Comparison Between nebulized Lidocaine and Budesonide for Prevention of airway complications after adult ophthalmic surgeries

AbstractWe aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Fifty-one patients (age < 28 months) were consecutively divided into conventional (n = 28) and ultrasound (n = 23) groups. Tracheal tube size and insertion depth were determined using the age-based formula and auscultation in the conventional group, whereas using ultrasonographic measurement of subglottic diameter with auscultation and lung ultrasonography in the ultrasound group. We evaluated the initially selected tube size, insertion depth, ventilatory indices, and the incidence of airway complications and adverse events. Tube insertion depth (median [interquartile range]) was significantly greater in the ultrasound group than in the conventional group (13.5 cm [12.5–14.0] vs 13.0 cm [11.8–13.0], P = 0.045). The number of complications and adverse events was significantly higher in the conventional group than in the ultrasound group (32.1% vs 4.3%, P = 0.013). Airway ultrasound application could reduce airway-related complications and adverse events by determining the appropriate tracheal tube size and insertion depth.

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Are Subfascial Drains Necessary to Prevent Airway Complications Following Anterior Cervical Discectomy and Fusion?

Clinical Spine Surgery ◽

10.1097/bsd.0000000000000828 ◽

2020 ◽

Vol 33 (1) ◽

pp. 5-8

Author(s):

Patrick B. Morrissey ◽

J. Scott Donoughe ◽

Justin D. Stull ◽

I. David Kaye

Keyword(s):

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Airway Complications

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Airway complications in patients with closed-head injuries

American Journal of Otolaryngology ◽

10.1016/s0196-0709(87)80030-3 ◽

1987 ◽

Vol 8 (2) ◽

pp. 91-96 ◽

Cited By ~ 25

Author(s):

Peggyann Nowak ◽

Arnold M. Cohn ◽

Mary Ann Guidice

Keyword(s):

Head Injuries ◽

Closed Head Injuries ◽

Airway Complications ◽

Closed Head

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A new endoscopic standardized grading system for macroscopic central airway complications following lung transplantation: the MDS classification

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezt499 ◽

2013 ◽

Vol 45 (2) ◽

pp. e33-e38 ◽

Cited By ~ 23

Author(s):

H. Dutau ◽

T. Vandemoortele ◽

S. Laroumagne ◽

C. Gomez ◽

V. Boussaud ◽

...

Keyword(s):

Lung Transplantation ◽

Grading System ◽

Airway Complications ◽

Central Airway

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The Diagnosis and Management of Airway Complications Following Lung Transplantation

CHEST Journal ◽

10.1016/j.chest.2017.02.021 ◽

2017 ◽

Vol 152 (3) ◽

pp. 627-638 ◽

Cited By ~ 21

Author(s):

Amit K. Mahajan ◽

Erik Folch ◽

Sandeep J. Khandhar ◽

Colleen L. Channick ◽

Jose F. Santacruz ◽

...

Keyword(s):

Lung Transplantation ◽

Diagnosis And Management ◽

Airway Complications

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Evaluation of Airway Complications in High-Risk Preterm Infants: Application of Flexible Fiberoptic Airway Endoscopy

PEDIATRICS ◽

10.1542/peds.95.4.567 ◽

1995 ◽

Vol 95 (4) ◽

pp. 567-572

Author(s):

Gregory J. Downing ◽

Howard W. Kilbride

Keyword(s):

