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https://www.readbyqxmd.com/read/29457950/knowledge-and-skills-of-critical-care-nurses-in-assisting-with-intubation
#1
Chris Williams, Andrew Parry
Assisting with tracheal intubation is an aspect of clinical practice that requires knowledge and skill if the procedure is to be carried out in a timely and safe manner. Maintaining this knowledge and skill requires good quality education and regular opportunities to practise. These two factors appear to be inconsistent in critical care units. This article details an audit performed on a large tertiary referral centre critical care unit. It was undertaken in two phases: the first was a self-assessment of knowledge and the second was a practical assessment of the audit subjects in a simulated setting...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457113/pulmonary-embolism-caused-by-ovarian-vein-thrombosis-during-cesarean-section-a-case-report
#2
Yutaka Oda, Michie Fujita, Chika Motohisa, Shinichi Nakata, Motoko Shimada, Ryushi Komatsu
Background: Ovarian vein thrombosis is a rare complication of pregnancy. The representative complaints of patients with ovarian vein thrombosis are abdominal pain and fever. In some cases, however, fatal pulmonary embolism may develop. We report a case of pulmonary embolism presenting with severe hypotension and loss of consciousness during cesarean section possibly caused by ovarian vein thrombosis. Case presentation: A 25-year-old woman at 38 weeks 4 days of gestation was scheduled for repeat cesarean section...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456702/application-of-pre-injection-of-dexmedetomidine-of-different-doses-in-pediatric-intravenous-general-anesthesia-without-tracheal-intubation
#3
Mi Zhou, Qiang Wang, Qiong Zhang, Yifei Liu, Leyun Zhan, Aihua Shu
This study observed the clinical efficacy of pre-injection of dexmedetomidine of different doses before surgery and the adverse reactions during the recovery period in pediatric intravenous general anesthesia without tracheal intubation. Pediatric patients who received general anesthesia without tracheal intubation before surgery from January 2016 to March 2017 were randomly divided into four groups (n=30), and were respectively treated with intravenous pump infusion of loaded dexmedetomidine of high-dose (2...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29455825/urgent-surgical-approach-to-mediastinal-cyst-causing-life-threatening-tracheal-obstruction
#4
Lin Cheng, Ai Huang, Ke Jiang, Shijie Xing, Jianjun Wang, Jun Nie
This case describes an urgent surgical approach to a patient with symptoms of rapid progressive respiratory compromise resulting from a massive mediastinal cyst. To relieve tracheal compression, ultrasound-guided percutaneous fine-needle aspiration was performed as an urgent procedure, which immediately improved the patient's airway obstruction and facilitated double-lumen endotracheal intubation. Methylene blue was injected into the cyst through the puncturing needle and accurately marked the margins of the cyst...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29455141/comparison-of-scoring-tools-for-the-prediction-of-in-hospital-mortality-in-status-epilepticus
#5
Caroline Reindl, Ruben U Knappe, Maximilian I Sprügel, Jochen A Sembill, Tamara M Mueller, Hajo M Hamer, Hagen B Huttner, Dominik Madžar
PURPOSE: Several scoring tools have been developed for the prognostication of outcome after status epilepticus (SE). In this study, we compared the performances of STESS (Status Epilepticus Severity Score), mSTESS (modified STESS), EMSE-EAL (Epidemiology-based Mortality Score in Status Epilepticus- Etiology, Age, Level of Consciousness) and END-IT (Encephalitis-NCSE-Diazepam resistance-Image abnormalities-Tracheal intubation) in predicting in-hospital mortality after SE. METHOD: Data collected retrospectively from a cohort of 287 patients with SE were used to calculate STESS, mSTESS, EMSE-EAL, and END-IT scores...
