scholarly journals Airway management in a patient with an intratracheal tumor near the carina by a two-stage operation

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110145
Author(s):  
Chaerim Oh ◽  
Hyun Joo Kim
Keyword(s):  
Mechanical Ventilation ◽  
Airway Management ◽  
General Anesthesia ◽  
Distal Part ◽  
High Flow ◽  
Tracheal Resection ◽  
Two Stage ◽  
Partial Obstruction ◽  
Surgical Access ◽  
Surgical Field

In patients with intratracheal tumors, airway management while maintaining oxygenation and providing surgical access to the airway can be challenging. Here, we present a case of a two-stage operation to remove an intratracheal tumor causing partial obstruction near the carina. In the otorhinolaryngology department, a biopsy was performed during apnea under high-flow nasal oxygenation support. A few days later, a thoracic surgeon performed tracheal resection after sternotomy under general anesthesia. Mechanical ventilation was performed by inserting a sterile endotracheal tube in the resected distal part of the trachea in the surgical field for tracheal end-to-end anastomosis. Airway was successfully secured through close communication between teams of anesthesiologists and surgeons.

scholarly journals Application of high-flow nasal oxygenation as a rescue therapy in difficult videolaryngoscopic intubation

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110100
Author(s):  
Min Ho Lee ◽  
Hyun Joo Kim
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Rescue Therapy ◽  
High Flow ◽  
Mask Ventilation ◽  
Induction Process ◽  
Management Method ◽  
Adequate Oxygenation

In difficult airway situations, the next step of the airway management method is selected according to the prior presence of difficulties in mask ventilation and endotracheal intubation. It is important for the practitioner to be calm, quick in judgment, and take action in cases of difficult intubation. Recently, high-flow nasal oxygenation has been rapidly introduced into the anesthesiology field. This technique could extend the safe apnea time to desaturation. Especially, it maintains adequate oxygenation even in apnea and allows time for intubation or alternative airway management. We report two cases in which high-flow nasal oxygenation was implemented in the middle of the induction process after quick judgment by clinicians. High-flow nasal oxygenation was successfully used to assist in prolonging the safe apnea time during delicate airway securing attempts.

scholarly journals Airway management of a child after tracheal resection

1999 ◽  
Vol 46 (12) ◽  
pp. 1178-1180 ◽  
Author(s):  
Napoleon Burt ◽  
Mary M. Pruner ◽  
Andrea R. Williams
Keyword(s):  
Airway Management ◽  
Tracheal Resection

Effects of General Anesthesia, Muscle Paralysis, and Mechanical Ventilation on Pulmonary Nitrogen Clearance

1971 ◽  
Vol 35 (6) ◽  
pp. 591-601 ◽  
Author(s):  
Kai Rehder ◽  
David J. Hatch ◽  
Alan D. Sexier ◽  
Harold M. Marsh ◽  
Ward S. Fowler
Keyword(s):  
Mechanical Ventilation ◽  
General Anesthesia ◽  
Muscle Paralysis

scholarly journals ROLE OF ACCESS OSTEOTOMY IN HEAD AND NECK LESIONS – A REVIEW

2021 ◽  
pp. 25-30
Author(s):  
BHARATHI K ◽  
MANOJ CHANDRASEKAR ◽  
KAPIL DEV KUMAR S ◽  
BALA JAGANNATH GUPTA B
Keyword(s):  
Head And Neck ◽  
Surgical Resection ◽  
Hand Search ◽  
Surgical Access ◽  
Operative Care ◽  
Specific Tumor ◽  
Surgical Field ◽  
Tumor Types ◽  
Neurovascular Structures

The surgical resection of the head and neck lesions summarizes the principles, classifications, applications, complications, and post-operative care of osteotomy with the standard protocols performed safely. It often poses a great surgical challenge due to the anatomical complexity, difficulty in accessibility, and proximity of vital structures. A multidisciplinary approach is often required in these situations for their better exposure to provide surgical access. Access osteotomy is the choice and type for these head and neck lesions, which are most often based on the anatomic extent of the lesion, vascularity of the lesion, and involvement of neurovascular structures in and around it. The literature search using Medline from the year 1986 to 2019 were performed and textbooks were also collected by hand search from the same period. The role of aggressive surgical resection has not been established for malignant head and neck lesions with the technical feasibility and its efficacy for specific tumor types must be defined by the future studies. Thus, we would like to conclude that access osteotomy allows the surgeon a better view and an access of the surgical field to resect the tumor completely with safer margins, preserving the vital structures, pre-operative functions, and reducing post-operative complications.

Use of High-Flow Nasal Cannula in Patients With Pneumonia and Hypoxemic Respiratory Failure at Altitudes Above 2600 m: What Is the Best Predictor of Success?

2021 ◽  
pp. 088506662110575
Author(s):  
Molano Franco Daniel ◽  
Gómez Duque Mario ◽  
Beltrán Edgar ◽  
Villabon Mario ◽  
Hurtado Alejandra ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Respiratory Rate ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Multicenter Cohort Study ◽  
Hypoxemic Respiratory Failure ◽  
Severity Scores ◽  
High Flow Oxygen

Introduction: The use of high-flow nasal cannulas (HFNC) in patients with hypoxemic ventilatory failure reduces the need for mechanical ventilation and does not increase mortality when intubation is promptly applied. The aim of the study is to describe the behavior of HFNC in patients who live at high altitudes, and the performance of predictors of success/failure of this strategy. Methods: Prospective multicenter cohort study, with patients aged over 18 years recruited for 12 months in 2020 to 21. All had a diagnosis of hypoxemic respiratory failure secondary to pneumonia, were admitted to intensive care units, and were receiving initial management with a high-flow nasal cannula. The variables assessed included need for intubation, mortality in ICU, and the validation of SaO2, respiratory rate (RR) and ROX index (IROX) as predictors of HFNC success / failure. Results: One hundred and six patients were recruited, with a mean age of 59 years and a success rate of 74.5%. Patients with treatment failure were more likely to be obese (BMI 27.2 vs 25.5; OR: 1.03; 95% CI: .95-1.1) and had higher severity scores at admission (APACHE II 12 vs 20; OR 1.15; 95% CI: 1.06-1.24). Respiratory rates after 12 (AUC .81 CI: .70-.92) and 18 h (AUC .85 CI: .72-0.90) of HFNC use were the best predictors of failure, performing better than those that included oxygenation. ICU mortality was higher in the failure group (6% vs 29%; OR 8.8; 95% CI:1.75-44.7). Conclusions: High-flow oxygen cannula therapy in patients with hypoxemic respiratory failure living at altitudes above 2600 m is associated with low rates of therapy failure and a reduced need for mechanical ventilation in the ICU. The geographical conditions and secondary physiological changes influence the performance of the traditionally validated predictors of therapy success. Respiratory rate <30 proved to be the best indicator of early success of the device at 12 h of use.

Mechanical ventilation strategies

2021 ◽  
pp. 1-8
Author(s):  
Ray Higginson ◽  
Bridie Jones ◽  
Tamara Kerr ◽  
Paul Burrows
Keyword(s):  
Mechanical Ventilation ◽  
Airway Management ◽  
Medical Emergency ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Ventilation Strategies ◽  
The Common ◽  
Coronary Care

Any medical emergency resulting in a compromised airway will require emergency airway management, but subsequent continued airway support and artificial mechanical ventilation may also be needed. This article explores some of the common mechanical ventilation strategies and modes used during the COVID-19 pandemic and will discuss why coronary care nurses need to be familiar with these.

Sign in / Sign up

Export Citation Format

Share Document