Cystic Fibrosis

2018 ◽  
Author(s):  
Brian Tinch ◽  
David Martin ◽  
Junzheng Wu
Keyword(s):  
Cystic Fibrosis ◽  
Laryngeal Mask Airway ◽  
Respiratory Tract ◽  
Endotracheal Tube ◽  
Operating Room ◽  
Elective Surgery ◽  
Laryngeal Mask ◽  
Meconium Ileus ◽  
Respiratory Status ◽  
Intraoperative Ventilation

Cystic fibrosis is an inherited disorder. The diagnosis should be suspected in an infant who has meconium ileus or infants presenting to the operating room with volvulus. Cystic fibrosis is characterized by frequent mucous plugging in the respiratory tract which may manifest as wheezing and frequent intermittent flare-ups of respiratory decompensation. Optimization of the affected child’s respiratory status prior to elective surgery is mandatory to prevent difficulty with intraoperative ventilation. While the laryngeal mask airway may be used for short procedures, the use of an endotracheal tube facilitates suctioning of the frequently inspissated secretions that accompany cystic fibrosis in order to optimize ventilation.

scholarly journals Cluster cross-over randomised trial of paediatric airway management devices in the simulation lab and operating room among paramedic students

2020 ◽  
Vol 38 (1) ◽  
pp. 27-32
Author(s):  
Matthew Lee Hansen ◽  
Adam Wagner ◽  
Ashley Schnapp ◽  
Amber Lin ◽  
Nancy Le ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Operating Room ◽  
Randomised Trial ◽  
Multivariable Analysis ◽  
Random Order ◽  
Laryngeal Mask ◽  
Significant Difference ◽  
Mean Time

ObjectivesThe objective of this study was to compare paediatric emergency airway management strategies in the simulation lab and operating room environments.MethodsThis was a two-part cluster cross-over randomised trial including simulation lab and operating room environments conducted between January 2017 and June 2018 in Portland, Oregon, USA. In simulated infant cardiac arrests, paramedic students placed an endotracheal tube, an i-gel or a laryngeal mask airway in random order. In the operating room, paramedic students placed a laryngeal mask airway or i-gel device in random order in sequential patients. The primary outcome for both portions of the study was time to ventilation. In the operating room portion, we also evaluated leak pressures and average initial tidal volumes.ResultsThere were 58 paramedic students who participated in the simulation lab and 22 who participated in the operating room study. The mean time to airway placement in the simulation lab was 48.5 s for the i-gel, 68.9 s for the laryngeal mask and 129.5 s for the endotracheal tube. In the operating room, mean time to i-gel placement was 34.3 s with 45.2 s for the laryngeal mask. In multivariable analysis of the simulation study, the laryngeal mask and i-gel were significantly faster than the endotracheal tube, and the i-gel was faster than the laryngeal mask. In the operating room, there was no significant difference in time to placement, leak pressure and average volume of the first five breaths between the i-gel and laryngeal mask.ConclusionsWe found that paramedic students were able to place supraglottic devices rapidly with high success rates in simulation lab and operating room environments. Supraglottic devices, particularly the i-gel, were rated as easy to use. The i-gel may be easiest to use since it lacks an inflable cuff and requires fewer steps to place.

scholarly journals A comparison of laryngeal mask airway-supreme and endotracheal tube use with respect to airway protection in patients undergoing septoplasty: a randomized, single-blind, controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erol Karaaslan ◽  
Sedat Akbas ◽  
Ahmet Selim Ozkan ◽  
Cemil Colak ◽  
Zekine Begec
Keyword(s):  
Laryngeal Mask Airway ◽  
Adverse Events ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Fiberoptic Bronchoscopy ◽  
Laryngeal Mask ◽  
Controlled Clinical Trial ◽  
Airway Protection ◽  
Link Type ◽  
Single Blind

Abstract Background There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airway protection against blood leakage through the fiberoptic bronchoscopy, oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events. Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia. Results In the fiberoptic evaluation of the airway postoperatively, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not different between the two groups. Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases. Trial registration This trial is registered at the US National Institutes of Health (ClinicalTrials.gov) # NCT03903679 on April 5, 2019.

Laryngeal Mask Airway or Endotracheal Tube for Percutaneous Dilatational Tracheostomy

2010 ◽  
Vol 110 (4) ◽  
pp. 1076-1082 ◽  
Author(s):  
Ulf Linstedt ◽  
Michael Zenz ◽  
Kirsten Krull ◽  
Dietrich Häger ◽  
Andreas W. Prengel
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Percutaneous Dilatational Tracheostomy ◽  
Laryngeal Mask ◽  
Dilatational Tracheostomy
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