57 research outputs found
Initial experience with a synthetic sealant PleuraSealâ„¢ after pulmonary resections: a prospective study with retrospective case matched controls
The objective of this study was to evaluate postoperative outcome and efficacy of a hydrogel tissue sealant for prevention of alveolar leakage after open lung resections
Comparison of glottic views and intubation times in the supine and 25 degree back-up positions
Background: We explored whether positioning patients in a 25° back-up sniffing position improved glottic views
and ease of intubation.
Methods: In the first part of the study, patients were intubated in the standard supine sniffing position. In the
second part, the back of the operating table was raised 25° from the horizontal by flexion of the torso at the hips
while maintaining the sniffing position. The best view obtained during laryngoscopy was assessed using the
Cormack and Lehane classification and Percentage of Glottic Opening (POGO) score. The number of attempts at
both laryngoscopy and tracheal intubation, together with the use of ancillary equipment and manoeuvres were
recorded. The ease of intubation was indirectly assessed by recording the time interval between beginning of
laryngoscopy and insertion of the tracheal tube.
Results: Seven hundred eighty one unselected surgical patients scheduled for non-emergency surgery were
included. In the back-up position, ancillary laryngeal manoeuvres, which included cricoid pressure, backwards
upwards rightward pressure and external laryngeal manipulation, were required less frequently (19.6 % versus 24.
6 %, p = 0.004). The time from beginning of laryngoscopy to insertion of the tracheal tube was 14 % shorter
(median time 24 versus 28 s, p = 0.031) in the back-up position. There was no significant difference in glottic views.
Conclusions: The 25° back-up position improved the ease of intubation as judged by the need for fewer ancillary
manoeuvres and shorter time for intubation.
Trial registration: ClinicalTrials.gov Identifier: NCT02934347 registered retrospectively on 14th Oct 2016
Comparison of the Airtraq laryngoscope and the GlideScope for double-lumen tube intubation in patients with predicted normal airways: a prospective randomized trial
Chest tube insertion is one important factor leading to intercostal nerve impairment in thoracic surgery
Objectives: Chest tube insertion seems to be one important factor leading to intercostal nerve impairment. The purpose of this prospective study was to objectively evaluate intercostal nerve damage using current perception threshold testing in association with chest tube insertion. Methods: Sixteen patients were enrolled in this study. Intercostal nerve function was assessed with a series of 2000-Hz (Aβ fiber), 250-Hz (Aδ fiber), and 5-Hz (C fiber) stimuli using current perception threshold testing (Neurometer CPT/C R). Current perception threshold values at chest tube insertion were measured before surgery, during chest tube insertion and after removal of the chest tube. Intensities of ongoing pain were also assessed using a numeric rating scale (0-10). Results: Current perception thresholds at each frequency after surgery were significantly higher than before surgery. Numeric rating scale scores for pain were significantly reduced from 3.3 to 1.9 after removal of the chest tube (p = 0.004). The correlation between current perception threshold value at 2000 Hz and intensity of ongoing pain was marginally significant (p = 0.058). Conclusions: This is the first study to objectively evaluate intercostal nerve damage at chest tube insertion. The results confirmed that chest tube insertion has clearly deleterious effects on intercostal nerve function
Prise en charge des voies aériennes – 1re partie – Recommandations lorsque des difficultés sont constatées chez le patient inconscient/anesthésié
CASE 5—2014 Challenging Perioperative Management of a Massive Anterior Mediastinal Mass in a Symptomatic Adult
Inexpensive video-laryngoscopy guided intubation using a personal computer: initial experience of a novel technique
CASE 6—2016Cardiopulmonary Bypass as a Bridge to Clinical Recovery From Cardiovascular Collapse During Graft Reperfusion in Liver Transplantation
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