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"Endotracheal Tube" OR "Laryngeal Mask Airway" OR "Oropharyngeal Airway" OR "Nasopharyngeal Airway" OR "Bougie"

Shun-Ku Lin, Pei-Chia Lo, Wang-Chuan Chen, Jung-Nien Lai
Reducing the need for advanced nursing care and medical expenses is an essential concern of dementia care. We investigated the impact of traditional Chinese medicine (TCM) on advanced nursing care and medical costs.We used Longitudinal Health Insurance Database to implement a cohort study of patients with dementia between 1997 and 2012 in Taiwan. Data from the onset of dementia to 1st advanced nursing care for the endotracheal tube, urinal indwelling catheterization, and nasogastric tube were assessed using Cox regression proportional hazards model, and independent t test was used to determine the difference of hospitalization costs and days...
February 2019: Medicine (Baltimore)
B Schönhofer
Invasive ventilation via endotracheal tube as access to the airways often is treatment of choice of acute respiratory failure. Multifactor-related increases the number of patients who are dependent on the ventilator for a longer period. The prolonged weaning (or "liberation") from mechanical ventilation therefore has an increasing importance.In Germany since the 90s of the last century, weaning units have been established in lung clinics. With the aim of achieving the highest possible quality of treatment in these weaning centers, the network "WeanNet" was founded in 2007 within the German Society of Pneumology and Respiratory Medicine (DGP)...
February 2019: Pneumologie
Yuanping Xiong, Jieqing Yu, Qing Luo, Hongqun Jiang, Jian Zhang
OBJECTIVES: To determine the efficacy and safety of a novel bougie for the removal of esophageal coins lodged in the proximal esophagus. SUBJECTS AND METHODS: This was an observational study. Medical records were reviewed of patients who were confirmed with esophageal coins between July 2015 and October 2016 in our department. Sixty-three patients, upper esophageal coins were confirmed by radiographs, were treated by using this novel bougie to remove esophageal coins...
February 13, 2019: Annals of Otology, Rhinology, and Laryngology
Matthew J Rowland, Richard D Urman, Xinling Xu, Jesse M Ehrenfeld, David A Preiss, Joshua C Vacanti
Few studies have examined the impact of video laryngoscopy (VL) on operating room efficiency. We hypothesized that VL reduces anesthesia control time (ACT), a metric of anesthesia efficiency, compared with fiberoptic intubation (FOI) in potentially difficult airways, but that direct laryngoscopy (DL) remains more efficient in routine cases. We performed a multi-institutional, retrospective chart review of anesthetic cases from 2015 to 2016. Cases were compared based on choice of airway technique (laryngeal mask airway [LMA], DL, VL or FOI) and ACT...
February 11, 2019: Journal of Medical Systems
Ramya Ravi, V K Mohan, Ashok Shankar Badhe, Sandeep Kumar Mishra, Prasanna Udupi Bidkar
Background and Aims: Weight-based selection of ProSeal laryngeal mask airway (PLMA) size may be unreliable in some situations. The aim of this study was to compare the ventilation parameters using PLMA during controlled ventilation between weight-based size selection and pinna size-based selection in children. Methods: A total of 204 patients were randomised to receive either pinna size-based (Group P) or weight-based (Group W) size selection of PLMA. We tested the hypothesis that pinna size-based selection of PLMA was better than weight-based selection of PLMA in paediatric patients during controlled ventilation under general anaesthesia in terms of oropharyngeal sealing pressure (the primary end-point) and Brimacombe score...
January 2019: Indian Journal of Anaesthesia
Linda Rönnberg, Ulrica Nilsson, Ove Hellzén, Christina Melin-Johansson
PURPOSE: To describe Registered Nurse Anesthetists' (RNA's) experiences of the process of extubation of the endotracheal tube in patients undergoing general anesthesia. DESIGN: A descriptive qualitative design. METHODS: This study was conducted in two hospitals with 20 RNAs in total. Data were generated from focus group interviews. Content analysis was used to analyze data. FINDINGS: The RNAs' experiences were described within four categories and eight subcategories...
February 8, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Yu-Jia Sheu, Sung-Wei Yu, Tsai-Wei Huang, Feng-Lin Liu, Yen-Kuang Lin, Ka-Wai Tam
BACKGROUND: Endotracheal intubation (ETI) is a procedure widely performed for several clinical indications. In typical ETI, an endotracheal tube is placed into a patient's trachea with the help of a malleable metal rod covered with a clear plastic sheath (called a "stylet"). However, another intubation aid, a bougie (also named a "gum elastic bougie" or "endotracheal tube introducer"), was also introduced in the clinical setting to improve the efficacy of conventional ETI...
