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https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#1
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29033733/anesthesia-management-for-a-case-of-laryngeal-keel-placement
#2
Kundan Gosavi, Paulomi Dey, Sachin Swami, Akshay Salunke
Congenital laryngeal web is a rare anomaly with incidence of 1 in 10,000 births. Its clinical presentation may range from an asymptomatic patient or mild hoarseness of voice to severe respiratory stridor. The primary goals of surgical intervention for congenital laryngeal web are to establish a patent airway and to achieve a good voice quality. As recurrence rate after plain excision of laryngeal web is very high, its removal may be coupled by placement of a silastic keel in between vocal cords. Endolaryngeal placement of a keel is definitely less invasive than laryngofissure, but little is known about its anesthesia management...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033717/comparison-of-oropharyngeal-leak-pressure-of-air-q%C3%A2-i-gel%C3%A2-and-laryngeal-mask-airway-supreme%C3%A2-in-adult-patients-during-general-anesthesia-a-randomized-controlled-trial
#3
Srinath Damodaran, Sameer Sethi, Surender Kumar Malhotra, Tanvir Samra, Souvik Maitra, Vikas Saini
STUDY OBJECTIVE: Various randomized controlled trials and a meta-analysis have compared i-gel™ and laryngeal mask airway Supreme™ (LMA-S™) in adult patients and found that both the devices provided equivalent oropharyngeal leak pressure (OLP). However, no randomized controlled trial has compared air-Q™ with i-gel™ and LMA-S™ in adult patient. Hence, we designed this study to compare air-Q™ with LMA-S™ and i-gel™ in adult patients. MATERIALS AND METHODS: A total of 75 adult patients of the American Society of Anesthesiologists physical status I/II of both sexes, between 18 and 60 years, were included in this prospective randomized controlled trial conducted in a tertiary care center...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29031661/guidelines-and-algorithms-for-managing-the-difficult-airway
#4
M A Gómez-Ríos, L Gaitini, I Matter, M Somri
The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms.
October 11, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29028157/transthoracic-catheter-drainage-for-large-symptomatic-congenital-pulmonary-airway-malformation
#5
Seong Hee Oh, Chae Young Kim, Byong Sop Lee, Dong Kwan Kim, Ellen Ai-Rhan Kim, Ki-Soo Kim
BACKGROUND: Surgical resection of large symptomatic congenital pulmonary airway malformation (CPAM) in newborns has high risks of mortality and postoperative morbidity. This study aimed to report the clinical outcomes of newborns who underwent percutaneous transthoracic catheter drainage (PTCD) of large symptomatic CPAM before surgical resection. METHODS: This was a retrospective, descriptive study based on review of the medical records of newborn infants who required surgical resection of large symptomatic CPAM at a single tertiary hospital from 2001 to 2017...
October 13, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29027869/acceptance-of-telemonitoring-among-patients-with-obstructive-sleep-apnea-syndrome-how-is-the-perceived-interest-by-and-for-patients
#6
Julie S Bros, Caroline Poulet, Nathalie Arnol, Chrystèle Deschaux, Marc Gandit, Marie Charavel
BACKGROUND: Obstructive sleep apnea syndrome, a chronic respiratory disease, requires regular adherence to Continuous Positive Airway Pressure (CPAP) therapy. Telemonitoring may be relevant to support adherence, but nonetheless this raises ethical issues around the intrusive nature of the daily life of patients Objective: To explore the acceptance of telemonitoring by patients and the impact of this on adherence. MATERIALS AND METHODS: A prospective and observational study has been performed with 160 patients who initiated their CPAP therapy...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29027772/supraglottic-airway-devices-indications-contraindications-and-management
#7
Joanna Gordon, Richard M Cooper, Matteo Parotto
Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an alternative to face mask ventilation and/or endotracheal intubation. The range of proposed uses and features have increased significantly. They are used in pre- and in-hospital settings, elective and emergency anesthesia, in spontaneously breathing and ventilated patients, as conduits for intubation, as a bridge to extubation and for airway rescue...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29026807/airway-management-in-pierre-robin-sequence-the-vancouver-classification
#8
Wai-Yee Li, Alana Poon, Douglas Courtemanche, Cynthia Verchere, Sandra Robertson, Marija Bucevska, Claudia Malic, Jugpal S Arneja
BACKGROUND: Pierre Robin sequence (PRS) is a triad of micrognathia, glossoptosis, and respiratory distress. There is no standard clinical classification used in the management of neonatal airway in patients with PRS. The goal of our study was to review the presentation and management of patients with PRS and formulate a clinical grading system and treatment algorithm. METHODS: A 10-year retrospective review of all neonates diagnosed with PRS was performed after obtaining institutional ethics approval...
