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advanced airway

Do-Yang Park, Hyo Jin Chung, Sang Chul Park, Jin Won Kim, Joo-Heon Yoon, Jeung-Gweon Lee, Chang-Hoon Kim, Hyung-Ju Cho
PURPOSE: Considerable number of patients with obstructive sleep apnea (OSA) failed to respond to positive airway pressure therapy and so turned to surgical procedures. A wide variety of surgical procedures have been developed and advanced, according to obstruction and target site through nasal cavity to trachea. We introduced our overlapping lateral pharyngoplasty (OLP) technique as a surgical option for OSA and evaluated its surgical outcomes both with and without endoscope-guided coblator tongue base resection (CobTBR)...
March 21, 2018: European Archives of Oto-rhino-laryngology
Christopher J R Gough, Jerry P Nolan
PURPOSE OF REVIEW: Cardiac arrest mortality remains high, and the impact on outcome of most advanced life support interventions is unclear. The optimal method for managing the airway during cardiac arrest remains unknown. This review will summarize and critique recently published evidence comparing basic airway management with the use of more advanced airway interventions [insertion of supraglottic airway (SGA) devices and tracheal intubation]. RECENT FINDINGS: Systematic reviews generally document an association between advanced airway management and worse neurological outcome but they are subject to considerable bias...
March 20, 2018: Current Opinion in Critical Care
Steve A Aguilar, Nicholas Asakawa, Cameron Saffer, Christine Williams, Steven Chuh, Lewei Duan
Introduction: A benefit of in-hospital cardiac arrest is the opportunity for rapid initiation of "high-quality" chest compressions as defined by current American Heart Association (AHA) adult guidelines as a depth 2-2.4 inches, full chest recoil, rate 100-120 per minute, and minimal interruptions with a chest compression fraction (CCF) ≥ 60%. The goal of this study was to assess the effect of audiovisual feedback on the ability to maintain high-quality chest compressions as per 2015 updated guidelines...
March 2018: Western Journal of Emergency Medicine
Jennifer L Walton, Diane K Dunn, Nhi Y Haines, Ilana Heisler, Michael T Bigham, Teresa A Volsko
BACKGROUND: The American Academy of Pediatrics Section on Transport recommends the use of portable ventilators during the transport of patients with advanced airways. We sought to identify knowledge gaps and evaluate the effectiveness of a transport ventilator competency boot camp. METHODS: Electronic health records of children requiring ventilatory support during air and ground interfacility transport from January 1 through December 31, 2015, were reviewed to determine when manual ventilation was used in lieu of a portable ventilator, and simulations were constructed from commonly occurring scenarios...
April 2018: Respiratory Care
Joanna Jackowska, Elisabeth V Sjogren, Anna Bartochowska, Hanna Czerniejewska-Wolska, Krzysztof Piersiala, Malgorzata Wierzbicka
The purpose of the study was to assess the role of laser-assisted posterior cordectomy in the management of patients with bilateral vocal cord paralysis. We aimed an analysis of 132 consecutive patients treated by CO2 laser posterior cordectomy, aged 38-91, 31% tracheotomized on admission. Cordectomy was performed under microlaryngoscopy using CO2 laser (Lumenis AcuPulse 40 CO2 laser, wavelength 10.6 μm, Lumenis Ltd., Yokneam, Israel). We looked at the number of laser glottic procedures necessary to achieve decannulation in tracheotomized patients and to achieve respiratory comfort in non-tracheotomized subjects and we evaluated the two groups for differences in patient characteristics...
March 20, 2018: Lasers in Medical Science
Emily K Cope
Despite growing efforts to understand the role of the microbiota in airway disease, mechanisms that link microbial community dysbiosis to chronic inflammation remain elusive. Our laboratory is interested in how altered microbiota composition or function influences airway inflammatory diseases, including chronic rhinosinusitis, asthma, and cystic fibrosis. Given the tight interplay between host-associated microbes and host immunity, the potential for translational microbiome research to guide clinical decisions and novel therapeutics is becoming better appreciated...
