Emergency cardiopulmonary bypass for impassable airway

2006 ◽  
Vol 120 (8) ◽  
pp. 687-690 ◽  
Author(s):  
I Tyagi ◽  
A Goyal ◽  
R Syal ◽  
S K Agarwal ◽  
P Tewari

Introduction: Some medical emergencies need compromised airway management as the first measure. Most of these cases are first seen by an ENT surgeon, whose proper evaluation and timely intervention can prove decisive. Knowledge of alternatives for airway management can prove life-saving, although these may require the active involvement of other specialities.Case reports: Two patients, a 27-year-old man and a 31-year-old woman, presented in respiratory distress with cyanosis. Each had a pedunculated mass in the lower trachea above the carina, with about 90 per cent tracheal lumen obstruction. They were managed successfully with femorofemoral cardiopulmonary bypass and restoration of airway.Conclusion: Femorofemoral cardiopulmonary bypass can be a relatively safe option which gains time for airway management in such conditions. Knowledge of this procedure among ENT surgeons can lead to timely intervention, in properly selected cases, which can save valuable time.

Author(s):  
Rupesh Kumar ◽  
Parag W. Barwad ◽  
Banashree Mandal

The bidirectional Glenn surgery is a life-saving palliative surgery in patients with univentricular cardiac anatomy and physiology. This procedure can be performed either under cardiopulmonary bypass (CPB) or off CPB. In this article, we will present a new innovative technique, which was performed on 6 individuals of age ranging from 2 to 18 years and followed up over a few months, which is effective, less morbid, as well as simple, safe, economically more viable, and is easily reproducible.


2020 ◽  
Vol 3 (1) ◽  
pp. 267-271
Author(s):  
HY Embu ◽  
SI Nuhu ◽  
SP Bishmang

Advanced Trauma Life Support (ATLS) protocols aim to provide good trauma care by enhancing the skills of medical personnel all over the world and while this is well established in developed countries it does not appear to be so in developing countries. This study aims to assess the knowledge and proficiency in initial trauma management skills among health caregivers in some general/cottage hospitals in north central Nigeria. Questionnaires were developed to assess the knowledge and skills of care givers in airway management, respiratory distress and shock. The questionnaires were administered on caregivers involved in trauma care in some general/cottage hospitals that offer secondary care in a state in north-central Nigeria. There were 34 health workers who responded, 10 (29.41%) were doctors and 24(70.54%) were nurses. Their years of experience were from 2 to 35 years (median 14years). Ten (29.41%) had at least one training in ATLS in the past while 24(70.59%) had none. In assessing their management skills, 97.06% reported they were able to assess the airway, 88.24% could do chin lift, 73.53% jaw thrust while 91.18% were able to insert oral airway. Thirty-one (91.18%) were able to recognize respiratory distress, 88.24 were able to administer oxygen using facemask and 64.71% using nasal prong. Thirty (88.24%) could assess a patient for shock, 82.35% could splint fractures for haemorrhage control. Twenty-seven (79.41%) reported knowing parameters to monitor during resuscitation. We concluded that knowledge of airway management was high but proficiency and confidence in performing these skills were low.


2021 ◽  
Vol 14 (6) ◽  
pp. e242701
Author(s):  
Aahd Kubbara ◽  
Feras Hawari ◽  
John Johnkoski

Diffuse alveolar haemorrhage (DAH) is known to occur from several infectious and non-infectious aetiologies. Among the infectious aetiologies, Haemophilus influenzae, an organism known to cause community-acquired pneumonia, has not been reported in association with DAH prior to this case. On the other hand, vaping, an evolving epidemic concern, has been linked to various types of lung injury, including DAH. However, DAH related to vaping is only limited to several case reports. Our case describes H. influenzae pneumonia with DAH in a patient known to have vaped until the night prior to elective lobectomy for lung cancer and developed DAH within 24 hours of hospitalisation. He subsequently recovered with treatment. DAH requires immediate recognition, and healthcare providers need to be aware that neither haemoptysis nor decrease in haemoglobin level is necessarily associated. Prior to diagnosis, empirical treatment with intravenous steroids and antibiotics can be life-saving.


