Anesthetic Implications for Tracheal Injury During Bronchoscopy-Guided Percutaneous Dilational Tracheostomy

We present a case of a critically ill patient undergoing percutaneous dilation tracheostomy complicated by tracheal wall injury and airway loss. The airway was successfully conservatively managed as well as the tracheal injury. Anesthetic implications, safety, and management options as well as recommendations are reviewed.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports: Clinical Care Source Type: research

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The current study investigates the effect of bronchoscopy-guided percutaneous dilatational tracheostomy (PDT) on the evolution of respiratory acidosis depending on endotracheal tube (ET) sizes. In addition, th...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Authors: Mishra N, Singh S PMID: 31257817 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
AbstractPurposeThe purpose of this retrospective study was to evaluate perioperative risk factors concerning difficult airway management, primary tracheostomy, and need for intensive care unit (ICU) admission in severe odontogenic space infections.MethodsPerioperative risk factors were retrospectively analyzed in 499 cases. Fisher ’s exact test and analysis of variance were performed to analyze associations between categorical and continuous variables. Univariate regression analysis was used for estimating predictors for ICU admission. A risk model for ICU admission was performed using multivariate regression analysi...
Source: Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
Conclusions: These results suggest that height and sex should be considered when performing PDT without bronchoscope guidance. PMID: 30744310 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
Publication date: Available online 7 February 2019Source: The Annals of Thoracic SurgeryAuthor(s): Francesco Puma, Mattia Meattelli, Miroslawa Kolodziejek, Marina Giuliana Properzi, Rosanna Capozzi, Alberto Matricardi, Lucio Cagini, Jacopo VannucciAbstractAn innovative technique for airway management, utilizing a small diameter, short-cuffed, orotracheal tube for assisting rigid bronchoscopy in critical airway obstruction is reported. The device, part of Translaryngeal Tracheostomy KIT, was placed beyond the stenosis and used in combination with the rigid bronchoscope.This procedure improves safety during the management of...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract An innovative technique for airway management, utilizing a small diameter, short-cuffed, orotracheal tube for assisting rigid bronchoscopy in critical airway obstruction is reported. The device, part of Translaryngeal Tracheostomy KIT, was placed beyond the stenosis and used in combination with the rigid bronchoscope. This procedure improves safety during the management of critical tracheal stenoses, because the airway is constantly under the anesthesiologist's control. Consequently, inhalation anesthesia is feasible, use of neuromuscular blockage is possible, end-tidal CO2 monitoring is reliable and the ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Semin Respir Crit Care Med 2018; 39: 720-730 DOI: 10.1055/s-0038-1676573Tracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is more readily performed at bedside than ST in the ICU; hence, PT is an attractive alternative to ST in the ICU. Bedside PT generates significant cost savings by eliminating operating room and anesthesia charges. Bronchoscopy is commonly use...
Source: Seminars in Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Review Article Source Type: research
Conclusion: Large airway intervention using rigid bronchoscopy under general anaesthetic within the confines of a multidisciplinary team is safe, successful and well tolerated. Rigid bronchoscopy at our centre is progressively increasing.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Thoracic Surgery Source Type: research
Conclusions: Cryotherapy through flexible bronchoscopy is safe and effective in simple benign tracheal stenoses following intubation and tracheostomy.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
We present a case of tracheal cartilaginous sleeve diagnosed by ultrasound (US) in a patient with Pfeiffer syndrome. The patient developed respiratory failure and was suspected at bronchoscopy to have tracheal cartilaginous sleeve. US performed before tracheostomy placement demonstrated continuous hypoechoic cartilage along the anterior surface of the trachea, confirming the diagnosis. Our report shows that US can make a definitive diagnosis of tracheal cartilaginous sleeve and raises the possibility of using US to screen for the condition in patients with syndromic craniosynostosis without the need for anesthesia or ionizing radiation.
Source: Pediatric Radiology - Category: Radiology Source Type: research
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