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tracheal intubation

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https://www.readbyqxmd.com/read/27902612/intubation-without-use-of-stylet-for-mcgrath-videolaryngoscopy-in-patients-with-expected-normal-airway-a-randomized-noninferiority-trial
#1
Hyun Jeong Kwak, Sook Young Lee, Su Youn Lee, Yong Beom Kim, Jong Yeop Kim
BACKGROUND: During McGrath videolaryngoscope (VL) intubation, a styletted endotracheal tube maintaining an upward distal tip angle is recommended by some manufacturers. However, a styletted endotracheal tube can elicit rare but potentially serious complications. The purpose of this study was to demonstrate that a nonstyletted tube with exaggerated curvature would be noninferior to a styletted tube for orotracheal intubation using McGrath VL in patients with expected normal airway, by comparing the time to intubation and ease of intubation...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900760/choice-of-anaesthesia-for-category-1-caesarean-section-in-women-with-anticipated-difficult-tracheal-intubation-the-use-of-decision-analysis
#2
A J Krom, Y Cohen, J P Miller, T Ezri, S H Halpern, Y Ginosar
A predicted difficult airway is sometimes considered a contra-indication to rapid sequence induction of general anaesthesia, even in an urgent case such as a category-1 caesarean section for fetal distress. However, formally assessing the risk is difficult because of the rarity and urgency of such cases. We have used decision analysis to quantify the time taken to establish anaesthesia, and probability of failure, of three possible anaesthetic methods, based on a systematic review of the literature. We considered rapid sequence induction of general anaesthesia with videolaryngoscopy, awake fibreoptic intubation and rapid spinal anaesthesia...
November 30, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27890997/complete-subglottic-tracheal-stenosis-managed-with-rigid-bronchoscopy-and-t-tube-placement
#3
Kuruswamy Thurai Prasad, Sahajal Dhooria, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Ritesh Agarwal
Surgery is the preferred treatment modality for benign tracheal stenosis. Interventional bronchoscopy is used as a bridge to surgery or in instances when surgery is not feasible or has failed. Stenosis in the subglottic trachea is particularly a treatment challenge, in view of its proximity to the vocal cords. Herein, we describe a patient with complete tracheal stenosis in the subglottic region, which developed after prolonged intubation and mechanical ventilation. The patient developed recurrent stenosis despite multiple surgical and endoscopic procedures...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#4
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27889843/a-randomized-comparison-of-the-ambu-auragain-versus-the-lma-supreme-in-patients-undergoing-gynaecologic-laparoscopic-surgery
#5
Ana M Lopez, Merce Agusti, Pedro Gambus, Montserrat Pons, Teresa Anglada, Ricard Valero
Second generation supraglottic airway devices providing high seal airway pressures are suitable for patients undergoing gynecologic laparoscopy. We compared the seal pressure achieved by the new Ambu AuraGain™ versus LMA Supreme™ following pneumoperitoneum in the Trendelenburg position. Sixty female patients were randomly allocated to ventilation with either the AuraGain or the Supreme. A target-controlled system was used to administer total intravenous anesthesia. Intracuff pressure was maintained below 60 cm H2O...
November 26, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#6
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27887736/use-of-clarus-video-system-%C3%A2-in-expected-difficult-airway-in-a-patient-with-rett-syndrome
#7
L España Fuente, R E Méndez Redondo, J L González González
Difficult airway management remains one of the key points in our specialty, as the difficulty or impossibility of tracheal intubation is the main cause of morbidity/mortality attributable to anaesthesia. Rett syndrome is a severe and incapacitating neurological disease. We present the case of a 21-year-old girl affected by this syndrome, with significant psychomotor retardation and difficult airway predictors, who was scheduled to have a laparoscopic cholecystectomy under general anaesthesia. We decided on one attempt of Clarus Video System(®) fiberoptic intubation as primary intervention...