February 7, 2019: Journal of Trauma and Acute Care Surgery
Rajiv Sonti, Michael Sanley, Ajeet Vinayak
BACKGROUND: Bedside percutaneous tracheostomy (PT) placement in critically ill patients is performed in a variety of ways, largely driven by institutional preference. We have recently transitioned to primarily extubating the patient and placing a laryngeal mask airway (LMA) before tracheostomy insertion in lieu of retracting the endotracheal tube (ETT) in place. This allows for lower sedative use and provides a superior view of the operative field. Here, we seek to describe the safety and efficiency of that approach...
February 6, 2019: Journal of Bronchology & Interventional Pulmonology
Olga Bougie, Jenna Healey, Sukhbir S Singh
Endometriosis is a common gynecologic condition, affecting approximately 10% of reproductive aged women1-3 . It commonly presents with pelvic pain, painful periods, and infertility and can significantly impact one's quality of life4-6 . Early exploration into the pathophysiology of this condition identified race as a risk factor for endometriosis, with the condition predominantly identified in white women7, 8 . It is still unclear if there is biological basis for this conviction, or if it can be explained by methodological and social bias that existed in the literature at that time9-11 ...
February 6, 2019: American Journal of Obstetrics and Gynecology
Makoto Sasaki, Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Masahide Ohtsuka, Osamu Yamaguchi, Takahisa Goto
BACKGROUND: Endotracheal tubes used for neonates are not as resistant to breathing as originally anticipated; therefore, spontaneous breathing trials (SBTs) with continuous positive airway pressure (CPAP), without pressure support (PS), are recommended. However, PS extubation criteria have predetermined pressure values for each endotracheal tube diameter (PS 10 cmH2 O with 3.0- and 3.5-mm tubes or PS 8 cmH2 O with 4.0-mm tubes). This study aimed to assess the validity of these SBT criteria for neonates, using an artificial lung simulator, ASL 5000™ lung simulator, and a SERVO-i Universal™ ventilator (minute volume, 240-360 mL/kg/min; tidal volume, 30 mL; respiratory rate, 24-36/min; lung compliance, 0...
February 8, 2019: Intensive Care Medicine Experimental
Thomas Clairfeuille, Alexander Cloake, Daniel T Infield, José P Llongueras, Christopher P Arthur, Zhong Rong Li, Yuwen Jian, Marie-France Martin-Eauclaire, Pierre E Bougis, Claudio Ciferri, Christopher A Ahern, Frank Bosmans, David H Hackos, Alexis Rohou, Jian Payandeh
Fast inactivation of voltage-gated sodium (Nav) channels is essential for electrical signaling but its mechanism remains poorly understood. Here, we determined the structures of a eukaryotic Nav channel alone and in complex with a lethal α-scorpion toxin, AaH2, by electron microscopy, both at 3.5-A resolution. AaH2 wedges into voltage-sensor domain IV (VSD4) to impede fast activation by trapping a deactivated state in which gating charge interactions bridge to the acidic intracellular C-terminal domain. In the absence of AaH2, the S4 helix of VSD4 undergoes a ~13-Å translation to unlatch the intracellular fast inactivation gating machinery...
February 7, 2019: Science
Robert M DiBlasi, Christine N Kearney, Justin C Hotz, John W Salyer, Jonathan A Poli, Dave N Crotwell, Silvia M Hartmann
BACKGROUND: Different brands of volume-targeted modes may vary the location of tidal volume (VT ) monitoring and whether peak inspiratory pressure is adjusted based on inspiratory, expiratory, or leak-compensated VT . These variables may result in different levels of support provided to patients, especially when an endotracheal tube (ETT) leak is present. We hypothesized that there would be no differences in gas exchange, triggering, or work of breathing between volume-targeted modes of 3 different brands of equipment in a surfactant-deficient, spontaneously breathing animal model with and without an ETT leak...
February 5, 2019: Respiratory Care
X Zhang, Y H Liu, J Wu, C B Gao, Y Zhao, Y Wang, D Wang
Objective: To explore the clinical value of modified cricothyrotomy in the multiplane surgery under general anesthesia for patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS). Method: A retrospective review was made among 20 cases with severe OSAHS treated a concurrent multiplane surgery under the condition of modified cricothyrotomy with general anesthesia, performed during recent 3 years, with their clinical data reviewed carefully. General anesthesia was carried out by inserting trachea cannula through mouth at first, and then, modified cricothyrotomy was performed via a transverse incision, followed by pulling out trachea cannula and inserting endotracheal tube through thyrocricoid incision...