February 1, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29447809/difficult-airway-intubation-simulation-using-bonfils-fiberscope-and-rigid-fiberscope-for-surgical-training
#6
Harish Dharmarajan, Yi-Chun Carol Liu, Helena Karlberg Hippard, Binoy Chandy
INTRODUCTION: Pediatric otolaryngologists are frequently called to assist in difficult airway management in newborns with Pierre Robin Sequence (PRS) who have microretrognathia, glossoptosis, and an anterior larynx. The Bonfils fiberscope (BF) is a curved rigid scope designed to provide superior visualization in the anterior larynx. OBJECTIVE: (1) to assess whether BF provides an improvement in intubation success rate, time to intubation, or airway visualization as compared to rigid fiberscope (RF) in a difficult airway simulation setting and (2) to determine whether a training program for BF can improve time to intubation through practice trials...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29441909/the-effect-of-continuous-perfusion-of-esmolol-on-cardiovascular-risk-in-elderly-patients-undergoing-noncardiac-surgery
#7
X K Zhang, Q Hu, Q H Chen, W X Wang
We evaluated the effect of continuous perfusion of esmolol on cardiovascular risk during curative laparoscopic surgery for gastrointestinal cancer in elderly patients. Sixty patients with gastrointestinal cancer, aged from 60 to 80 years, were divided into an esmolol group (ES, n = 30) and a control group (NS, n = 30). ES patients were treated with esmolol at a dose of 0.3 mg/kg 3 min before tracheal intubation, and received continuous perfusion of esmolol at a dose of 50 μg/kg/min during operation. In NS, esmolol was replaced by saline...
August 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29436277/initial-load-stability-of-different-trachea-suture-techniques-tests-on-an-ex-vivo-model
#8
Andreas Kirschbaum, Helen Abing, Nikolas Mirow
Objective Tracheal anastomosis can be performed with different suture techniques. In this experimental work, the resilience of anastomotic techniques to pressure and tensile stress was studied. Study Design Ex vivo pig model. Setting Experimental. Subjects and Methods The trachea with the 2 main bronchi in freshly slaughtered pigs was isolated and intubated (CH 8.0). Both main bronchi were closed distally by a stapler. After resection of the trachea, an anastomosis (n = 15 per group) was created: group 1, single interrupted sutures; group 2, continuous running suture; group 3, mixed technique...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29436138/the-incidence-of-postoperative-respiratory-complications-a-retrospective-analysis-of-cuffed-vs-uncuffed-tracheal-tubes-in-children-0-7-years-of-age
#9
Michel de Wit, Linda M Peelen, Leo van Wolfswinkel, Jurgen C de Graaff
BACKGROUND: The use of cuffed vs uncuffed endotracheal tubes in pediatric anesthesia is widely debated. This study aimed to investigate whether the use of cuffed vs uncuffed tubes is associated with an increased incidence of acute postoperative respiratory complications. METHODS: We retrospectively studied all children aged 0-7 years in which the trachea was intubated between September 28, 2006 and August 26, 2016 in a pediatric university hospital. Logistic regression analysis was performed to estimate the association between tube design (cuffed vs uncuffed) and the incidence of acute postoperative respiratory complications (stridor, wheezing, or dyspnea; desaturations ≤90%) in need of intervention (epinephrine, dexamethasone, nebulizers, supplementary oxygen, or reintubation), adjusting for potential confounders...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29432379/dexmedetomidine-as-a-part-of-general-anaesthesia-for-caesarean-delivery-in-patients-with-pre-eclampsia-efficacy-and-foetal-outcome-a-randomised-double-blinded-trial
#10
Ashraf M Eskandr, Ahmed A Metwally, Abd-Elrahman A Ahmed, Elham M Elfeky, Islam M Eldesoky, Manar A Obada, Osama A Abd-Elmegid
BACKGROUND: During general anaesthesia, endotracheal intubation of patients with pre-eclampsia causes stimulation of the sympathetic nervous system and catecholamine release, which may lead to maternal and neonatal complications. OBJECTIVE: To attenuate both the stress response and the haemodynamic response to tracheal intubation in patients with pre-eclampsia. DESIGN: A randomised, double-blind, controlled study. SETTING: Single University Hospital...