February 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026294/comparison-of-the-peripheral-blood-eosinophil-count-using-near-patient-testing-and-standard-automated-laboratory-measurement-in-healthy-asthmatic-and-copd-subjects
#9
Kirsty Hambleton, Clare M Connolly, Catherine Borg, Joanne H Davies, Helen P Jeffers, Richard Ek Russell, Mona Bafadhel
Near-patient testing (NPT) allows clinical decisions to be made in a rapid and convenient manner and is often cost effective. In COPD the peripheral blood eosinophil count has been demonstrated to have utility in providing prognostic information and predicting response to treatment during an acute exacerbation. For this potential to be achieved having a reliable NPT of blood eosinophil count would be extremely useful. Therefore, we investigated the use of the HemoCue(®) WBC Diff System and evaluated its sensitivity and specificity in healthy, asthmatic and COPD subjects...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29025886/th17-cytokines-novel-potential-therapeutic-targets-for-copd-pathogenesis-and-exacerbations
#10
REVIEW
Olivier Le Rouzic, Muriel Pichavant, Emilie Frealle, Antoine Guillon, Mustapha Si-Tahar, Philippe Gosset
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways caused mainly by cigarette smoke exposure. COPD progression is marked by exacerbations of the disease, often associated with infections. Recent data show the involvement in COPD pathophysiology of interleukin (IL)-17 and IL-22, two cytokines that are important in the control of lung inflammation and infection. During the initiation and progression of the disease, increased IL-17 secretion causes neutrophil recruitment, leading to chronic inflammation, airways obstruction and emphysema...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29024308/does-remote-monitoring-change-osa-management-and-cpap-adherence
#11
REVIEW
Jean L Pépin, Renaud Tamisier, Dennis Hwang, Suresh Mereddy, Sairam Parthasarathy
It is increasingly recognized that the high prevalence of obstructive sleep apnoea (OSA), and its associated cardio-metabolic morbidities make OSA a burden for society. Continuous positive airway pressure (CPAP), the gold standard treatment, needs to be used for more than 4 h/night to be effective, but suffers from relatively poor adherence. Furthermore, CPAP is likely to be more effective if combined with lifestyle changes. Thus, the remote telemonitoring (TM) of OSA patients in terms of CPAP use, signalling of device problems, following disease progression, detection of acute events and monitoring of daily physical activity is an attractive option...
November 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29019723/accidental-hanging-injuries-in-children-recognition-and-management
#12
Siba P Paul, Ruby Paul, Paul A Heaton
Accidental hanging is rare in childhood but is often fatal. Window blind cords pose a particular and unique risk to young children in the UK, accounting for one to two deaths annually. These accidents are frequently associated with non-adherence to the safety instructions provided by the manufacturers. Early discovery of the child and initiation of effective cardiopulmonary resuscitation at the site of the incident are likely to improve the outcome. Prolonged suspension, children who are pulseless at first contact by the emergency paramedic responder, and patients with prolonged periods of remaining in asystole before return of spontaneous circulation after starting cardiopulmonary resuscitation are unlikely to have intact neurological survival...
October 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29019172/clinical-airway-management-an-illustrated-case-based-approach-d-john-doyle-basem-abdelmalak-editors-cambridge-university-press-2017-price-99-99-hardcover-370-pages-isbn-978-1-316-60135-8
#13
Gemma Malpas
No abstract text is available yet for this article.