March 2018: MSystems
Melinda M Pettigrew, Christian P Ahearn, Janneane F Gent, Yong Kong, Mary C Gallo, James B Munro, Adonis D'Mello, Sanjay Sethi, Hervé Tettelin, Timothy F Murphy
Nontypeable Haemophilus influenzae (NTHi) exclusively colonize and infect humans and are critical to the pathogenesis of chronic obstructive pulmonary disease (COPD). In vitro and animal models do not accurately capture the complex environments encountered by NTHi during human infection. We conducted whole-genome sequencing of 269 longitudinally collected cleared and persistent NTHi from a 15-y prospective study of adults with COPD. Genome sequences were used to elucidate the phylogeny of NTHi isolates, identify genomic changes that occur with persistence in the human airways, and evaluate the effect of selective pressure on 12 candidate vaccine antigens...
March 19, 2018: Proceedings of the National Academy of Sciences of the United States of America
C Incorvaia, S Masieri, C Cavaliere, E Makri, B Sposato, F Frati
A large amount of data show that AR and asthma are associated both epidemiologically and clinically, introducing the definition of “united airway disease”. The mechanisms underlying such association were initially suggested to start from the nose, including the loss of the protective and homeostatic effects of nasal function, the activation of a naso-bronchial reflex and the spread of allergic inflammation from the nose to the lower airways. Later, other factors such as microbial stimuli and systemic inflammatory mechanisms, involving bloodstream and bone marrow, were advocated...
January 2018: Journal of Biological Regulators and Homeostatic Agents
Cheng-Chieh Hsu, Wing-Yin Li, Pen-Yuan Chu
RATIONALE: Salivary duct carcinoma (SDC) is a rare and aggressive subtype of salivary gland carcinoma that histologically resembles in situ and invasive ductal carcinoma of the breast. We present the first case of advanced SDC of the minor salivary gland arising from the supraglottis and review the literature on the clinicopathologic characteristics and prognosis of SDC. PATIENT CONCERNS: A 59-year-old male patient with progressive difficulty in swallowing and a muffled voice for 2 months...
March 2018: Medicine (Baltimore)
David Stevens, Rodrigo Tomazini Martins, Sutapa Mukherjee, Andrew Vakulin
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy...
2018: Frontiers in Surgery
Christopher Mallow, Jeffrey Thiboutot, Roy Semaan, Margaret M Hayes, Russell Hales, Ashwin Ram, David Feller-Kopman, Hans Lee, Lonny Yarmus
BACKGROUND AND OBJECTIVE: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. METHODS: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed...
March 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Bernar Tan Wen Sheng, Patrick Wong, Constance Teo Ee Hoon
INTRODUCTION: Recurrent respiratory papillomatosis results in hoarseness, stridor and airway obstruction. Management is surgical, with most surgeons using microdebrider or laser. Transoral robotic surgery (TORS) has been successfully utilised for the excision of oropharyngeal malignancies and paediatric airway surgery. This is the first case report of TORS being used for the excision of laryngeal papillomas. CASE REPORT: A 36 year old Chinese female was diagnosed with juvenile onset recurrent respiratory papillomatosis...
March 3, 2018: American Journal of Otolaryngology
You-Ning Gao, Yun-Chun Wu, Shih-Ying Lin, Jenny Zwei-Chieng Chang, Yu-Kang Tu
Many treatments have been proposed for adult obstructive sleep apnea (OSA), but no comprehensive comparison of all interventions has been performed. We aimed to compare and rank the effectiveness of all minimally invasive treatments for adult OSA in a systematic review and network meta-analysis. Literature was searched within Ovid MedLine, EMBASE Classic+Embase, Cochrane library, and Cochrane Database of Systematic Reviews from inception to Aug 9th, 2016 for randomized controlled trials comparing minimally invasive treatments for adult OSA...
March 6, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
D J Brewster, C P Nickson, J J Gatward, M Staples, F Hawker
This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Questionnaire data collection and post-collection data analysis was used to determine basic respondent demographics, frequency of certain airway procedures in the past 12 months, confidence with advanced airway practices in ICU, participation in airway education in the past three years, knowledge of can't intubate, can't oxygenate (CICO) algorithms, preference for certain airway equipment/techniques, and support for required airway education as a component of the CICM CPD program...
