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Tracheostomy care

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https://www.readbyqxmd.com/read/29765893/successful-management-of-acquired-tracheomalacia-of-patients-with-amyotrophic-lateral-sclerosis-a-report-of-three-cases
#1
Jung Hyun Yang, Tae Wan Kim, Byeong Ju Lee, Jin A Yoon, Myung Jun Shin, Yong Beom Shin
Tracheomalacia is characterized by weakness of the tracheal walls and supporting cartilage. It results in dynamic compression of the airway, where the cross-sectional area of the trachea is reduced by expiratory compression. Acquired tracheomalacia results from complications associated with the use of endotracheal or tracheostomy tubes. In this report, we present three cases of patients with amyotrophic lateral sclerosis (ALS) successfully treated for tracheomalacia, including one case where the patient underwent surgery for combined tracheoesophageal fistula...
April 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29756290/a-standardized-closed-loop-system-for-monitoring-pediatric-tracheostomy-related-adverse-events
#2
Mallory McKeon, Daphne Munhall, Brian K Walsh, Roger Nuss, Reza Rahbar, Mark Volk, Karen Watters
OBJECTIVES/HYPOTHESIS: Advancement in neonatal and pediatric intensive care has increased the need for chronic-care interventions, including tracheostomy. It is well established that children with a tracheostomy are at a high risk for adverse events, many of which are preventable. Despite this, there is no standardized method of monitoring tracheostomy-related adverse events (TRAEs). Our objective was to describe and assess a standardized, closed-loop system for monitoring TRAEs. STUDY DESIGN: Prospective Study...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29752173/associations-of-coexisting-conditions-with-healthcare-spending-for-children-with-cerebral-palsy
#3
Jay G Berry, Laurie Glader, Richard D Stevenson, Fareesa Hasan, Charis Crofton, Kinza Hussain, Matt Hall
OBJECTIVE: To determine which coexisting conditions have the strongest associations with healthcare use and spending among children with cerebral palsy (CP). STUDY DESIGN: Retrospective analysis of 16 695 children ages 0-18 years with CP - identified with International Classification of Diseases, Ninth Revision, Clinical Modification codes - using Medicaid from January 1, 2013 to December 31, 2013 from 10 states in the Truven MarketScan Medicaid Database. Using generalized linear models, we assessed which coexisting conditions (including medical technology) identified with Agency for Healthcare Research and Quality's Chronic Condition Indicators had the strongest associations with total healthcare spending across the healthcare continuum...
May 8, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29749260/effectiveness-safety-and-economic-comparison-of-inhaled-flolan-and-veletri-in-cardiothoracic-surgery-patients
#4
Jaclyn M Hawn, Matthew Wanek, Seth R Bauer, Mahmoud A Ammar, Steven Insler, Ahmad Adi, Heather Torbic
BACKGROUND: No previous studies exist examining inhaled Flolan compared with inhaled Veletri in a homogeneous cardiothoracic surgery patient population. OBJECTIVE: To compare the impact of inhaled Flolan and inhaled Veletri on the effectiveness, safety, or cost in cardiothoracic surgery patients. MATERIALS AND METHODS: This was a retrospective, noninferiority study comparing inhaled Flolan and inhaled Veletri in cardiothoracic surgery patients...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29742220/humidification-and-heating-of-inhaled-gas-in-patients-with-artificial-airway-a-narrative-review
#5
Gustavo Adrián Plotnikow, Matias Accoce, Emiliano Navarro, Norberto Tiribelli
Instrumentation of the airways in critical patients (endotracheal tube or tracheostomy cannula) prevents them from performing their function of humidify and heating the inhaled gas. In addition, the administration of cold and dry medical gases and the high flows that patients experience during invasive and non-invasive mechanical ventilation generate an even worse condition. For this reason, a device for gas conditioning is needed, even in short-term treatments, to avoid potential damage to the structure and function of the respiratory epithelium...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29735862/influence-of-visual-information-on-consent-for-invasive-procedures-in-intensive-care-unit
#6
E C Celik, M Ekinci, B Ciftci, B E Gölboyu, O Ö Kilinç
Objective: Patients hospitalized in Intensive Care Units (ICU) are critically ill. Sometimes informed consent for invasive procedures cannot be obtained from patients or relatives due to insufficient information. Methodology: Relatives of the patients who were being hospitalized in ICUs of state hospitals in 3 provinces in Eastern part of Turkey during year 2015, who were planned to undergo central venous catheter insertion, tracheostomy, and percutaneous gastroenterostomy (PGE) were asked to sign consent forms and these relatives were included in the study...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29730059/nasotracheal-intubation-the-preferred-airway-in-oral-cavity-microvascular-reconstructive-surgery
#7
Jordan Gigliotti, Godwin Cheung, Omar Suhaym, Ramanakumar V Agnihotram, Michel El-Hakim, Nicholas Makhoul
PURPOSE: We aimed to describe the safety and effectiveness of nasotracheal intubation (NTI) in a cohort of patients undergoing reconstruction of oral cavity defects with free tissue transfer (FTT). MATERIALS AND METHODS: We implemented a retrospective cohort study and enrolled a sample composed of consecutive patients undergoing FTT reconstruction of oral cavity, maxillary, or mandibular defects between 2013 and 2017. These patients were all subject to a newly developed enhanced recovery-after-surgery protocol...