2002 ◽  
Vol 1 (3) ◽  
Author(s):  
Chris Roseveare ◽  

So the brief ‘respite’ of summer is over, and we find ourselves plunging, once more towards the abyss of winter bed pressures. Hopefully those of you working at the coalface will find time to browse through the following pages. The production of a third issue in this ‘shortened’ year, following the launch of the Journal in July, is a credit to the hard work of the editorial and publishing teams. I am, as ever, grateful for their support. Next year will see a return to the planned 4-monthly cycle, with issues anticipated in March, July and November. One casualty of the tight schedule has been a minor adjustment to the cycle of reviews – COPD will now appear next Spring. In its place we have included an interesting paper reviewing the management of Neuroleptic Malignant Syndrome and Serotonin Syndrome, submitted by Consultant Psychiatrist David McNamara. Gastrointestinal haemorrhage and atrial fibrillation will be more familiar to readers, while Dr Joanna Girling’s review of the management of medical emergencies in pregnancy is essential reading for any physician working close to a maternity unit. Myasthenia gravis may not be the commonest medical emergency; nonetheless it is important that physicians are able to suspect, diagnose and initiate treatment for this condition. As I mentioned in my last editorial, I am keen to encourage submissions of case reports, audits, and pieces of original research provided they would appeal to a general medical readership. Cases need not be rare conditions, but must contain a clear teaching message for the reader. In future editions case reports will be categorised as ‘Tales of the Unexpected’, and ‘A Case to Remember’ (a memorable case or one with a message that readers should remember in future). The report on page 106 is an example of the latter – an important reminder that a radiological diagnosis of ‘pneumonia’ does not always imply an infective cause. Finally, I would like to thank those of you who have written with feedback following the previous edition of CPD Acute Medicine. We are clearly attempting to appeal to physicians from a broad range of backgrounds, and I hope that all readers find something which appeals to them in the pages which follow. Please feel free to write with your comments on any issue which you would like to share with the editorial team – depending on the response we may consider including a correspondence section in future editions of the journal.


2002 ◽  
Vol 81 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Rose Mary S. Stocks ◽  
Robert Egerman ◽  
Jerome W. Thompson ◽  
Michael Peery

Successful airway management of an infant or child with moderate to severe retrognathia first requires recognition of a potential problem. If the child cannot be intubated in a standard fashion, the use of a laryngeal mask airway (LMA) should be considered. We describe two cases wherein a toddler and an infant with severe retrognathia failed multiple attempts at traditional intubation. Both had an anterior larynx and hypoplasia of the mandible. In both cases, a subsequent LMA was successfully placed. The severely retrognathic newborn or child presents to the physician a unique challenge in airway management. Techniques to manage this difficult pediatric airway are different from those used in the adult. Otolaryngologists should be aware of this intubation technique and include it in their armamentarium of airway-management strategies. The LMA is not recommended as the technique of choice for securing a difficult airway, but it is an effective alternative when indicated, and it might be life-saving.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sz-Jiun Shiu ◽  
Ting-Ting Li ◽  
Bor-Jen Lee ◽  
Pin-Kuei Fu ◽  
Chen-Yu Wang ◽  
...  

Acute respiratory distress syndrome (ARDS) and hemophagocytic lymphohistiocytosis (HLH) are accompanied with poor outcome and high mortality when miliary tuberculosis is a causative pathogen for both of them. A patient complicated with ARDS and HLH is unusual in critical care, and few case reports are present in PudMed. Besides, the relationship between HLH and ARDS is still unknown and has not been reviewed in the literature. In this report, we present the case of a 74-year-old Taiwanese woman suffering from pulmonary tuberculosis and miliary tuberculosis, and she developed ARDS and HLH on the 3rd day after admission. We arranged serial laboratory examination, various serum markers, bone marrow aspiration, and bronchoscopy with alveolar lavage for survey; we prescribed empirical antibiotics and antituberculosis medication soon after alveolar lavage showing positive acid-fast stain. She was extubated on hospital day 31 and discharged on hospital day 73. In conclusion, early diagnosis and intervention for underlying disease and intensive bundle care for multiorgan failure are crucial for both ARDS and HLH.


Sign in / Sign up

Export Citation Format

Share Document