February 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29430408/using-bronchoscopy-to-detect-acquired-tracheoesophageal-fistula-in-mechanically-ventilated-patients
#11
Michael S Green, Johann J Mathew, Lia J Michos, Parmis Green, Mansoor M Aman
Introduction: An acquired Tracheoesophageal fistula (TEF) is commonly caused by a malignancy or trauma, with pulmonary infection or aspiration being the presenting symptom. However, in the critical care setting the presentation can be subtle and may present with difficult ventilation. High endotracheal tube cuff pressures can lead to tracheal erosions and thus increasing the chances for developing a TEF. Prolonged intubation in the presence of other risk factors like poor general state of health, episodic hypotension, nasogastric tubes, and repeated intubations can increase the likelihood of developing an acquired TEF...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29429553/intubation-in-two-patients-with-difficult-airway-management-and-tracheal-stenosis-after-tracheostomy-in-thoracic-surgery
#12
M Granell Gil, P Solís Albamonte, C Córdova Hernández, I Cobo, R Guijarro, J A de Andrés Ibañez
Lung isolation in thoracic surgery is a challenge, this is even more complex in the presence of unknown tracheal stenosis (TS). We report two cases of unknown TS and its airway management. TS appears most frequently after long term intubation close to the endotracheal tube cuff or in the stoma of tracheostomy that appears as a consequence of the granulation tissue after the surgical opening of the trachea. Clinical history, physical examination, difficult intubating predictors and imaging tests (CT scans) are crucial, however most of tracheal stenosis may be unnoticed and symptoms depend on the degree of obstruction...
February 8, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29429458/-burkholderia-cepacia-infection-in-children-a-clinical-analysis-of-16-cases
#13
Fang Peng, Li-Li Zhong, Xiao-Juan Lin, Min Chen, Miao Zhou
OBJECTIVE: To investigate the distribution characteristics and clinical features of Burkholderia cepacia infection in children. METHODS: A retrospective analysis was performed for the clinical data of 16 children with Burkholderia cepacia infection who were hospitalized between June 2012 and September 2017. RESULTS: All 16 children with Burkholderia cepacia infection were sporadic cases. A total of 16 strains of Burkholderia cepacia were isolated, among which 8 were detected by sputum culture, 5 were detected by blood culture, 2 were detected by tracheal intubation tip culture, and 1 was detected by lung biopsy culture...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29428567/clinical-features-of-fatal-severe-fever-with-thrombocytopenia-syndrome-that-is-complicated-by-invasive-pulmonary-aspergillosis
#14
Xiancheng Chen, Zhuxi Yu, Yajun Qian, Danjiang Dong, Yingying Hao, Ning Liu, Qin Gu
INTRODUCTION: Severe fever with thrombocytopenia syndrome (SFTS) has been prevalent in parts of Asia during recent years. However, SFTS with invasive pulmonary aspergillosis (IPA) is rare, and it is important to understand its clinical features. MATERIALS AND METHODS: Total four cases of SFTS with IPA are reviewed and detailing the disease progression, treatment options, and prognosis were summarized and analyzed. RESULTS: The patients with SFTS-associated IPA first presented with fever, gastrointestinal symptoms, thrombocytopenia, leukopenia, and multiple organ failure...
