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Patent Airway (patent + airway)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Pathologic paediatric conditions associated with a compromised airway

INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2010
SUHER BAKER
International Journal of Paediatric Dentistry 2010; 20: 102,111 Purpose., The purpose was to describe pathologic paediatric conditions associated with airway compromise adversely affecting dental treatment with sedation and general anaesthesia. Methods., A review of available literature was completed, identifying pathologic paediatric conditions predisposing to airway compromise. Results., Airway-related deaths are uncommon, but respiratory complication represents the greatest cause of morbidity and mortality during the administration of general anaesthesia. Differences in anatomy and physiology of the paediatric and adult airway contribute to the child's predisposition to rapid development of airway compromise and respiratory failure; juvenile rheumatoid arthritis, cervical spine injury, morbid obesity, and prematurity represent only a few conditions contributing to potential airway compromise of which the paediatric clinician needs to be aware. In all cases, thorough physical examination prior to treatment is mandated to affect a positive treatment outcome. Conclusions., Successful management of children and adolescents with a compromised airway begins with identification of the problem through a detailed medical history and physical examination. Due to the likely fragile nature of many of these patients, and possibility of concomitant medical conditions affecting airway management, dental treatment needs necessitating pharmacological management are best treated in a controlled setting such as the operating room, where a patent airway can be maintained. [source]

A comparison of the effectiveness of dexmedetomidine versus propofol target-controlled infusion for sedation during fibreoptic nasotracheal intubation

ANAESTHESIA, Issue 3 2010
C.-J. Tsai
Summary Fibreoptic intubation is a valuable modality for airway management. This study aimed to compare the effectiveness of dexmedetomidine vs target controlled propofol infusion in providing sedation during fibreoptic intubation. Forty patients with anticipated difficult airways and due to undergo tracheal intubation for elective surgery were enrolled and randomly allocated into the dexmedetomidine group (1.0 ,g.kg,1 over 10 min) (n = 20) or the propofol target controlled infusion group (n = 20). Intubating conditions and patient tolerance as graded by a scoring system were evaluated as primary outcomes. Intubation was successful in all patients. Satisfactory intubating conditions were found in both groups (19/20 in each group). The median (IOR [range]) comfort score was 2 (1,2 [1,4]) in the dexmedetomidine group and 3 (2,4 [2,5]) in the propofol group (p = 0.027), favouring the former. The dexmedetomidine group experienced fewer airway events and less heart rate response to intubation than the propofol group (p < 0.003 and p = 0.007, respectively). Both dexmedetomidine and propofol target-controlled infusion are effective for fibreoptic intubation. Dexmedetomidine allows better tolerance, more stable haemodynamic status and preserves a patent airway. [source]

An evaluation of the Airway Management Device

ANAESTHESIA, Issue 7 2001
apparatus
We have evaluated the Airway Management Device (AMDÔ) in 105 anaesthetised patients. We were successful in establishing a clear airway on the first attempt on 69 occasions and unable to establish a patent airway at all in 10 patients. Airway obstruction requiring removal of the device occurred during maintenance of anaesthesia in a further two cases and during emergence in three. Loss of the airway during anaesthesia occurred in eight of 95 patients and could be reversed by manipulation of the airway in six cases. Overall, a mean of 0.56 manipulations per patient were required to establish an airway and a further 0.42 per patient were required during maintenance of anaesthesia. In the 95 patients in whom an airway was established, assisted ventilation was satisfactory in 93, with a leak pressure above 20 cmH2O in 65. Intracuff pressure was measured in 12 cases and was above 100 cmH2O in eight. Minor complications occurred in 12 patients. Blood was visible on removal of the device in six cases. [source]

The oesophageal,tracheal Combitube Small AdultÔAn alternative airway for ventilatory support during gynaecological laparoscopy

ANAESTHESIA, Issue 7 2000
T. Hartmann
Airway management during gynaecological laparoscopy is complicated by intraperitoneal carbon dioxide inflation, Trendelenburg tilt, increasing airway pressures and pulmonary aspiration risk. We investigated whether the oesophageal,tracheal Combitube 37 Fr SAÔ is a suitable airway during laparoscopy. One hundred patients were randomly allocated to receive either the Combitube SAÔ (n = 49) or tracheal intubation (n = 51). Oesophageal placement of the Combitube was successful at the first attempt [16 (3) s]. Peak airway pressures were 25 (5) cmH2O. An airtight seal was obtained using air volumes of 55 (13) ml (oropharyngeal balloon) and 10 (1) ml (oesophageal cuff). Significant correlations were observed between patient's height and weight and the balloon volumes necessary to produce a seal. Similar findings were recorded for the control group, with tracheal intubation being difficult in three patients. The Combitube SAÔ provided a patent airway during laparoscopy. Non-traumatic insertion was possible and an airtight seal was provided at airway pressures of up to 30 cmH2O. [source]

Suspension Laryngoscopy for Endotracheal Stenting,

THE LARYNGOSCOPE, Issue 1 2003
Hans Edmund Eckel MD
Abstract Objectives/Hypothesis Airway stents have recently been used to establish and maintain patent airways in patients with malignant central airway obstruction, but insertion modalities remain controversial to date. The study seeks to determine the role of suspension laryngoscopy in interdisciplinary airway stenting. Study Design Retrospective, single-institution analysis of a case series treated by a multidisciplinary airway team. Methods Ninety-three consecutive patients with malignant obstruction of the trachea and/or tracheobronchial bifurcation underwent endotracheal stenting through a suspension laryngoscopy approach for the relief of impending respiratory distress. Feasibility, mortality, survival, and complications were analyzed as main outcome measures. Results Stenting through a suspension laryngoscopy approach was feasible 91 of 93 patients (97.8%). Fifteen patients needed repeated stenting, and in all, 121 stents were implanted during the observation period. This approach allowed for the repeated insertion of rigid bronchoscopes of graded sizes to establish an airway and for precise stent positioning. Optical instruments and stent introducer systems could easily be used while adequate ventilation was continuously maintained. Silicone stents of maximal size were inserted without injury of the vocal cords during intubation. Median survival for all patients was 8 months. No intraoperative airway complications were observed, and no patient died secondary to stenting. Conclusions Suspension laryngoscopy and jet ventilation provide an ideal setting for the precise placement of tracheal and bifurcation airway stents. Laryngologists should actively participate in interdisciplinary airway stenting programs. [source]