total thyroidectomies which can be multifactorial, especially in children. We report two siblings who had undergone thyroidectomy with subsequent respiratory distress. Electrothermal bipolar and harmonic scalpel were used during thyroid dissections. Both patients had early postoperative respiratory problems. The older one suffered from mild respiratory distress for 24 hours and then he spontaneously recovered. The younger one was extubated but then she had serious stridor accompanied with abdominal and intercostal retractions...
1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28096586/comparison-of-intubating-laryngeal-mask-airway-and-fiberoptic-bronchoscopy-for-endotracheal-intubation-in-patients-undergoing-cervical-discectomy
#6
Kolli S Chalam, Jyothi Gupta
BACKGROUND AND AIMS: Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094479/retromolar-laryngoscopy-a-randomised-cross-over-vocal-cords-visualisation-study
#7
Christian Reiterer, Barbara Waltl, Barbara Kabon, Wolfgang Schramm
BACKGROUND: Vocal cords visualisation is a major determinant for successful tracheal intubation. The aim of our study was to compare vocal cord visualisation by using conventional direct laryngoscopy with retromolar direct laryngoscopy in patients with an existing retromolar gap at the right mandible. METHODS: We enrolled 100 adults needing endotracheal intubation for elective surgery. In each patient the vocal cords were visualised and scored according to Cormack & Lehane with a Macintosh blade #3 for conventional technique and with a Miller blade #4 for the retromolar technique in a randomised sequence...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28089425/-a-comparison-of-various-supraglottic-airway-devices-for-fiberoptical-guided-tracheal-intubation
#8
Thomas Metterlein, Anna Dintenfelder, Christoph Plank, Bernhard Graf, Gabriel Roth
BACKGROUND: Fiberoptical assisted intubation via placed supraglottic airway devices has been described as safe and easy procedure to manage difficult airways. However visualization of the glottis aperture is essential for fiberoptical assisted intubation. Various different supraglottic airway devices are commercially available and might offer different conditions for fiberoptical assisted intubation. The aim of this study was to compare the best obtainable view of the glottic aperture using different supraglottic airway devices...
January 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28081306/tracheal-intubation-in-patients-immobilized-by-a-rigid-collar-a-comparison-of-glidescope-and-an-intubating-laryngeal-mask-airway
#9
Semih Özdil, Zehra İpek Arslan Aydın, Zehra Nur Baykara, Kamil Toker, Zeynep Mine Solak
BACKGROUND/AIM: Intubation must be rapidly performed with the utmost care in cervical trauma patients. We present the first comparison of GlideScope and an intubating laryngeal mask airway (ILMA) regarding insertion and intubation times, intubation success rates, mucosal damage, need for optimization maneuvers, effects on hemodynamic changes, and postoperative minor complications in a simulated cervical injury with a Philadelphia cervical collar. MATERIALS AND METHODS: Ethics committee approval and patient consent were obtained and 94 American Society of Anesthesiology physical status I or II patients were enrolled in this study...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28077525/oxygen-supplementation-during-prolonged-tracheal-intubation-should-be-the-standard-of-care
#10
EDITORIAL
J E Fiadjoe, R S Litman
No abstract text is available yet for this article.
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074798/proseal-laryngeal-mask-airway-as-an-alternative-to-standard-endotracheal-tube-in-securing-upper-airway-in-the-patients-undergoing-beating-heart-coronary-artery-bypass-grafting
#11
Kalpana Shah
BACKGROUND: ProSeal laryngeal mask airways (PLMAs) are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies. In long duration surgeries, use of endotracheal tube (ETT) is associated with various hemodynamic complications, which are minimally affected during PLMA use. However, except for few studies, there are no significant data available that promote the use of laryngeal mask during cardiac surgery...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074795/comparative-effect-of-grape-seed-extract-vitis-vinifera-and-ascorbic-acid-in-oxidative-stress-induced-by-on-pump-coronary-artery-bypass-surgery
#12
Naser Safaei, Hossein Babaei, Rasoul Azarfarin, Ahmad-Reza Jodati, Alireza Yaghoubi, Mohammad-Ali Sheikhalizadeh
BACKGROUND: This study aimed to test the beneficial effect of grape seed extract (GSE) (Vitis vinifera) and Vitamin C in oxidative stress and reperfusion injury induced by cardiopulmonary bypass (CPB) in coronary artery bypass surgery. PATIENTS AND METHODS: In this randomized trial, 87 patients undergoing elective and isolated coronary bypass surgery included. The patients were randomly assigned into three groups (n = 29 each): (1) Control group with no treatment, (2) GSE group who received the extract 24 h before operation, 100 mg every 6 h, orally, (3) Vitamin C group who received 25 mg/kg Vitamin C through CPB during surgery...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074791/selection-of-an-appropriate-left-sided-double-lumen-tube-size-for-one-lung-ventilation-among-asians
#13
Siti Salwani Ideris, Muhamad Rahimi Che Hassan, Mohd Ramzisham Abdul Rahman, Joanna Su Min Ooi
CONTEXT: Selecting an appropriate size double-lumen tube (DLT) for one-lung ventilation has always been a challenge as most choose it based on experience or using the existing guidelines based on gender and height. AIMS: The aim of this study was to determine if the appropriate choice of this tube could be based on the patients' height, weight, tracheal diameter (TD), or the left main stem bronchus diameter (LMBD) and also to determine the relationship between height and depth of insertion among Asians...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072483/optimization-of-ultrasound-transducer-positioning-for-endotracheal-tube-placement-confirmation-in-cadaveric-model
#14
Tiffany Lonchena, Sokpoleak So, James Ibinson, Peter Roolf, Steven L Orebaugh
OBJECTIVES: Sonography has been suggested as a possible means of endotracheal tube (ETT) placement confirmation. However, optimum ultrasound transducer placement has not been established. Using a cadaveric model, ETT placement by the sonographic appearance at the thyroid cartilage, cricoid cartilage, and suprasternal notch in the upper airway was assessed to determine which ultrasound transducer placement offered the most optimal images for ETT confirmation in the airway. METHODS: One provider intubated 5 cadavers, with the ultrasound transducer at each of the 3 levels, for a total of 30 intubations per specimen, while 2 providers assigned a visual score of 1 (subtle), 2 (clear), or 3 (pronounced) to each sonogram of the ETT in the airway...
