scholarly journals Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

2021 ◽  
Vol 8 ◽  
Author(s):  
Chengchao Zhang ◽  
Xinlei Qin ◽  
Wenyi Zhou ◽  
Shuaijie He ◽  
Ao Liu ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Statistical Significance ◽  
Cricoid Cartilage ◽  
Double Lumen Tube ◽  
Transverse Diameter ◽  
Double Lumen ◽  
Significant Difference ◽  
Basic Characteristics ◽  
And Gender ◽  
Ultrasound Group

Background: Currently, there is no uniform standard for selecting the left double lumen tubes (LDLT). Advantages, such as safety and convenience of the ultrasonic technology, and measurement accuracy, make it more widely applied in the clinical anesthesia, and computed tomography (CT) multi-planar reconstruction (MPR) technology will certainly provide a more accurate measurement. For better application for thoracic surgery choice LDLT, relieving the injury to patients, and reducing the complications, this study will compare the two approaches.Methods: The first part, 120 cases of patients were selected according to the height and gender; recording the patient's optimum LDLT and measurement the transverse diameter of the cricoid cartilage (TD-C) by ultrasound and CT MPR, and then obtained the TD-C range measurement by ultrasound and CT MPR corresponding to different types of LDLT. The second part, total of 102 patients were divided into the ultrasound group and the CT MPR group. In the ultrasound group, TD-C was measured by ultrasound, the corresponding size for intubation was selected based on the conclusions derived from the first part. In the CT MPR group, TD-C was measured by CT MPR, the corresponding size of LDLT based on the conclusions derived from the first part.Results: In the first part, 120 patients were no significant difference in the basic characteristics (P > 0.05). The accuracy of selecting the LDLT by conventional experience, namely height and gender was 58.3%. Ultrasonic measurement TD-C range was as follows: 32 Fr <15.88, 35 Fr: 15.88–16.80, 37 Fr: 16.75–17.81, and 39 Fr > 17.80. CT MPR measurement TD-C range was as follows: 32 Fr <15.74, 35 Fr: 15.74–16.65, 37 Fr: 16.56–17.68, and 39 Fr > 17.65. In the second part, there was no significant difference in the basic characteristics between the two groups (P > 0.05). The accuracy of intubation in the ultrasound group was 90.2% and the corresponding in the CT MPR group was 94.1% (P > 0.05).Conclusions: The accuracy of selecting the LDLT based on TD-C is significantly higher than conventional experience; it can significantly reduce the post-operative complications and there was no statistical significance in the accuracy of LDLT selected for TD-C measurement by ultrasound vs. CT, and both of them could be safely used for the evaluation before intubation under anesthesia in thoracic surgery.

scholarly journals Current practice of thoracic anaesthesia in Europe – a survey by the European Society of Anaesthesiology Part I – airway management and regional anaesthesia techniques

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jerome Defosse ◽  
Mark Schieren ◽  
Torsten Loop ◽  
Vera von Dossow ◽  
Frank Wappler ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Airway Management ◽  
Difficult Airway ◽  
European Society ◽  
Double Lumen Tube ◽  
Standards Of Care ◽  
Difficult Airway Management ◽  
Double Lumen ◽  
Lumen Tube ◽  
Thoracic Anaesthesia

Abstract Background The scientific working group for “Anaesthesia in thoracic surgery” of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) has performed an online survey to assess the current standards of care and structural properties of anaesthesia workstations in thoracic surgery. Methods All members of the European Society of Anaesthesiology (ESA) were invited to participate in the study. Results Thoracic anaesthesia was most commonly performed by specialists/board-certified anaesthetists and/or senior/attending physicians. Across Europe, the double lumen tube (DLT) was most commonly chosen as the primary device for lung separation (461/ 97.3%). Bronchial blockers were chosen less frequently (9/ 1.9%). Throughout Europe, bronchoscopy was not consistently used to confirm correct double lumen tube positioning. Respondents from Eastern Europe (32/ 57.1%) frequently stated that there were not enough bronchoscopes available for every intrathoracic operation. A specific algorithm for difficult airway management in thoracic anaesthesia was available to only 18.6% (n = 88) of the respondents. Thoracic epidural analgesia (TEA) is the most commonly used form of regional analgesia for thoracic surgery in Europe. Ultrasonography was widely available 93,8% (n = 412) throughout Europe and was predominantly used for central line placement and lung diagnostics. Conclusions While certain „gold standards “are widely met, there are also aspects of care requiring substantial improvement in thoracic anaesthesia throughout Europe. Our data suggest that algorithms and standard operating procedures for difficult airway management in thoracic anaesthesia need to be established. A European recommendation for the basic requirements of an anaesthesia workstation for thoracic anaesthesia is expedient and desirable, to improve structural quality and patient safety.

