An alternative method for airway management with combined tracheal intubation and rigid bronchoscope

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 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 distal airway is protected by blood and debris soilage during the tumor debulking. Surgery is quicker being uninterrupted.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Abstract Failure to manage bleeding in the airway is an important cause of airway-related death. The purpose of this narrative review is to identify techniques and strategies that can be employed when severe bleeding in the upper airway may render traditional airway management (e.g., facemask ventilation, intubation via direct/video laryngoscopy, flexible bronchoscopy) impossible because of impeded vision. An extensive literature search was conducted of bibliographic databases, guidelines, and textbooks using search terms related to airway management and bleeding. We identified techniques that establish a def...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth 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
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
Publication date: Available online 23 June 2018Source: Anaesthesia &Intensive Care MedicineAuthor(s): Andrew Laurie, Jamie MacdonaldAbstractAirway management provides gas exchange, protects the lungs from injury and permits treatment. This requires safe, effective and reliable use of equipment, often in combination. A management plan with backups is essential, but a sequence of logical plans forming an airway management strategy is better. Correct equipment use needs correct knowledge, skill and attitudes. There are five approaches to airway management in which equipment is used: facemask ventilation with adjuncts, use...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
BY ALICE S. Y. LEE, MD​Emergency physicians usually respond to in-house cardiopulmonary arrests, and each case is somewhat the same. You arrive at the bedside with no information about the patient, and must quickly assess the situation via a combination of nurse report and a focused patient exam. Securing an airway in cardiopulmonary arrest is critical to the resuscitation, and the EP should be the most skilled at this task.​​This was put to the test in our hospital recently. A 70-year-old, 54 kg woman with a history of end-stage renal disease (ESRD) had been admitted to our hospital with marked hyperkalemia. She had...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusion The practice of anesthesiologists in Cairo university hospitals is close to the recommendations of the ASA guidelines for management of difficult airway. There is increased skills in fiberoptic bronchoscopes and SGA with increased frequency of difficult airway managements training courses; however, they need to improve their skills in awake fiberoptic intubations technique and they need to be trained on invasive airway management access to close the discrepancy between their theoretical choices in different situations and their actual skills.
Source: Egyptian Journal of Anaesthesia - Category: Anesthesiology Source Type: research
We report repeated anesthetic management for orthognathic surgeries for a KFS patient with micrognathia. Because KFS can be associated with a number of other anomalies, we therefore performed a careful preoperative evaluation to exclude them. The patient had an extremely small mandible, significant retrognathia, and severe limitation of cervical mobility due to cervical vertebral fusion. As difficult intubation was predicted, awake nasal endotracheal intubation with a fiberoptic bronchoscope was our first choice for gaining control of the patient's airway. Moreover, the possibility of respiratory distress due to postoperat...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
Publication date: Available online 20 July 2015 Source:Anaesthesia & Intensive Care Medicine Author(s): David R. Ball Airway management provides gas exchange, protects the lungs from injury and permits treatment. This requires safe, effective and reliable use of equipment, often in combination. A management plan with backup plans is essential, but a sequence of logical plans forming an airway management strategy is better. Correct equipment use needs correct knowledge, skill and attitudes. There are five approaches to airway management in which equipment is used: facemask ventilation with adjuncts, airway clearance ...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
We report here our experience over 6 years (January 2008 and December 2013) during which a total of 15 patients was diagnosed with cervical necrotising fasciitis. Of 6 patients, admitted between January 2008 and March 2010, 5 had routine tracheostomy under local anaesthesia, 1 had direct laryngoscopy intubation, and 9 who were admitted between Spring 2010 and December 2013 were treated with nasotracheal intubation. Postoperatively all patients were given moderate sedation and analgesia. Nasotracheal intubation was continued until the infection had been controlled. During intubation patency of the endotracheal tube was main...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
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