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38 papers 0 to 25 followers
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
Caroline Dahlqvist, Sebahat Ocak, Maximilien Gourdin, Anne Sophie Dincq, Laurie Putz, Jean-Paul d'Odémont
Introduction. We herein report our experience with new fully covered self-expanding metallic stents in the setting of inoperable recurrent benign tracheobronchial stenosis. Methods. Between May 2010 and July 2014, 21 Micro-Tech® FC-SEMS (Nanjing Co., Republic of Korea) were placed in our hospital in 16 patients for inoperable, recurrent (after dilatation), and symptomatic benign airway stenosis. Their medical files were retrospectively reviewed in December 2014, with focus on stent's tolerance and durability data...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Perenlei Enkhbaatar, Basil A Pruitt, Oscar Suman, Ronald Mlcak, Steven E Wolf, Hiroyuki Sakurai, David N Herndon
Smoke inhalation injury is a serious medical problem that increases morbidity and mortality after severe burns. However, relatively little attention has been paid to this devastating condition, and the bulk of research is limited to preclinical basic science studies. Moreover, no worldwide consensus criteria exist for its diagnosis, severity grading, and prognosis. Therapeutic approaches are highly variable depending on the country and burn centre or hospital. In this Series paper, we discuss understanding of the pathophysiology of smoke inhalation injury, the best evidence-based treatments, and challenges and future directions in diagnostics and management...
October 1, 2016: Lancet
L V Duggan, B Ballantyne Scott, J A Law, I R Morris, M F Murphy, D E Griesdale
BACKGROUND: Transtracheal jet ventilation (TTJV) is recommended in several airway guidelines as a potentially life-saving procedure during the 'Can't Intubate Can't Oxygenate' (CICO) emergency. Some studies have questioned its effectiveness. METHODS: Our goal was to determine the complication rates of TTJV in the CICO emergency compared with the emergency setting where CICO is not described (non-CICO emergency) or elective surgical setting. Several databases of published and unpublished literature were searched systematically for studies describing TTJV in human subjects...
September 2016: British Journal of Anaesthesia
S J Mercer, C P Jones, M Bridge, E Clitheroe, B Morton, P Groom
INTRODUCTION: Non-iatrogenic trauma to the airway is rare and presents a significant challenge to the anaesthetist. Although guidelines for the management of the unanticipated difficult airway have been published, these do not make provision for the 'anticipated' difficult airway. This systematic review aims to inform best practice and suggest management options for different injury patterns. METHODS: A literature search was conducted using Embase, Medline, and Google Scholar for papers after the year 2000 reporting on the acute airway management of adult patients who suffered airway trauma...
September 2016: British Journal of Anaesthesia
Christa Walgaard, Hester F Lingsma, Pieter A van Doorn, Mathieu van der Jagt, Ewout W Steyerberg, Bart C Jacobs
BACKGROUND: Respiratory insufficiency occurs in 20 % of Guillain-Barré syndrome (GBS) patients, and the duration of mechanical ventilation (MV) ranges widely. We identified predictors of prolonged MV to guide clinical decision-making on tracheostomy. METHODS: We analyzed prospectively collected data from 552 patients with GBS in the context of two clinical trials and three cohort studies in The Netherlands. Potential predictors for prolonged MV, defined as duration of ≥14 days, were considered using crosstabs...
August 18, 2016: Neurocritical Care
Robert L Sheridan
No abstract text is available yet for this article.
August 4, 2016: New England Journal of Medicine
Rachid Tazi-Mezalek, Ali I Musani, Sophie Laroumagne, Philippe J Astoul, Xavier B D'Journo, Pascal A Thomas, Hervé Dutau
BACKGROUND AND OBJECTIVE: Iatrogenic tracheal injury (ITI) is a rare yet severe complication of endotracheal tube (ETT) placement or tracheostomy. ITI is suspected in patients with clinical and/or radiographic signs or inefficient mechanical ventilation (MV) following these procedures. Bronchoscopy is used to establish a definitive diagnosis. METHODS: We conducted a retrospective, single-centre chart review of 35 patients between 2004 and 2014. Depending on the nature and location of ITI and need for MV, patients were triaged to surgical repair, endoscopic management with airway stents or conservative treatment consisting of ETT or tracheotomy cannula (TC) placement distal to the wound and bronchoscopic surveillance...