January 10, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28066624/practical-anesthetic-considerations-in-patients-undergoing-tracheobronchial-surgeries-a-clinical-review-of-current-literature
#15
REVIEW
Sanchit Ahuja, Barak Cohen, Jochen Hinkelbein, Pierre Diemunsch, Kurt Ruetzler
Tracheobronchial surgeries require close cooperation and extensive communication between the anesthesia providers and the surgeons. Anesthetic management of tracheal and bronchial pathologies differ basically from regular upper airways management, due access to the patients airway is limited, mostly even practically impossible for the anesthesia providers. As a consequence, the surgeon overtakes responsibility for the airway access from the anesthesia provider in the variety of the cases. Preoperative recognition of a difficult airway, detailed planning and being aware of plan B and plan C are the elementary keys to success...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28066621/the-non-intubated-anesthesia-for-airway-surgery
#16
REVIEW
Katsuhiro Okuda, Ryoichi Nakanishi
Surgical treatment for lung cancer including airway resection following reconstruction is typically performed under general anesthesia with single-lung ventilation because it is necessary to maintain a sufficient working space and to adjust the airway pressure for the leak test. However, non-intubated thoracic surgery has been gradually developed in recent years for thoracoscopic surgery, due to its lower rate of postoperative complications, shorter hospitalization duration, and lower invasiveness than the usual single-lung anesthesia...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28066602/a-novel-surgical-method-for-acquired-non-malignant-complicated-tracheoesophageal-and-bronchial-gastric-stump-fistula-the-double-patch-technique
#17
Guang Yang, Wei-Miao Li, Jin-Bo Zhao, Jian Wang, Yun-Feng Ni, Yong-An Zhou, Yong Han, Xiao-Fei Li, Xiao-Long Yan
BACKGROUND: To manage the acquired benign complicated tracheoesophageal fistula (TEF) and bronchial-gastric stump fistula (BGSF) are clinical technical challenge. The purpose of this study is to retrospectively review a surgical "double patch" technique in treating nonmalignant complicated TEF and BGSF, and then clarify the long-term curative effect of the technique. METHODS: Clinical records of 30 patients with non-malignant complicated TEF and BGSF treated by "double patch" technique in Tangdu Hospital between August 2004 and August 2014, were analyzed and summarized retrospectively...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065557/manual-laryngeal-fixation-facilitates-tracheal-intubation-during-chest-compression-a-randomized-crossover-manikin-study
#18
Takanobu Fujisawa, Nobuyasu Komasawa, Kazuo Hattori, Ryosuke Mihara, Toshiaki Minami
PURPOSE: We compared the effectiveness of external manual laryngeal fixation (MLF) for tracheal intubation during chest compression using three laryngoscopes, the Macintosh laryngoscope (McL), McGRATH® MAC (McGRGTH), and Pentax-AWS Airwayscope® (AWS) on an adult manikin. METHODS: Sixteen novice doctors and 15 experienced anesthesiologists performed tracheal intubation during chest compression on an adult manikin using the McL, McGRATH, and AWS with or without MLF...
December 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28065228/comparison-of-the-ambu-aura-i-with-the-air-q-intubating-laryngeal-airway-as-a-conduit-for-fiberoptic-guided-tracheal-intubation-in-children-with-ear-deformity
#19
Juan Zhi, Xiao-Ming Deng, Dong Yang, Chao Wen, Wen-Li Xu, Lei Wang, Jin Xu
Objective To compare the Ambu Aura-i with the Air-Q intubating laryngeal airway for fiberoptic-guided tracheal intubation in ear deformity children.Methods Totally 120 children who were scheduled for elective auricular reconstruction surgery requiring general anaesthesia with tracheal intubation were enrolled in this prospective study. They were randomized to receive either the Ambu Aura-i (Aura-i group) or Air-Q (Air-Q group). The time for successful tracheal intubation was assessed. The attempts for successful device insertion, leak pressures, cuff pressures, fiberoptic grade of laryngeal view, time for removal of the device after endotracheal intubation, and complications were recorded...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28059945/airway-management-with-a-stereotactic-headframe-in-situ-a-mannequin-study
#20
Melissa Brockerville, Zoe Unger, Nathan C Rowland, Francesco Sammartino, Pirjo H Manninen, Lashmi Venkatraghavan
BACKGROUND: Stereotactic headframe-based imaging is often needed for target localization during surgery for insertion of deep brain stimulators. A major concern during this surgery is the need for emergency airway management while an awake or sedated patient is in the stereotactic headframe. The aim of our study was to determine the ease of emergency airway management with a stereotactic headframe in situ. MATERIALS AND METHODS: We conducted an observational study using a mannequin...
January 4, 2017: Journal of Neurosurgical Anesthesiology
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