October 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29018800/asthma-endotypes-and-an-overview-of-targeted-therapy-for-asthma
#14
REVIEW
Sarah Svenningsen, Parameswaran Nair
Guidelines for the management of severe asthma do not emphasize the measurement of the inflammatory component of airway disease to indicate appropriate treatments or to monitor response to treatment. Inflammation is a central component of asthma and contributes to symptoms, physiological, and structural abnormalities. It can be assessed by a number of endotyping strategies based on "omics" technology such as proteomics, transcriptomics, and metabolomics. It can also be assessed using simple cellular responses by quantitative cytometry in sputum...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29017400/minimally-invasive-method-to-activate-the-expiratory-muscles-to-restore-cough
#15
Anthony F DiMarco, Robert T Geertman, Kutaiba Tabbaa, Rebecca R Polito, Krzysztof E Kowalski
CONTEXT: Spinal cord stimulation (SCS) via disc electrodes surgically placed via laminotomy incisions has been shown to restore an effective cough in subjects with spinal cord injury (SCI). The purpose of this study was to evaluate a new method of expiratory muscle activation utilizing spinal cord wire leads, which can be implanted with minimally invasive techniques. METHODS: In a subject with SCI, parallel wire leads with two electrode contacts were inserted percutaneously through a needle, advanced to the T9, T11 spinal levels and connected to an implanted radiofrequency receiver...
October 11, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28993356/life-threatening-parapharyngeal-and-retropharyngeal-abscess-in-an-infant
#16
Anusha Balasubramanian, J Redzwan Shah, Norzi Gazali, Philip Rajan
Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5.3×8 cm collection involving the left parapharyngeal and retropharyngeal space, causing significant airway narrowing. 40 mL of frank pus was drained via intraoral incision and drainage with the aid of endoscope, and undesirable complications from an external approach were averted...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28991116/incidence-and-operative-factors-associated-with-discretional-postoperative-mechanical-ventilation-after-general-surgery
#17
Juliet J Ray, Meredith Degnan, Krishnamurti A Rao, Jonathan P Meizoso, Charles A Karcutskie, Danielle B Horn, Luis Rodriguez, Richard P Dutton, Carl I Schulman, Roman Dudaryk
BACKGROUND: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28990962/two-stage-technique-used-to-manage-severe-upper-airway-obstruction-and-avoid-surgical-tracheostomy-a-case-report
#18
Desire N Onwochei, Kariem El-Boghdadly, Imran Ahmad
Severe upper airway obstruction is commonly managed with surgical tracheostomy under local anesthesia. We present a 49-year-old woman with postradiotherapy laryngeal fixation and transglottic stenosis for dilation of a pharyngeal stricture who refused elective tracheostomy. A 2-stage technique was used, which involved an awake fiberoptic intubation, followed by the transtracheal insertion of a Cricath needle and ventilation using an ejector-based Ventrain device. We discuss management aspects of this clinical scenario and the principles by which the Ventrain works...
October 5, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28989817/medical-and-surgical-advancements-in-the-management-of-cystic-fibrosis-chronic-rhinosinusitis
#19
Kiranya E Tipirneni, Bradford A Woodworth
PURPOSE OF REVIEW: The purpose of this review is to provide otolaryngologists with the most up-to-date advancements in both the medical and surgical management of CF-related sinus disease. RECENT FINDINGS: Recent studies have supported more aggressive CRS management, often with a combination of both medical and surgical therapies. Comprehensive treatment strategies have been shown to reduce hospital admissions secondary to pulmonary exacerbations in addition to improving CRS symptoms...
March 2017: Current Otorhinolaryngology Reports
https://www.readbyqxmd.com/read/28987399/review-of-difficult-airway-management-in-thoracic-surgery
#20
M Granell, M J Parra, M J Jiménez, L Gallart, A Villalonga, O Valencia, M C Unzueta, A Planas, J M Calvo
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers...
October 4, 2017: Revista Española de Anestesiología y Reanimación
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