November 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Patrick Brass, Martin Hellmich, Angelika Ladra, Jürgen Ladra, Anna Wrzosek
BACKGROUND: Tracheostomy formation is one of the most commonly performed surgical procedures in critically ill intensive care participants requiring long-term mechanical ventilation. Both surgical tracheostomies (STs) and percutaneous tracheostomies (PTs) are used in current surgical practice; but until now, the optimal method of performing tracheostomies in critically ill participants remains unclear. OBJECTIVES: We evaluated the effectiveness and safety of percutaneous techniques compared to surgical techniques commonly used for elective tracheostomy in critically ill participants (adults and children) to assess whether there was a difference in complication rates between the procedures...
2016: Cochrane Database of Systematic Reviews
Aisling Longworth, David Veitch, Sandeep Gudibande, Tony Whitehouse, Catherine Snelson, Tonny Veenith
Tracheostomy is one of the most common procedures undertaken in critically ill patients. It offers many theoretical advantages over translaryngeal intubation. Recent evidence in a heterogeneous group of critically ill patients, however, has not demonstrated a benefit for tracheostomy, in terms of mortality, length of stay in Intensive Care Unit (ICU), or incidence of ventilator-associated pneumonia. It may be a beneficial intervention in articular subsets of ICU patients. In this article, we will focus on the evidence for the timing of tracheostomy and its effect on various subgroups of patients in critical care...
May 2016: Indian Journal of Critical Care Medicine
Afshin Gholipour Baradari, Abolfazl Firouzian, Alieh Zamani Kiasari, Mohsen Aarabi, Seyed Abdollah Emadi, Ali Davanlou, Nima Motamed, Ensieh Yousefi Abdolmaleki
BACKGROUND: Laryngoscopy and intubation frequently used for airway management during general anesthesia, is frequently associated with undesirable hemodynamic disturbances. OBJECTIVES: The aim of this study was to compare the effects of etomidate, combination of propofol-ketamine and thiopental-ketamine as induction agents on hemodynamic response to laryngoscopy and intubation. PATIENTS AND METHODS: In a double blind, randomized clinical trial a total of 120 adult patients of both sexes, aged 18 - 45 years, scheduled for elective surgery under general anesthesia were randomly assigned into three equally sized groups...
February 2016: Anesthesiology and Pain Medicine
Cengiz Özdemir, Sinem Nedime Sökücü, Levent Karasulu, Seda Tural Önür, Levent Dalar
BACKGROUND: Self-expandable metallic stents (SEMS) can be used to treat malignant obstructions and fistulas of the central airways. SEMS can be placed using different methods. Recently, a rigid bronchoscope has been used for stent placement without the need for fluoroscopy. We retrospectively evaluated patients for whom SEMS were placed using a rigid bronchoscope, without employing guidewires or fluoroscopy. We describe the intra- and post-procedural complications of the method. METHODS: Data collected between January 2014 and July 2015 were retrospectively evaluated by reference to hospital records...
2016: Multidisciplinary Respiratory Medicine
Wilson W L Li, Wim Jan P van Boven, Jouke T Annema, Susanne Eberl, Houke M Klomp, Bas A J M de Mol
Large mediastinal masses are rare, and encompass a wide variety of diseases. Regardless of the diagnosis, all large mediastinal masses may cause compression or invasion of vital structures, resulting in respiratory insufficiency or hemodynamic decompensation. Detailed preoperative preparation is a prerequisite for favorable surgical outcomes and should include preoperative multimodality imaging, with emphasis on vascular anatomy and invasive characteristics of the tumor. A multidisciplinary team should decide whether neoadjuvant therapy can be beneficial...
March 2016: Journal of Thoracic Disease
Brit Long, Alex Koyfman
BACKGROUND: Emergency physicians must be masters of the airway. The patient with tracheostomy can present with complications, and because of anatomy, airway and resuscitation measures can present several unique challenges. Understanding tracheostomy basics, features, and complications will assist in the emergency medicine management of these patients. OBJECTIVE OF REVIEW: The aim of this review is to provide an overview of the basics and features of the tracheostomy, along with an approach to managing tracheostomy complications...