November 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Andrew L Juergens, Brandon W Odom, Christine E Ren, Kirk E Meyers
INTRODUCTION: The utility of digital intubation, especially in an austere environment with limited equipment, has been previously described. However, evidence supporting best practices for its technique is limited. We seek to quantify the time to intubation and the rate of successful placement of the tube for digital intubation using different approaches and assistance devices. METHODS: Using a manikin, digital intubation was performed with an endotracheal tube alone, with an endotracheal tube and a 14-French stylet, or with a gum-elastic bougie...
January 30, 2019: Wilderness & Environmental Medicine
Thomas E Pearson, Meg A Frizzola, Henry H Khine
OBJECTIVE: The effect of using uncuffed endotracheal tubes in children during interfacility critical care transport has not yet been assessed. We hypothesized that many children with uncuffed endotracheal tubes experience complications leading to replacement with a cuffed tube after arrival at a tertiary pediatric care facility. METHODS: We conducted a retrospective case review of all intubated patients transported by our dedicated pediatric critical care transport team to our pediatric intensive care unit over a 3-year period...
January 2019: Air Medical Journal
Megan D Henley, Priya A Kumar
Tracheal laceration during cardiac surgery is a rarely reported form of iatrogenic tracheal injury. During dissection prior to sternotomy, the interclavicular ligament must be divided. This structure overlies the proximal trachea, predisposing the trachea to injury at this location. Challenges related to tracheal laceration in cardiac surgery include patients with already tenuous cardiopulmonary status, surgical positioning that increases the risk of injury, obscured traditional clinical findings causing delayed recognition, increased risk of mediastinitis, and a heightened risk of airway fire...
February 1, 2019: Seminars in Cardiothoracic and Vascular Anesthesia
W F Kappelle, J E van Hooft, M C W Spaander, F P Vleggaar, M J Bruno, F Maluf-Filho, A Bogte, E van Halsema, P D Siersema
Background and study aims  Fully covered self-expanding metal stents (FCSEMS) provide an alternative to bougie dilation (BD) for refractory benign esophageal strictures. Controlled studies comparing temporary placement of FCSES to repeated BD are not available. Patients and methods  Patients with refractory anastomotic esophageal strictures, dysphagia scores ≥ 2, and two to five prior BD were randomized to 8 weeks of FCSEMS or to repeated BD. The primary endpoint was the number of BD during the 12 months after baseline treatment...
February 2019: Endoscopy International Open
Jochen Renner, Anna Tesdorpf, Sandra Freitag-Wolf, Helga Francksen, Rainer Petzina, Georg Lutter, Norbert Frey, Derk Frank
Objectives: The current 2017 ESC/EACTS guidelines recommend transcatheter aortic valve implantations (TAVIs) as the therapy of choice for inoperable patients with severe symptomatic aortic stenosis. Most of the TAVIs worldwide are performed under general anaesthesia (GA). Although conscious sedation (CS) concepts are increasingly applied in Europe, it is still a matter of debate which concept is associated with highest amount of safety for this high-risk patient population. The aim of this single center, before-and-after study was to investigate feasibility and safety of CS compared with GA with respect to peri-procedural complications and 30-day mortality in patients scheduled for transfemoral TAVI (TF-TAVI)...
January 2019: Health science reports
Eman Ramadan Salama, Doaa El Amrousy
Background and Objective: Anesthesiologists encounter difficulties during laryngoscopy and tracheal intubation of neonates with myelodysplasia. Tracheal intubation in lateral position in such cases deemed profitable but not easy because of the compromised laryngeal view. We compared GlideScope video laryngoscope (GVL) versus conventional Miller direct laryngoscope (DL) for tracheal intubation in laterally positioned neonates with myelodysplasia. Materials and Methods: Sixty neonates scheduled for elective surgical repair of meningeocele or meningeomyelocele under general anesthesia were allocated randomly for endotracheal intubation using GVL or DL...
January 2019: Saudi Journal of Anaesthesia
Phillip A Romanski, Leslie V Farland, Lawrence C Tsen, Elizabeth S Ginsburg, Erin I Lewis
OBJECTIVE: To assess the effect of class III (body mass index [BMI] 40-49.9 kg/m2 ) and class IV obesity (BMI ≥ 50 kg/m2 ) on oocyte retrieval complications and outcomes. DESIGN: Cohort study. SETTING: Academic center. PATIENT(S): Women who underwent an oocyte retrieval from January 1, 2012 to May 31, 2017. Women with BMI ≥ 40 kg/m2 (n = 144) were age-matched to women with BMI <25, 25-29.9, 30-34.9, and 35-39...
February 2019: Fertility and Sterility
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