Managing and securing the bleeding upper airway: a narrative review.

Managing and securing the bleeding upper airway: a narrative review. Can J Anaesth. 2019 Sep 23;: Authors: Kristensen MS, McGuire B 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 definitive airway, even in cases of impeded visibility resulting from severe bleeding in the airway. These include flexible video-/optical- scope-guided intubation via a supraglottic airway device; cricothyroidotomy or tracheotomy; and retrograde-, blind nasal-, oral-digital-, light-, and ultrasound-guided intubation. We provide a structured approach to managing bleeding in the airway that accounts for the source of bleeding and the estimated risk of failure to intubate using direct laryngoscopy or to achieve a front-of-neck access for surgical airway rescue. In situations where these techniques are predicted to be successful, the recommended approach is to identify the cricothyroid membrane (in preparation for rescue ...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research

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Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Physicians Eric Weinhandl JAMA medical research public health Public Policy public policy research Source Type: blogs
Abstract Dietary supplements (DS) pose many side effects and multiple interactions with perioperative medications, which may increase surgical morbidity and mortality. Descriptive empirical data are essentially nonexistent related to DS consumption and patient knowledge of DS. The aims of this study were to investigate the prevalence of use, type of supplements used, and the knowledge base among military beneficiaries and veterans consuming DS during the preoperative period. This descriptive cross-sectional study solicited data from 2,623 volunteer, preoperative patients at 6 different military medical centers thr...
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ConclusionAfter great improvements in rectal cancer treatment, late gastrointestinal toxicity after radiotherapy is experienced less frequent and less severe; however, it remains a great concern associated with worse quality of life.
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Source: International Orthopaedics - Category: Orthopaedics Source Type: research
Authors: Wheeler AP, Hemingway C, Gailani D Abstract INTRODUCTION: Factor XI (FXI) deficiency is associated with highly variable bleeding, including excessive gynecologic and obstetrical bleeding. Since approximately 20% of FXI-deficient women will experience pregnancy-related bleeding, careful planning and knowledge of appropriate hemostatic management is pivotal for their care. AREAS COVERED: In this manuscript, authors present our current understanding of the role of FXI in hemostasis, the nature of the bleeding phenotype caused by its deficiency, and the impact of deficiency on obstetrical care. The authors...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Authors: Merideth MA, Introne WJ, Wang JA, O'Brien KJ, Huizing M, Gochuico BR Abstract Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by defective biogenesis of lysosome-related organelles. Clinical manifestations include a bleeding diathesis due to a platelet delta storage pool deficiency, oculocutaneous albinism, inflammatory bowel disease, neutropenia, and pulmonary fibrosis. Ten genes associated with HPS are identified to date, and each gene encodes a protein subunit of either Biogenesis of Lysosome-related Organelles Complex (BLOC)-1, BLOC-2, BLOC-3, or the Adaptor Protein...
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Publication date: Available online 22 May 2020Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Ryo Tamura, Corina Moldovan, Milan Gopal
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
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