June 2016: American Journal of Emergency Medicine
Paul Sooby, Laura Pocock, Trevor King, George Manjaly
A 50-year-old woman was admitted to the intensive care unit (ICU) for a life-threatening exacerbation of asthma requiring intubation and ventilation for 7 days. On day 8, she was stepped down from the ventilator via the insertion of a tracheostomy to aid weaning. It was initially decided that a percutaneous tracheostomy would be attempted on ICU, however, following further consideration, it was decided that due to anatomical factors (short neck) a surgical tracheostomy would be performed by the ear, nose and throat (ENT) team...
2016: BMJ Case Reports
Hyung-Jun Kim, Deog Kyeom Kim, Young Whan Kim, Yeon Joo Lee, Jong Sun Park, Young-Jae Cho, Se Joong Kim, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee
Low-dose chest computed tomography (LDCT) screening increased detection of airway nodules. Most nodules appear to be secretions, but pathological lesions may show similar findings. The National Comprehensive Cancer Network (NCCN) recommends repeating LDCT after 1 month and proceeding to bronchoscopy if the nodules persist. However, no reports exist about incidentally detected airway nodules. We investigated the significance of airway nodules detected by LDCT screening.We screened patients with incidental airway nodules detected by LDCT in the Seoul National University Hospital group...
May 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
K Pilarczyk, N Haake, M Dudasova, B Huschens, D Wendt, E Demircioglu, H Jakob, F Dusse
Bleeding complications after percutaneous dilatational tracheostomy (PDT) are infrequent but may have a tremendous impact on a patient's further clinical course. Therefore, it seems necessary to perform risk stratification for patients scheduled for PDT. We retrospectively reviewed the records of 1001 patients (46% male, mean age 68.1 years) undergoing PDT (using the Ciaglia Blue Rhino® technique with direct bronchoscopic guidance) in our cardiothoracic ICU between January 2003 and February 2013. Patients were stratified into two groups: patients suffering acute moderate, severe, or major bleeding (Group A) and patients who had no or only mild bleeding (Group B)...
March 2016: Anaesthesia and Intensive Care
Pierre Schmitt, Levent Dalar, Stéphane Jouneau, Bénédicte Toublanc, Juliette Camuset, Gérard Chatte, Laurent Cellerin, Hervé Dutau, Stéphane Sanchez, Maxime Sauvage, Jean-Michel Vergnon, Sandra Dury, Gaetan Deslée, François Lebargy
BACKGROUND: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by enlargement of the trachea and main bronchi and associated with recurrent respiratory tract infections. OBJECTIVE: This multicenter, retrospective study was carried out to describe respiratory conditions associated with tracheobronchomegaly. METHODS: Nine institutions involved in the 'Groupe d'Endoscopie de Langue Française' (GELF) participated in this study. A standard form was used to record patient characteristics, treatments and follow-up from medical charts...
2016: Respiration; International Review of Thoracic Diseases
Christina L Costantino, Douglas J Mathisen
Idiopathic laryngotracheal stenosis (ILTS) is a rare inflammatory disease of unknown etiology. Infectious, traumatic and immunologic processes must first be excluded. The majority of patients affected are female who present with progressive symptoms of upper airway obstruction, which can extend over a number of years. ILTS is characterized by short segment, circumferential stenotic lesions, located particularly at the level of the cricoid. Bronchoscopic evaluation is essential for establishing the diagnosis and operative planning...
March 2016: Journal of Thoracic Disease
Stefano Gasparini, Martina Bonifazi
PURPOSE OF REVIEW: Owing to the high morbidity and mortality rates related to airways obstruction, an effective management of endobronchial tumors is essential to improve survival and symptoms in these patients. As interventional pulmonology plays a major role in this context, the purpose of the present review is to focus on current evidence and indications of therapeutic bronchoscopy, in particular of ablative techniques. RECENT FINDINGS: Several ablative techniques are currently available and include 'immediate' or 'delayed' procedures according to the expected time to restore airways patency...
May 2016: Current Opinion in Pulmonary Medicine
2016-03-09 23:53:48
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