Fiberoptic intubation of a child with huge maxillofacial tumor under spontaneous respiration

Aims and Objectives: To study an incidence of myocardial dysfunction in neonates admitted with perinatal asphyxia, to find out its correlation with severity of birth asphyxia and its outcome. Methods: This prospective study was conducted among 40 term neonates admitted in NICU of Civil Hospital Ahmedabad who had suffered with perinatal asphyxia (defined by WHO ), resuscitated as per NRP guidelines-2015 including both intramural and extramural admissions and who developed to hypoxic ischemic encephalopathy as defined by Levene staging. Neonates with congenital heart diseases, major central nervous system malformations and neonatal sepsis were excluded. Myocardial involvement was assessed by clinical evaluation, ECG, Creatinine Kinase Total (25-200IU/L), CK-MB (0-25IU/L) and Troponin I (0-0.03ug/L) measurements. Results: Among 40 cases, 10(25%) neonates had moderate birth asphyxia while 30(75%) had severe birth asphyxia. Respiratory distress was observed in 34(77.5%), poor spontaneous respiration 4(10%),shock in 14(35%),CCF 19(47.5%) while ECG was abnormal in 30(76.7%). Serum levels of CPK Total, CPK- MB and Troponin I were raised in 34(85%), 32(80%) and 28 (70%) neonates, respectively. Conclusion: There was a direct correlation between ECG changes and enzymatic levels which showed increasing abnormalities with increasing with severity of HIE.

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Faculty Opinions recommendation of Airway management in two of newborns with Pierre Robin Sequence: the use of disposable vs multiple use LMA for fiberoptic intubation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1057755.510698 ◽

2006 ◽

Author(s):

Francis Veyckemans

Keyword(s):

Airway Management ◽

Fiberoptic Intubation ◽

Pierre Robin Sequence ◽

Multiple Use ◽

Robin Sequence ◽

Pierre Robin

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Faculty Opinions recommendation of Total intravenous anesthesia and spontaneous respiration for airway endoscopy in children--a prospective evaluation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3994956.3754055 ◽

2010 ◽

Author(s):

Victor Baum

Keyword(s):

Total Intravenous Anesthesia ◽

Spontaneous Respiration ◽

Prospective Evaluation ◽

Intravenous Anesthesia

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Awake Fiberoptic Intubation: A narrative clinical review based on the Cleveland Clinic Experience

Trends in Anaesthesia and Critical Care ◽

10.1016/j.tacc.2021.05.006 ◽

2021 ◽

Author(s):

Ursula Galway ◽

Reem Khatib ◽

Andrew Zura ◽

Sandeep Khanna ◽

Mi Wang ◽

...

Keyword(s):

Clinical Review ◽

Cleveland Clinic ◽

Fiberoptic Intubation ◽

Clinic Experience ◽

Awake Fiberoptic Intubation

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Effect of Dexmedetomidine on Perioperative Stress Response and Immune Function in Patients With Tumors

Technology in Cancer Research & Treatment ◽

10.1177/1533033820977542 ◽

2020 ◽

Vol 19 ◽

pp. 153303382097754

Author(s):

Lihong Zheng ◽

Juan Zhao ◽

Likun Zheng ◽

Shuangfeng Jing ◽

Xiaoting Wang

Keyword(s):

Heart Rate ◽

Stress Response ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Immune Function ◽

Spontaneous Respiration ◽

General Anesthetics ◽

Ifn Γ ◽

Group D ◽

Perioperative Stress

Objective: This study aims to investigate the effect of dexmedetomidine on perioperative stress response and immune function in patients with tumors. Methods: Sixty patients who underwent selective radical gastrectomy for cancer were randomly divided into 3 groups: remifentanil group (group R), dexmedetomidine group (group D), and sufentanil group (group S). Remifentanil, dexmedetomidine, and sufentanil were used as general anesthetics. Endotracheal intubation and mechanical ventilation were performed after the spontaneous respiration disappeared. Then, the data were recorded, and blood samples were collected at all time points. Results: The heart rate significantly increased ( P < 0.05) at T1 in group S, and both heart rate and mean arterial pressure significantly increased ( P < 0.05) in group R when compared to group D. The heart rate significantly increased ( P < 0.05) at T2 in group S and group R. Furthermore, the heart rate significantly increased ( P < 0.05) at T3 and T4 in group S and group R. Intra-group comparison: The heart rate at T1–T4 and mean arterial pressure at T1–T4 significantly increased ( P < 0.05) in group S, and the heart rate at T1 and T4, and mean arterial pressure at T2–T4 significantly increased ( P < 0.05) in group R when compared to T0. The serum IL-6, IFN-γ, and β-EP significantly increased ( P < 0.05) at T0’ in group S and group R when compared to group D. Blood glucose, and serum IL-10, IFN-γ, and β-EP significantly increased ( P < 0.05), while IL-18 significantly decreased ( P < 0.05) at T1’ in group S and group R. Conclusion: Continuous infusion of dexmedetomidine in combination with the inhalation of sevoflurane is superior to sevoflurane + remifentanil or sufentanil in patients undergoing tumor surgery.

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