April 11, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29729952/tracheostomy-in-intensive-care-patients-and-families-will-never-walk-alone
#8
EDITORIAL
Paolo Pelosi, Lorenzo Ball, Iole Brunetti, Maria Vargas, Nicolò Patroniti
No abstract text is available yet for this article.
June 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29713897/coordination-of-pharyngeal-and-laryngeal-swallowing-events-during-single-liquid-swallows-after-oral-endotracheal-intubation-for-patients-with-acute-respiratory-distress-syndrome
#9
Martin B Brodsky, Ishani De, Kalyan Chilukuri, Minxuan Huang, Jeffrey B Palmer, Dale M Needham
To evaluate timing and duration differences in airway protection and esophageal opening after oral intubation and mechanical ventilation for acute respiratory distress syndrome (ARDS) survivors versus age-matched healthy volunteers. Orally intubated adult (≥ 18 years old) patients receiving mechanical ventilation for ARDS were evaluated for swallowing impairments via a videofluoroscopic swallow study (VFSS) during usual care. Exclusion criteria were tracheostomy, neurological impairment, and head and neck cancer...
April 30, 2018: Dysphagia
https://www.readbyqxmd.com/read/29712526/the-estimated-cost-of-surgically-managed-isolated-traumatic-head-injury-secondary-to-road-traffic-accidents
#10
Xinli You, Boon S Liew, Azmin K Rosman, Dcsn, Kamarul Imran Musa, Zamzuri Idris
OBJECTIVE Traumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury. METHODS Relevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709466/the-communication-experience-of-tracheostomy-patients-with-nurses-in-the-intensive-care-unit-a-phenomenological-study
#11
Angela Tolotti, Annamaria Bagnasco, Gianluca Catania, Giuseppe Aleo, Nicola Pagnucci, Lucia Cadorin, Milko Zanini, Gennaro Rocco, Alessandro Stievano, Franco A Carnevale, Loredana Sasso
OBJECTIVES: To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit. RESEARCH METHODOLOGY/DESIGN: Benner's interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses. SETTING: The intensive care unit of a hospital in Northern Italy...
April 27, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29707505/acute-airway-management
#12
Nikhil Panda, Dean M Donahue
Acute airway management has challenged clinicians for nearly four millennia. History underscores the discoveries of surgeons and anesthesiologists, whose advances in technology and surgical technique have transformed management algorithms from primarily surgical tracheostomy, to transoral endotracheal intubation under direct laryngoscopy. Despite this progress and a better understanding of airway anatomy, physiology and pathogenesis of disease, the acute airway, whether obstructed, traumatically disrupted, or externally compressed, remains a life-threatening challenge...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#13
Alessandro Marchioni, Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Matteo Fontana, Luca Tabbì, Andrea Viani, Francesco Giaroni, Valentina Ruggieri, Stefania Cerri, Enrico Clini
BACKGROUND: Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). METHODS: A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29702711/acute-post-tracheostomy-clinical-decompensations-in-infants-are-there-predictive-markers
#14
Michael F Nyp, Jane B Taylor, Antonio Petralia, Alexandra Oschman, Mike Norberg, Robert A Weatherly, William Truog, Winston Manimtim
OBJECTIVE:  To report on the population of infants receiving a tracheostomy, identify acute post-tracheostomy clinical decompensations, and seek predictive markers associated with acute complications following the placement of a tracheostomy. STUDY DESIGN:  Retrospective deidentified clinical data was provided by the Infant Pulmonary Data Repository at Children's Mercy Hospital, Kansas City. Data from infants undergoing tracheostomy from January 1, 2008 through September 30, 2016 were divided into one of two study groups based on clinical correlations: (1) no acute decompensations within 72 hours post-tracheostomy or (2) acute clinical decompensation defined as sustained escalation of respiratory care within the 72 hours following tracheostomy...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29699834/respiratory-muscle-strength-and-state-of-consciousness-values-measured-prior-to-the-decanulation-in-different-levels-of-complexity-a-longitudinal-prospective-case-series-study
#15
L Diaz-Ballve, D Villalba, M Andreu, M Escobar, G Morel-Vulliez, J Lebus, E Rositi
OBJECTIVE: To describe the variables related to effective cough capacity and the state of consciousness measured prior to decannulation and compare their measured values between the different areas of care such as the Intensive Care Unit (ICU), General ward and Mechanical Ventilation Weaning and Rehabilitation Centers (MVWRC). Secondarily analyze the evolution of patients once decannulated. DESIGN: Case series, longitudinal and prospective. SCOPE: Multicentric 31 ICUs (polyvalent) and 5 MVWRC...