February 7, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29422724/effect-of-continuous-versus-intermittent-subglottic-suctioning-on-tracheal-mucosa-by-the-mallinckrodt-taperguard-evac-oral-tracheal-tube-in-intensive-care-unit-ventilated-patients-a-prospective-randomized-study
#15
Philippe Seguin, Harmonie Perrichet, Estelle Le Pabic, Yoann Launey, Marie Tiercin, Romain Corre, Graziella Brinchault, Bruno Laviolle
Background and Aims: A risk of tracheal mucosa injury induced by subglottic suctioning has been raised. Therefore, this prospective randomized study aims to compare the effect of continuous suctioning of subglottic secretions versus intermittent suctioning of subglottic secretions (CSSS vs. ISSS) secretions on tracheal mucosa in front of the suctioning port of the endotracheal tube. Patients and Methods: Patients requiring intubation or reintubation in Intensive Care Unit with an expected ventilation duration > 24 h were eligible...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29419952/-long-term-results-of-the-early-endoscopic-treatment-of-acquired-tracheal-subglottic-stenosis-10-years-of-experience
#16
A Vilanova, C A De la Torre, A Sánchez-Galán, F Hernández Oliveros, J L Encinas, R Ortiz, V Núñez Cerezo, O De la Serna, M I Barrio, L Castro, L Builes, C Verdú, M López Santamaría
INTRODUCTION: Acquired stenosis of the airway is a common complication after endotracheal intubation. Endoscopic dilation has been accepted as the treatment of choice in cases detected precociously. Our goal is to know the current status of the patients treated in our hospital with endoscopic dilation in the last 10 years. MATERIAL AND METHODS: Retrospective cohort study of patients with subglottic and tracheal acquired stenosis (STAS) early treated endoscopically with balloon dilation at our center in the last 10 years...
February 1, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29416908/acute-tetraplegia-following-laryngotracheal-reconstruction-surgery
#17
Belgin Erhan, Rahsan Kemerdere, Osman Kizilkilic, Berrin Gunduz, Murat Hanci
Background: Paraplegia following thoracic spinal surgery or abdominal operations is usually attributed to spinal cord ischemia due to interruption of the segmental spinal vascular supply. Alternatively, the etiology of spinal cord ischemia following cervical surgery is less clear. Case Description: A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29416585/predicting-difficult-intubation-in-emergency-department-by-intubation-assessment-score
#18
Winchana Srivilaithon, Sombat Muengtaweepongsa, Yuwares Sittichanbuncha, Jayanton Patumanond
Background: The difficult intubation is associated with failure of emergency tracheal intubation. This study aimed to develop and validate a model for predicting difficult intubation in emergency department (ED). Methods: A cross-sectional study was conducted in the ED. We collected data from all consecutive adult patients who underwent emergency tracheal intubation. Patients were excluded if they were intubated by low experience intubator. The difficult intubation was defined by grade III or IV of Cormack and Lehane classification...
March 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29416460/endotrol-tracheal-tube-and-mcgrath-mac-are-an-effective-combination-for-oral-tracheal-intubation
#19
Azusa Shimazaki, Hironobu Ueshima, Hiroshi Otake
Background: Tracheal intubation using the 2nd-generation video laryngoscope sometimes cannot be performed easily because there is no functional endotracheal tube (ETT) guide. Therefore, a rigid stylet is often required during tracheal intubation. The Endotrol® tracheal tube (Endotrol) is a single use ETT that whole tube can be bent and slide easily into the trachea. We studied the intubation ease of a combination of an Endtrol and the McGrath® video laryngoscope (McGrath), which is one of the 2nd-generation video laryngoscopes...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416459/neck-fat-volume-as-a-potential-indicator-of-difficult-intubation-a-pilot-study
#20
Romualdo Del Buono, Lorenzo Sabatino, Federico Greco
Background: Direct laryngoscopy is the gold standard of the airway management in patients without predicted difficulties. If unpredicted difficulties are encountered instead, different algorithms to follow have been developed. To date, no single predictor is sufficiently valid. In clinical practice, it is used a combination of them to enhance the estimate, and despite the variety of parameters used, not all the difficult intubations are predicted. The aim of this work is to retrospectively analyze neck computed tomography scans of 37 patients who have had tracheal intubation and search for anatomic neck fat compartments that correlate with the intubation difficulty, and eventually find a suitable, clinical parameter that can potentially enhance the prediction of a difficult airway when used in combination of the preexisting scores...
January 2018: Saudi Journal of Anaesthesia
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