scholarly journals Head-neck movement may predispose to the development of arytenoid dislocation in the intubated patient: a 5-year retrospective single-center study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun-A Jang ◽  
Kyung Yeon Yoo ◽  
Seongheon Lee ◽  
Seung Won Song ◽  
Eugene Jung ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Poisson Regression ◽  
First Year ◽  
Laryngeal Injury ◽  
Single Center Study ◽  
Arytenoid Dislocation ◽  
Dislocation Group ◽  
Head Neck

Abstract Background Arytenoid dislocation is a rare laryngeal injury that may follow endotracheal intubation. We aimed to determine the incidence and risk factors for arytenoid dislocation after surgery under general anaesthesia. Methods We reviewed the medical records of patients who underwent operation under general anaesthesia with endotracheal intubation from January 2014 to December 2018. Patients were divided into the non-dislocation and dislocation groups depending on the presence or absence of arytenoid dislocation. Patient, anaesthetic, and surgical factors associated with arytenoid dislocation were determined using Poisson regression analysis. Results Among the 25,538 patients enrolled, 33 (0.13%) had arytenoid dislocation, with higher incidence after anterior neck and brain surgery. Patients in the dislocation group were younger (52.6 ± 14.4 vs 58.2 ± 14.2 yrs, P = 0.025), more likely to be female (78.8 vs 56.5%, P = 0.014), and more likely to be intubated by a first-year anaesthesia resident (33.3 vs 18.5%, P = 0.048) compared to those in the non-dislocation group. Patient positions during surgery were significantly different between the groups (P = 0.000). Multivariable Poisson regression identified head-neck positioning (incidence rate ratio [IRR], 3.10; 95% confidence interval [CI], 1.50–6.25, P = 0.002), endotracheal intubation by a first-year anaesthesia resident (IRR, 2.30; 95% CI, 1.07–4.64, P = 0.024), and female (IRR, 3.05; 95% CI, 1.38–7.73, P = 0.010) as risk factors for arytenoid dislocation. Conclusion This study showed that the incidence of arytenoid dislocation was 0.13%, and that head-neck positioning during surgery, less anaesthetist experience, and female were significantly associated with arytenoid dislocation in patients who underwent surgeries under general anaesthesia with endotracheal intubation.

Risk Factors for Intubation Injury of the Larynx

1987 ◽  
Vol 96 (6) ◽  
pp. 684-686 ◽  
Author(s):  
David Volpi ◽  
Daniel B. Kuriloff ◽  
Pi-Tang Lin ◽  
Charles P. Kimmelman
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Endotracheal Intubation ◽  
Related Factors ◽  
Intubation Technique ◽  
Laryngeal Injury ◽  
History Of ◽  
Tube Geometry

The endolaryngeal structures are subjected to insult from prolonged endotracheal intubation. Factors that may exacerbate this injury include intubation technique, duration of intubation, tube geometry and constitution, frequency of reintubation, and patient-related factors such as concomitant medical diseases. The contribution of underlying medical disease to laryngeal intubation injury was studied prospectively by sequential endoscopy from the time of tracheotomy. Diabetes mellitus, congestive heart failure, and a history of stroke or tuberculosis increased the likelihood of severe laryngeal injury. The association of these disorders with severe laryngeal injury should lead to consideration of earlier tracheotomy in such patients.

scholarly journals Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients

2017 ◽  
Vol 45 (2) ◽  
pp. 744-752 ◽  
Author(s):  
Jin Young Lee ◽  
Woo Seog Sim ◽  
Eun Sung Kim ◽  
Sangmin M Lee ◽  
Duk Kyung Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anaesthesia ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Intracuff Pressure ◽  
Postoperative Sore Throat ◽  
Korean Patients ◽  
Elective Surgical Procedures

Objective To investigate the incidence of postoperative sore throat (POST) in Korean patients undergoing general anaesthesia with endotracheal intubation and to assess potential risk factors. Methods This prospective study enrolled patients who underwent all types of elective surgical procedures with endotracheal intubation and general anaesthesia. The patients were categorized into group S (those with a POST) or group N (those without a POST). The demographic, clinical and anaesthetic characteristics of each group were compared. Results This study enrolled 207 patients and the overall incidence of POST was 57.5% ( n = 119). Univariate analysis revealed that significantly more patients in group S had a cough at emergence and hoarseness in the postanaesthetic care unit compared with group N. Receiver operating characteristic curve analysis showed that an intracuff pressure ≥17 cmH2O was associated with POST. Multivariate analysis identified an intracuff pressure ≥17 cmH2O and cough at emergence as risk factors for POST. At emergence, as the intracuff pressure over ≥17 cmH2O increased, the incidence of hoarseness increased. Conclusions An intracuff pressure ≥17 cmH2O and a cough at emergence were risk factors for POST in Korean patients. Intracuff monitoring during anaesthesia and a smooth emergence are needed to prevent POST.

scholarly journals Infectious events in patients with severe COVID-19: results of a cohort of patients with high prevalence of underlying immune defect

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anastasia Saade ◽  
Giulia Moratelli ◽  
Guillaume Dumas ◽  
Asma Mabrouki ◽  
Jean-Jacques Tudesq ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cumulative Incidence ◽  
Cumulative Risk ◽  
Incidence Density ◽  
Hospital Acquired Infections ◽  
Underlying Malignancy ◽  
Single Center Study ◽  
High Prevalence ◽  
Immune Defect ◽  
Hospital Acquired