scholarly journals Development of polytoxicomania in function of defense from psychoticism

2011 ◽  
Vol 139 (1-2) ◽  
pp. 76-80
Author(s):  
Milutin Nenadovic ◽  
Rosa Sapic
Keyword(s):  
Statistical Significance ◽  
Group Testing ◽  
Executive Dysfunction ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Psychoactive Substances ◽  
High Statistical Significance ◽  
Significant Difference ◽  
Measures Of Dispersion ◽  
And Gender

Introduction. Polytoxicomanic proportions in subpopulations of youth have been growing steadily in recent decades, and this trend is pan-continental. Psychoticism is a psychological construct that assumes special basic dimensions of personality disintegration and cognitive functions. Psychoticism may, in general, be the basis of pathological functioning of youth and influence the patterns of thought, feelings and actions that cause dysfunction. Objective. The aim of this study was to determine the distribution of basic dimensions of psychoticism for commitment of youth to abuse psychoactive substances (PAS) in order to reduce disturbing intrapsychic experiences or manifestation of psychotic symptoms. Methods. For the purpose of this study, two groups of respondents were formed, balanced by age, gender and family structure of origin (at least one parent alive). The study applied a DELTA-9 instrument for assessment of cognitive disintegration in function of establishing psychoticism and its operationalization. The obtained results were statistically analyzed. From the parameters of descriptive statistics, the arithmetic mean was calculated with measures of dispersion. A cross-tabular analysis of variables tested was performed, as well as statistical significance with Pearson?s ?2-test, and analysis of variance. Results. Age structure and gender are approximately represented in the group of polytoximaniacs and the control group. Testing did not confirm the statistically significant difference (p>0.5). Statistical methodology established that they significantly differed in most variables of psychoticism, polytoxicomaniacs compared with a control group of respondents. Testing confirmed a high statistical significance of differences of variables of psychoticism in the group of respondents for p<0.001 to p<0.01. Conclusion. A statistically significant representation of the dimension of psychoticism in the polytoxicomaniac group was established. The presence of factors concerning common executive dysfunction was emphasized.

scholarly journals Non routine use of alveolar incision in Von Langenbeck technique palatoplasty in children; a safe and viable technique in our centre

2019 ◽  
Vol 6 (7) ◽  
pp. 2239
Author(s):  
Philemon E. Okoro ◽  
Benjamin M. Kejeh
Keyword(s):  
Blood Loss ◽  
Cleft Palate ◽  
Statistical Significance ◽  
Test Group ◽  
Control Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Prospective Comparative Study ◽  
And Gender ◽  
Isolated Cleft Palate

Background: Repair of the palate is among the challenging reconstructive surgeries in children. No single technique has achieved completely satisfactory results. The von Langenbeck technique (VLT) is one of the techniques in common use. We have sort to find out if the lateral alveolar incision in VLT can be safely avoided in selected cases.Methods: This is a prospective comparative study of cases of isolated unilateral cleft palate in children 18 years and below which were repaired using the VLT with and without lateral alveolar incision in our centre between January 2013 and December 2018. Outcome parameters obtained included duration of surgery, blood loss, complication and fistula rates. Data was analyzed using SPSS 21. Statistical significance was set at p<0.05.Results: Eighty four patients were included in the study; 36 were in the test group and 48 were in the control group. There was no significant difference in the age, weight and gender of the two groups. The duration of surgery was significantly shorter in the test group and fistula and complication rate was less.Conclusions:This study has demonstrated that comparable, if not better results can be achieved in well selected patients with unilateral isolated cleft palate using only dissection along the margin of the cleft. This new technique reduces the duration of surgery and anaesthesia and may reduce blood loss and complications. 

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