High Risk ◽

Preterm Infants ◽

Clinical Signs ◽

Signs And Symptoms ◽

Subglottic Stenosis ◽

High Risk Population ◽

Risk Population ◽

Airway Complications ◽

Airway Injury ◽

Airway Abnormalities

Objectives. We sought to determine factors that would predict the development of subglottic stenosis (SGS) and tracheomalacia (TM) in preterm infants. The utility of a semiquantitative measurement of airway dimensions was assessed in relation to signs of airway complications. We also sought to determine from a high-risk population of infants those likely to have abnormal findings identified by bronchoscopic examination. Methods. Prospective airway endoscopy was performed for preterm infants who were intubated for 7 days or more or who demonstrated chronic oxygen needs beyond 28 days after birth and 36 weeks postconceptional age. Subjects were 117 preterm (less than 36 weeks' gestation) infants from two level III intensive care nurseries. Endoscopy was used to classify the type and degree of airway injury. Subglottic stenosis was defined subjectively and compared with an objective measurement using subglottic spatial relations described as a trans- subglottic/vocal cord ratio (TSG/VC). Clinical signs and symptoms and other risk factors were evaluated as significant predictors of SGS and TM, identified by bronchoscopy. Results. Moderate or severe airway abnormalities were identified in 32 patients (27.3%); 13 with SGS, 17 with TM, and 2 with both. All but one infant with TSG/VC less than 0.83 had signs and symptoms of airway dysfunction. Variables more commonly found in patients with SGS included greater number of intubations, use of inappropriately large endotracheal tubes, and longer duration of intubation. Higher averaged mean airway pressure during the first week after birth and lower gestational age were clinical features associated with TM. Conclusions. Flexible bronchoscopic evaluation of a high-risk population demonstrated a higher incidence of moderate or severe SGS or TM than previously suspected. Subglottic stenosis and TM appear to have different etiologies based on different factors associated with their development. The TSG/VC ratio correlated well with obstructive symptoms and may represent a means to quantitate clinically subglottic narrowing. Infants with chronic lung disease who have persistently elevated partial pressure of carbon dioxide, apnea, or phonation abnormalities are most likely to have airway abnormalities identifiable by bronchoscopy.

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RISK FACTORS FOR AIRWAY COMPLICATIONS REQUIRING INTERVENTION AFTER LUNG TRANSPLANTATION

CHEST Journal ◽

10.1378/chest.134.4_meetingabstracts.s23001 ◽

2008 ◽

Vol 134 (4) ◽

pp. 23S

Author(s):

Erika D. Lease ◽

Scott M. Palmer ◽

Scott L. Shofer ◽

Momen M. Wahidi

Keyword(s):

Risk Factors ◽

Lung Transplantation ◽

Airway Complications

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Is Orally Administered Pentobarbital a Safe and Effective Alternative to Chloral Hydrate for Pediatric Procedural Sedation?

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-23.6.460 ◽

2018 ◽

Vol 23 (6) ◽

pp. 460-465

Author(s):

Jordan Anderson ◽

Sevilay Dalabih ◽

Esma Birisi ◽

Abdallah Dalabih

Keyword(s):

Chart Review ◽

Chloral Hydrate ◽

Pediatric Patients ◽

Age Groups ◽

Retrospective Chart Review ◽

Final Analysis ◽

Age Group ◽

Imaging Studies ◽

Airway Complications ◽

Adequate Sedation

OBJECTIVES Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate. METHODS Subjects who received pentobarbital were recruited from a prospectively collected database, whereas we used a retrospective chart review to study subjects who received chloral hydrate. Sedation success was defined as the ability to provide adequate sedation using a single medication. We included electively performed sedations for subjects aged 2 months to 3 years who received either pentobarbital or chloral hydrate orally. We excluded subjects stratified as American Academy of Anesthesiologists category III or higher and those who received sedation for electroencephalogram. The data collected captured subject demographics and complications. RESULTS Five hundred thirty-four subjects were included in the final analysis, 368 in the chloral hydrate group and 166 in the pentobarbital group. Subjects who received pentobarbital had a statistically significant higher success rate [136 (82%) vs 238 (65%), p < 0.001], but longer sleeping time (18.1% vs 0%, p < 0.001) in all age groups. Subjects who received chloral hydrate had a higher risk of airway complications in the <1 year of age group (6.5% vs 1.8%, p = 0.03). CONCLUSIONS For pediatric patients younger than 3 years of age undergoing sedation for imaging studies, oral pentobarbital may be at least as effective and as safe as chloral hydrate, making it an acceptable and practical alternative.

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