Abstract Background Empirical antibiotic has been considered in severe COVID-19 although little data are available regarding concomitant infections. This study aims to assess the frequency of infections, community and hospital-acquired infections, and risk factors for infections and mortality during severe COVID-19. Methods Retrospective single-center study including consecutive patients admitted to the intensive care unit (ICU) for severe COVID-19. Competing-risk analyses were used to assess cumulative risk of infections. Time-dependent Cox and fine and gray models were used to assess risk factors for infections and mortality. Propensity score matching was performed to estimate the effect of dexamethasone. Results We included 100 patients including 34 patients with underlying malignancies or organ transplantation. First infectious event was bacterial for 35 patients, and fungal for one. Cumulative incidence of infectious events was 27% [18–35] at 10 ICU-days. Prevalence of community-acquired infections was 7% [2.8–13.9]. Incidence density of hospital-acquired infections was 125 [91–200] events per 1000 ICU-days. Risk factors independently associated with hospital-acquired infections included MV. Patient’s severity and underlying malignancy were associated with mortality. Dexamethasone was associated with increased infections (36% [20–53] vs. 12% [4–20] cumulative incidence at day-10; p = 0.01). After matching, dexamethasone was associated with hospital-acquired infections (35% [18–52] vs. 13% [1–25] at 10 days, respectively, p = 0.03), except in the subset of patients requiring MV, and had no influence on mortality. Conclusions In this population of COVID-19 patients with high prevalence of underlying immune defect, a high risk of infections was noted. MV and use of steroids were independently associated with infection rate.

scholarly journals Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Si Chen ◽  
Yuelun Zhang ◽  
Lu Che ◽  
Le Shen ◽  
Yuguang Huang
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Case Control Study ◽  
Case Control ◽  
Airway Compromise ◽  
Physical Status ◽  
Fluid Load ◽  
High Fluid ◽  
Head Neck ◽  
Control Study

Abstract Background This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia. Methods This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls. Results A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age > 65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age > 65 (OR = 7.50, 95% CI 2.47–22.81, P < 0.001), ASA physical status 3 (OR = 6.51, 95% CI 1.18–35.92, P = 0.032), head-neck surgery (OR = 4.94, 95% CI 1.33–18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI 2.93–53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16–7.99, P = 0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR = 5.26, 95% CI 1.57–8.95, P < 0.001) and intensive care unit days (OR = 3.94, 95% CI 1.69–6.18, P < 0.001). Conclusions Age > 65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.

scholarly journals Early Infant Feeding Practices as Possible Risk Factors for Immunoglobulin E-Mediated Food Allergies in Kuwait

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Dalal Alkazemi ◽  
Munirah Albeajan ◽  
Stan Kubow
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Immunoglobulin E ◽  
Food Allergies ◽  
First Year ◽  
Antibiotic Exposure ◽  
Pediatric Allergy ◽  
Potential Risk Factors ◽  
Ige Mediated ◽  
First Year Of Life

Objective. Early feeding and infant exposures have been suggested as potential risk factors for immunoglobulin E- (IgE-) mediated food allergy (FA). We aimed to evaluate the association between IgE-mediated FA in children and early exposures including the child’s nutritional status, breastfeeding and its duration, the age at which the solid food was first introduced, antibiotic exposure during the first year of life, and the child’s vitamin D status during infancy. Design. A case-control study. Setting and Subjects. Children aged 0–13 years were recruited from pediatric allergy and immunology clinics (PAICs) located at major government hospitals in Kuwait (total FA cases: n=100; boys = 67%), and healthy controls (n=100, boys 55%) were recruited from various vaccination units at primary healthcare centers. Results. Cow’s milk allergy was the most common type of FA. FA status was independently associated with the early exposures of exclusive breastfeeding (aOR = 15.55 (3.26–74.19), p=0.001), vitamin D deficiency or insufficiency during infancy (aOR = 5.42 (1.92–15.30), p=0.001), and antibiotic exposure during the first year of life (aOR = 5.00 (1.58–15.84), p=0.006). Conclusions. FA is highly prevalent among children in Kuwait, and our data indicate that early nutrition-related and antibiotic exposures are associated with FA risk.

Study time, glasses utilization and age affect quality of life among senior first-year Chinese myopia students

2021 ◽  
pp. 112067212098252
Author(s):  
Ziqian Zhu ◽  
Yan He ◽  
Jiezheng Yang ◽  
Qiaoli Li ◽  
HuanHuan Cheng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Regression Analysis ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Study Time ◽  
First Year ◽  
Normal Vision ◽  
First Year Students

Purpose: To compare the quality of life of senior first-year students with normal vision and myopia, and to explore the risk factors related to quality of life in students with myopia. Methods: In this study, 1103 senior first-year students were enrolled in ten high schools. These students were divided according to the diopter degree, with 916 myopia students and 187 normal vision students. Visual function indexes, such as naked eye vision, were measured and recorded, and social demographic indexes and the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was used. The differences in quality of life between the two groups were compared. Multiple linear regression analysis was used to explore the possible risk factors for quality of life in myopia students. Results: In the NEI VFQ-25, the total quality of life scores of myopia students (77.06 ± 15.66) were lower than those of normal vision students (85.49 ± 12.37). The difference was statistically significant ( p = 0.007). In the correlation analysis, the total scores of quality of life in myopia students were positively correlated with wearing glasses ( p = 0.049), and were negatively correlated with study time ( p = 0.029). Multiple linear regression analysis showed that study time, wearing glasses and age were risk factors affecting quality of life in myopia students. Conclusion: Our results show that senior first-year myopia students have lower quality of life scores than students with normal vision. Study time, wearing glasses and age are risk factors for quality of life in senior first-year myopia students.

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