March 2018: Anaesthesia and Intensive Care
Akira Utsunomiya, Noritaka Oyama, Shiro Iino, Natsuki Baba, Takenao Chino, Natsuko Utsunomiya, Minoru Hasegawa
Immune checkpoint inhibitors, such as ipilimumab and nivolumab, reverse the imbalance of antitumor self-tolerance and enhance T-cell responses. Currently, ipilimumab and nivolumab have a reported therapeutic impact on unresectable or metastatic melanomas; however, they also induce immune-related adverse events (irAEs). Ipilimumab-induced cutaneous irAEs are mostly low grade and manageable, although all-grade rash may occur in approximately 45% of all patients. We here report the case of a young woman with erythema multiforme major, which developed after sequential use of these 2 immune checkpoint inhibitors for advanced melanoma of the scalp...
January 2018: Case Reports in Dermatology
Andrew S Young, Michael W Fischer, Nicholas S Lang, Matthew R Cooke
This study provides trends in the discipline of dental anesthesiology. A questionnaire-based survey was sent to 338 members of the American Society of Dentist Anesthesiologists to evaluate practice patterns. One focus of the study was modality of sedation/anesthesia used for dentistry in North America. Age, gender, years in practice, and geographic region of practice were also obtained. Data gathered from the returned questionnaires were entered into an Excel spreadsheet and then imported into JMP Statistical Discovery Software (v12...
2018: Anesthesia Progress
Vaishnavi Kundel, Maria Giovanna Trivieri, Nicolas A Karakatsanis, Phillip M Robson, Venkatesh Mani, Jorge R Kizer, Robert Kaplan, Zahi Fayad, Neomi Shah
PURPOSE: Evidence suggests that the inflammatory state of an atherosclerotic plaque is important in predicting future risk of plaque rupture. This study aims to investigate the feasibility of measuring plaque inflammation in patients with obstructive sleep apnea (OSA) utilizing advanced vascular imaging - hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) with fluorodeoxyglucose (FDG) tracer-before and after continuous positive airway pressure (CPAP). METHODS: Patients with newly diagnosed moderate to severe OSA underwent baseline PET/MRI for assessment of vascular inflammation of the carotid arteries and thoracic aorta prior to initiation of CPAP...
March 5, 2018: Sleep & Breathing, Schlaf & Atmung
Gemma Malpas, Orlando Hung, Ainslie Gilchrist, Chrison Wong, Blaine Kent, Gregory M Hirsch, Robert D Hart
While extracorporeal membrane oxygenation (ECMO) is an effective method of oxygenation for patients with respiratory failure, further refinement of its incorporation into airway guidelines is needed. We present a case of severe glottic stenosis from advanced thyroid carcinoma in which gas exchange was facilitated by veno-arterial ECMO prior to achieving a definitive airway. We also conducted a systematic review of the MEDLINE, EMBASE, CINAHL, and Web of Science databases, using the keywords "airway/ tracheal obstruction", "anesthesia", "extracorporeal", and "cardiopulmonary bypass" to identify reports where ECMO was initiated as the a priori method of oxygenation during difficult airway management...
March 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Tahsin Tepecik, Ümit Ertaş, Metin Akgün
PURPOSE: The aim of this study was to examine the effects of bimaxillary orthognathic surgery on pharyngeal airway space (PAS) and respiratory function during sleep. MATERIALS AND METHODS: The subjects were 21 patients with class III skeletal relationship, and all of the patients underwent bimaxillary surgery (Le Fort I advancement and bilateral sagittal split ramus setback osteotomies simultaneously). Pharyngeal volumes of nasopharyngeal (V-NPA), retropalatal (V-RPA), retrolingual (V-RLA), oropharyngeal (V-ORO) and total pharyngeal airways (V-TOT); minimum axial areas of retropalatal (MA-RPA), retrolingual (MA-RLA) and oropharyngeal airways (MA-ORO); and position of the hyoid were studied in order to detect dimensional PAS changes using cone-beam computed tomography (CBCT) with Dolphin 11...
February 2, 2018: Journal of Cranio-maxillo-facial Surgery
Alexander C Chen, Colin T Gillespie
PURPOSE: Bronchoscopy for peripheral pulmonary lesions continues to present challenges to clinicians. One potential limitation may be the inability to advance conventional bronchoscopes into close proximity of peripheral lesions prior to biopsy. This study was performed to assess the reach of a robotic endoscopic system within human cadaveric lungs compared to conventional thin bronchoscopes. DESCRIPTION: All segmental bronchi (RB1-10, LB1-10) were accessed in two human cadavers using a conventional thin bronchoscope and robotic endoscope of identical outer diameter...
February 24, 2018: Annals of Thoracic Surgery
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