November 22, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27887662/the-effects-of-water-lubrication-of-tracheal-tubes-on-post-intubation-airway-complications-study-protocol-for-a-randomized-controlled-trial
#8
Eugene Kim, Seong Mi Yang, So Jeong Yoon, Jae-Hyon Bahk, Jeong-Hwa Seo
BACKGROUND: Water is known to have lubricating properties, thus it is used for lubrication of tracheal tubes to reduce airway injuries caused by intubation. However, there is no definite evidence to substantiate the beneficial effects of lubricating tracheal tubes using water for attenuating airway injuries. Moreover, the lubrication pretreatment may cause contamination of the tube, leading to respiratory infections. Therefore, this trial aims to assess whether no pretreatment of tracheal tubes does not increase post-intubation airway complications as compared with water lubrication of tubes...
November 25, 2016: Trials
https://www.readbyqxmd.com/read/27886977/can-submandibular-tracheal-intubation-be-an-alternative-to-tracheotomy-during-surgery-for-major-maxillofacial-fractures
#9
Ahmed Gaber Hassanein, Ahmed M A Abdel Mabood
PURPOSE: During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. MATERIALS AND METHODS: This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27871575/dose-requirements-of-alfentanil-to-eliminate-autonomic-responses-during-rapid-sequence-induction-with-thiopental-4-mg-kg-and-rocuronium-0-6-mg-kg
#10
Mohammad H Abou-Arab, Morten Rostrup, Tom Heier
STUDY OBJECTIVE: Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. DESIGN: Prospective, randomized, observer-blinded, interventional clinical study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871554/evaluation-of-ph-on-removed-tracheal-tubes-after-general-anesthesia-a-prospective-observational-study
#11
Shiho Deguchi, Nobuyasu Komasawa, Takeshi Ueno, Michi Omori, Toshiaki Minami
STUDY OBJECTIVE: Aspiration pneumonia is a complication of tracheal intubation and mechanical ventilation. We hypothesized that tracheal tubes removed after anesthesia that have an acidic pH may reflect latent regurgitation of gastric fluid. DESIGN: A prospective observational study. SETTING: Operating room. PATIENTS: Tracheal tubes removed from 200 patients (age range, 20-85 years) who had undergone general anesthesia with tracheal intubation and gastric tube placement were examined...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871527/two-lost-airways-and-one-unexpected-problem-undiagnosed-tracheal-stenosis-in-a-morbidly-obese-patient
#12
Miguel A Cobas, Nicole D Martin, Heather B Barkin
Anesthetic care of the morbidly obese is complex due to anatomic and physiologic alterations. Airway management in particular can be challenging. High body mass index is predictive of difficult ventilation and possibly difficult intubation. Other airway anomalies, such as tracheal stenosis, add to the complexity of airway management. Tracheal stenosis, a form of central airway obstruction, may be challenging to diagnose, especially in the obese. Comorbidities can mask the diagnosis and routine imaging may fail to identify the pathology...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#13
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27869287/dexmedetomidine-for-attenuating-haemodynamic-response-to-intubation-stimuli-in-morbidly-obese-patients-anaesthetised-using-low-opioid-technique-comparison-with-fentanyl-based-general-anaesthesia
#14
Tomasz Gaszyński, Klaudia Czarnik, Łukasz Łaziński, Wojciech Gaszyński
BACKGROUND: Anaesthesiologists are facing the problem of an increasing population of morbidly obese patients. In order to minimize the risk of opioid-induced postoperative respiratory failure, the intraoperative administration of opioids should be reduced or replaced with other drugs. The purpose of this study was to compare haemodynamic response elicited by intubation in morbidly obese patients between two variants of anaesthesia induction: fentanyl-based or low-opioid using dexmedetomidine...