April 23, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29693940/the-peas-protocol-an-airway-ultrasound-technique
#16
Akihiro Suzuki
In the past ultrasound identification of the airway structure was rather difficult However, recent advancement of the high frequency linear type transducer allows us to visualize airway structure easily. Accordingly, now we have difficult airway society guideline 2015. resuscitation guideline 2015, and Australia and New Zealand Intensive Care Society guidelines for percutaneous dilatational tracheostomy which recommend use of ultrasound in airway management Airway ultrasound is an emerging technique for all physicians, and the author introduces perioperative evaluation of the airway via sonography, the PEAS protocol...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29683054/timing-and-outcomes-of-tracheostomy-performed-by-pulmonary-and-or-critical-care-physicians
#17
Shawn P E Nishi, Shiwan K Shah, Wei Zhang, Yong-Fang Kuo, Gulshan Sharma
BACKGROUND: Although pulmonary and/or critical care (P/CC) physicians perform percutaneous tracheostomy in mechanically ventilated patients, the trends, timing, and outcomes of this procedure have not been well described. This study aims to describe the trends, timing, and outcomes of this procedure. METHODS: Using 5% medicare data, we retrospectively examined a cohort who had tracheostomy performed after initiation of mechanical ventilation during acute hospitalization to describe the timing of tracheostomy placement by pulmonary and/or critical care (P/CC) physicians and associated outcomes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29681109/safety-and-efficacy-of-noncardiac-surgical-procedures-in-the-management-of-patients-with-trisomy-13-a-single-institution-based-detailed-clinical-observation
#18
Soichi Shibuya, Yuichiro Miyake, Shigeru Takamizawa, Eriko Nishi, Katsumi Yoshizawa, Tomoko Hatata, Kazuki Yoshizawa, Kenya Fujita, Masahiko Noguchi, Jun Ohata, Takehiko Hiroma, Tomohiko Nakamura, Tomoki Kosho
Intensive treatment including surgery for patients with trisomy 13 (T13) remains controversial. This study aimed to evaluate the safety and efficacy of noncardiac surgical intervention for T13 patients. Medical records of patients with karyotypically confirmed T13 treated in the neonatal intensive care unit in Nagano Children's Hospital from January 2000 to October 2016 were retrospectively reviewed, and data from patients who underwent noncardiac surgery were analyzed. Of the 20 patients with T13, 15 (75%) underwent a total of 31 surgical procedures comprising 15 types, including tracheostomy in 10 patients and gastrostomy in 4...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29678147/protocol-based-evaluation-for-feasibility-of-extubation-compared-to-clinical-scoring-systems-after-major-oral-cancer-surgery-safely-reduces-the-need-for-tracheostomy-a-retrospective-cohort-study
#19
Axel Schmutz, Rolf Dieterich, Johannes Kalbhenn, Pit Voss, Torsten Loop, Sebastian Heinrich
BACKGROUND: Despite risks, complications and negative impact to quality of life, tracheostomy is widely used to bypass upper airway obstruction after major oral cancer surgery (MOCS). Decision to tracheostomy is frequently based on clinical scoring systems which mainly have not been validated by different cohorts. Delayed extubation in the Intensive Care Unit (ICU) may be a suitable alternative in selected cases. We hypothesize that delayed routine ICU extubation after MOCS instead of scoring system based tracheostomy is safe, feasible and leads to lower tracheostomy rates...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29673728/infrahyoid-involvement-may-be-a-high-risk-factor-in-the-management-of-non-odontogenic-deep-neck-infection-retrospective-study
#20
Hui Yuan, Rong Gao
OBJECTIVES: This study sought to investigate the impact of involvement of the infrahyoid neck space on the management of non-odontogenic DNI. METHOD: Eighty-one patients treated for non-odontogenic DNI over 5 years were retrospectively recruited into this study. Demographics, etiology, radiology results, treatments, duration/cost of hospital stay, and complications were recorded. Differences between DNIs with and without infrahyoid involvement, as defined based on an anatomical chart, were analyzed...
March 16, 2018: American Journal of Otolaryngology
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