A novel scale for predicting delayed intubation in patients with inhalation injury

This study aimed to develop a novel scale, predicting the need for Delayed Intubation after inhalation injury (PDI) score.MethodsWe retrospectively identified patients with inhalation injury at four tertiary care centers in Japan between 2012 and 2018. We included patients aged 15 or older and excluded those intubated within 30 min after hospital arrival. Predictors for delayed intubation were identified with univariate analyses and scored on the basis of odds ratios. The PDI score was evaluated with the area under the receiver operating characteristic (AUROC) curve and compared with other scaling systems for burn injuries.ResultsData from 158 patients were analyzed; of these patients, 18 (11.4%) were intubated during the delayed phase. Signs of respiratory distress, facial burn, and pharyngolaryngeal swelling observed on laryngoscopy, were identified as predictors for delayed intubation. The discriminatory power of the PDI (AUROC curve = 0.90; 95% confidence interval, 0.83 to 0.97; p
Source: Burns - Category: Dermatology Source Type: research

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This study describes the clinical profile and recovery pattern of swallowing following inhalation burn injury. All patients admitted 2008 –2017 with confirmed inhalation burns on laryngoscopy and managed by speech-language pathology (SLP) were included. Initial dysphagia presentation and dysphagia recovery pattern were documented using the FOIS. Co-presence of dysphonia was determined clinically and rated present/absent. Persistent laryngeal/pharyngeal injury at 6 months was documented using laryngoscopy. Data were compared to published data from a large adult burn cohort. All patients with confirmed inhalation ...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research
CONCLUSION: Treatment is mainly symptom oriented. New and promising therapies are in development. PMID: 31811912 [PubMed - as supplied by publisher]
Source: Toxicology Letters - Category: Toxicology Authors: Tags: Toxicol Lett Source Type: research
Conclusion Only 8 out of 213 cases in the present series experienced complications, which is significantly less than the complication rates observed in other reports. Consistent and conscientious protection of the dentition and of the oral mucosa and limiting suspension times to 30 minutes are factors unique to our series that appear to reduce complications in endolaryngeal surgery. [...] Thieme Publicações Ltda Rio de Janeiro, BrazilArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: International Archives of Otorhinolaryngology - Category: ENT & OMF Authors: Tags: Original Research Source Type: research
Conclusion: We recommend that the bulb laryngoscope blade, if used, is not left open prior to intubation and that it is closed between intubation attempts.What is Known:•The preterm epidermis is particularly vulnerable to injury.What is New:•Bulb laryngoscope light bulbs consistently reach temperatures sufficient to burn neonatal skin in less than 100  s in an in vitrostudy.•Bulb light safety advice should be incorporated into intubation guidelines.
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
This study aims to investigate the influence of BAHS and associated skin reactions around the implant. A total of 45 patients were prospectively followed from implantation up to at least 1 year. Swabs were obtained at baseline, 12 weeks follow-up and during cases of inflammation (Holgers score ≥2). The microbiota was assessed using IS-proTM, a bacterial profiling method based on the interspace region between the 16S–23S rRNA genes. Detection of operational taxonomic units, the Shannon Diversity Index, sample similarity analyses and Partial Least Squares Discriminant Analysis (PLS-DA) were employed. Staphylococcus ...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In conclusion, for the radiological assessment of TB fractures, the entire VA should be regarded as a part of the otic capsule, and delayed inner ear sequelae should be anticipated for retrolabyrinthine fracture lines that course into or through the VA. When considering treatment options in cases similar to the present, our findings suggest that surgical interventions targeting the eES (ES shunting/decompression procedures (31–33), which are used in MD with the intention to drain the hydropic endolymphatic fluid space, or to improve the fluid resorptive functions of the eES, respectively, most likely cannot work as p...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Button battery ingestion is a big deal. So much so that The National Battery Ingestion Hotline (NBIH) was created in 1982 to study and advise best practices. They look at all types of batteries but swallowed button batteries account for 94% of batteries ingested. Until recently the agreed-upon first aid guidelines for a swallowed button battery were to take nothing at all by mouth (no oral intake!) but to get to the ER as soon as possible for timely x-rays to find the position of the battery, before promptly removing the battery with an endoscope. Who Swallows Button Batteries? Kids swallow button batteries, particularly k...
Source: Conversations with Dr Greene - Category: Child Development Authors: Tags: Dr. Greene's Blog Household Safety Toddler Health & Safety Source Type: blogs
Conclusions Intubation should be considered for patients displaying the Denver criteria, which includes full thickness facial burns, stridor, respiratory distress, swelling on laryngoscopy, upper airway trauma, altered mentation, hypoxia/hypercarbia, hemodynamic instability, suspected smoke inhalation, and singed facial hair. Patients lacking these criteria should not be intubated.
Source: Burns - Category: Dermatology Source Type: research
Conclusions This study showed disparity between signs and symptoms of airway injury and nasolaryngoscopy findings. Asymptomatic patients showed pathologic changes in 30% of scopes, but this finding only changed management 1% of the time. Furthermore, the two patients in this group were extubated quickly, suggesting they may have been suitable for observation without intubation. These results indicate that the presence of erythema or edema is of questionable clinical significance in asymptomatic patients and nasolaryngoscopy is of limited benefit in this group. Only 50% of the symptomatic patients with airway injury evident...
Source: Burns - Category: Dermatology Source Type: research
SMOKE inhalation (Supplemental Digital Content,http://links.lww.com/ALN/B432, video of the entire procedure with commentary) produces injury through direct thermal injury, chemical injury from soot and other irritant compounds, and systemic toxicity. In addition to direct thermal trauma, airway edema occurs as a result of exposure to inhaled components such as aldehydes, ammonia, and phosgene, as well as fluid resuscitation. This can rapidly lead to airway obstruction and hypoxia, making early evaluation and frequent reassessment essential. Obvious signs of injury include facial burns, soot at the nose and mouth, singed fa...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
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