November 21, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27868188/patency-of-paediatric-endotracheal-tubes-for-airway-instrumentation
#15
J Elfgen, P K Buehler, J Thomas, M Kemper, S Imach, M Weiss
BACKGROUND: Airway exchange catheters (AEC) and fiberoptic bronchoscopes (FOB) for tracheal intubation are selected so that there is only a minimal gap between their outer and inner diameter of endotracheal tube (ETT) to minimize the risk of impingement during airway instrumentation. This study aimed to test the ease of passage of FOBs and AECs through paediatric ETT of different sizes and from different manufacturers when using current recommendations for dimensional equipment compatibility taken from text books and manufacturers information...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27861696/a-cadaver-study-comparing-three-fibreoptic-assisted-techniques-for-converting-a-supraglottic-airway-to-a-cuffed-tracheal-tube
#16
B L Olesnicky, A Rehak, W B Bestic, J T Brock, L Watterson
After rescuing an airway with a supraglottic airway device, a method to convert it to a cuffed tracheal tube is often needed. The best method to do this has never been directly studied. We compared three techniques for conversion of a standard LMA(®) Unique airway to a cuffed endotracheal tube using a fibrescope. The primary endpoint was time to intubation, with secondary endpoints of success rate, perceived difficulty and preferred technique. We also investigated the relationship between level of training and prior training and experience with the techniques on the primary outcome...
November 11, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27856146/early-neurological-wake-up-test-in-intubated-brain-injured-patients-a-long-term-single-centre-experience
#17
Pierre Esnault, Ambroise Montcriol, Erwan D'Aranda, Julien Bordes, Philippe Goutorbe, Henry Boret, Eric Meaudre
BACKGROUND: In prehospital setting, a severe traumatic brain injury (TBI) requires tracheal intubation, sedation and mechanical ventilation pending the initial imagery. An early neurological wake-up test (ENWT), soon after the initial imaging assessment, allows a rapid neurological reassessment. This strategy authorises an initial clinical examination of reference with which will be compared the later examinations. The main objective of this study was to describe the characteristics of the patients who underwent an ENWT, and to determine its causes of failure...
November 14, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27855660/comparison-of-hemodynamic-response-to-tracheal-intubation-and-postoperative-pain-in-patients-undergoing-closed-reduction-of-nasal-bone-fracture-under-general-anesthesia-a-randomized-controlled-trial-comparing-fentanyl-and-oxycodone
#18
Yeon Sil Lee, Chong Wha Baek, Dong Rim Kim, Hyun Kang, Geun Joo Choi, Yong-Hee Park, Won-Joong Kim, Yong Hun Jung, Young Cheol Woo
BACKGROUND: The present study aimed to compare the intravenous bolus effect of oxycodone and fentanyl on hemodynamic response after endotracheal intubation and postoperative pain in patients undergoing closed reduction of nasal bone fracture. METHODS: In this prospective randomized double-blinded study, 64 patients undergoing closed reduction of nasal bone fracture were randomized into one of two groups: the fentanyl group (Group F) or the oxycodone group (Group O)...
November 17, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27853078/recurred-post-intubation-tracheal-stenosis-treated-with-bronchoscopic-cryotherapy
#19
Ye-Ryung Jung, Joon Taek Jeong, Myoung Kyu Lee, Sang-Ha Kim, Suk Joong Yong, Seok Jeong Lee, Won-Yeon Lee
Post-intubation tracheal stenosis accounts for the greatest proportion of whole-cause tracheal stenosis. Treatment of post-intubation tracheal stenosis requires a multidisciplinary approach. Surgery or an endoscopic procedure can be used, depending on the type of stenosis. However, the efficacy of cryotherapy in post-intubation tracheal stenosis has not been validated. Here, we report a case of recurring post-intubation tracheal stenosis successfully treated with bronchoscopic cryotherapy that had previously been treated with surgery...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27852241/comparison-of-glottic-views-and-intubation-times-in-the-supine-and-25-degree-back-up-positions
#20
Raj M Reddy, Manish Adke, Pranava Patil, Irina Kosheleva, Saxon Ridley
BACKGROUND: We explored whether positioning patients in a 25° back-up sniffing position improved glottic views and ease of intubation. METHODS: In the first part of the study, patients were intubated in the standard supine sniffing position. In the second part, the back of the operating table was raised 25° from the horizontal by flexion of the torso at the hips while maintaining the sniffing position. The best view obtained during laryngoscopy was assessed using the Cormack and Lehane classification and Percentage of Glottic Opening (POGO) score...
November 16, 2016: BMC Anesthesiology
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