Search Results
Results 501 - 550 of 923
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Ishoo E - - 1999
Angioedema is an immunologically mediated, anatomically limited, nonpitting edema that can lead to life-threatening airway obstruction. To predict the risk of airway compromise in angioedema, we retrospectively reviewed 93 episodes in 80 patients from 1985 to 1995. Intubation or tracheotomy was necessary in 9 (9.7%) cases. Angiotensin-converting enzyme inhibitor use ...
Bloom A I - - 1999
Pleurodesis using talc as the sclerosing agent is an effective procedure for preventing reaccumulation of malignant pleural effusions. Because of its thickness, the talc slurry is usually instilled through large bore (20-28 Fr), surgically placed thorocostomy tubes. However, these tubes often cause considerable patient discomfort. Herein we report a series ...
Schill T - - 1999
Proximal tubal occlusion (PTO), until recently a domain of microsurgery, can also be treated by a transcervical balloon dilatation and/or tubal recanalization. The aim of our study was to evaluate the possibility of transcervical tubal dilatation during transcervical Falloposcopy. Transcervical Falloposcopy and tubal dilatation was performed under laparoscopic control. During ...
Zimmert M - - 1999
A study of 56 patients was undertaken to determine whether there is a difference in the effect of the laryngeal mask airway and the endotracheal tube on the vocal tract after short-duration anaesthesia. All the patients were interviewed pre- and post-operatively. In 43 patients, it was possible to assess the ...
Sakles J C - - 1999
Rocuronium is a recently synthesized non-depolarizing neuromuscular blocking agent (NMBA) that has been demonstrated to have a faster onset of action than any other non-depolarizing NMBA. Although widely studied in the operating room, there are no reports regarding its use for emergent tracheal intubation in the emergency department (ED). The ...
Inomata S - - 1999
Sevoflurane has a non-pungent odour and provides smooth induction of anaesthesia. In contrast, isoflurane is irritating to the airway when used for induction, and this may also be evident during emergence from anaesthesia. We measured the end-tidal concentration of anaesthetic that prevented response to extubation in 50% of patients (MACEX) ...
Carpenter R O - - 1999
PURPOSE: The aim of this study was to compare three methods of postoperative feeding after pyloromyotomy for hypertrophic pyloric stenosis (HPS). METHODS: The authors reviewed retrospectively the charts of 308 patients who underwent pyloromyotomy for HPS from 1984 to 1997. Nineteen patients had prolonged hospitalization for other reasons and were ...
Wong J K - - 1999
Airway management in patients with unstable cervical spines remains a challenge for anesthesia providers. Because neurologic evaluations may be required following tracheal intubation and positioning for the surgical procedure, an awake intubation technique is desirable in this patient population. In this report, we describe the use of an intubating laryngeal ...
Ricard J D - - 1999
STUDY OBJECTIVE: To determine the correlation between simple rating of condensation seen in the flex-tube connecting the heating and humidifying device used with the endotracheal tube and hygrometric parameters (absolute and relative humidity and tracheal temperature) measured by psychrometry. DESIGN: Prospective randomized clinical trial. SETTING: Medical ICU of Louis Mourier ...
Wani M K - - 1999
OBJECTIVE: Describe a clinical syndrome of laryngeal hypersensitivity following laryngeal nerve injury. STUDY DESIGN: Retrospective review of six patients with laryngeal paralysis sustained during neck surgery who presented with paroxysms of coughing and stridor, progressing to brief episodes of complete airway occlusion. METHODS: Chart review. RESULTS: Superior laryngeal nerve blockade ...
Rumbak M J - - 1999
INTRODUCTION: Modern low-pressure, high-volume cuffed tracheotomy tubes have been shown to decrease tracheal injury. However, injury still occurs in patients requiring prolonged mechanical ventilation and prevents weaning, delays decannulation, prolongs hospitalization, and may totally obstruct the airway. We describe 37 patients, including the first reported case of failure to wean ...
Ramage I J - - 1999
Gastrostomy tube (g-tube) feeding is recognized to improve the nutritional delivery to children with end-stage renal disease. A retrospective study was undertaken assessing the complications of g-tube feeding in children receiving peritoneal dialysis (PD). Twenty-three patients, mean age 3.8+/-3.2 years received PD and g-tube feeding for 758 patient-months, with 127 ...
Yassa N A - - 1999
OBJECTIVE: To determine whether balloon-inflated feeding tubes may be a cause of bowel obstruction. METHODS: Evaluation of 10 patients with balloon-inflated feeding tubes who experienced cramping, nausea and vomiting. Conventional radiography of the abdomen was performed in all patients, a fluoroscopic barium examination in 6 patients, and computed tomographic scanning ...
Lundy D S - - 1999
The purpose of this investigation was to determine the overall prevalence of aspiration in dysphagic individuals referred for a modified barium swallow and the underlying anatomic and/or physiologic causes. A total of 166 patients were seen during a 1-month period at 5 participating institutions. Aspiration was detected in 51.2% of ...
Moll J - - 1999
Several case reports and animal studies raise concerns over the risk of aspiration pneumonia when administering activated charcoal (AC) to intubated patients. Therefore, we sought to determine the incidence of aspiration pneumonia in intubated overdose patients who then received AC. We conducted a retrospective review from January 1994 to April ...
Shulman G B - - 1999
PURPOSE: Placement of double lumen tubes (DLTs) in both normal and difficult airways may be considerably more difficult than standard laryngoscopy and intubation using standard tracheal tubes. Alternative techniques to place DLTs have not been uniformly successful and alternative tracheal tubes do not provide the versatility afforded by the DLT. ...
Schönhofer B - - 1999
OBJECTIVE: In tracheotomised patients the incidence of aspiration is difficult to determine because investigators often apply different criteria. In this study a scintigraphic method was used to visualise feeding aspiration directly and the results were compared with clinical evidence of aspiration. DESIGN: Prospective study in difficult-to-wean patients with tracheostomy. SETTING: ...
Roger G - - 1999
OBJECTIVES: To evaluate the need for a tracheotomy and its timing during the evolution of an association of malformations, including coloboma, heart defects, choanal atresia, developmental and growth retardation, genitourinary malformation, and ear anomalies (CHARGE association). DESIGN: Retrospective study from January 1988 through December 1997. SETTING: Four academic tertiary care ...
Fuchs G - - 1999
In patients with lesions of the cervical spine, direct laryngoscopy for endotracheal intubation entails the risk of injuring the spinal cord. In an attempt to avoid this complication, the authors used flexible fiberoptic nasal intubation in a series of 327 patients with cervical lesions undergoing elective neurosurgical procedures. The nasal ...
Tayal V S - - 1999
OBJECTIVES: Rapid-sequence intubation (RSI) is an active airway intervention used frequently in emergency medicine (EM). The authors hypothesized that RSI can be performed safely in the setting of an EM training program at a tertiary care center. METHODS: Observational study of RSI at an urban ED/Level 1 trauma center with ...
Laccourreye O - - 1999
The present prospective study was designed to analyze the results achieved with intracordal autologous fat injection for aspiration in a series of 20 patients with recurrent laryngeal nerve paralysis. Swallowing was documented by having each patient swallow puréed food colored with methylene blue during nasofibroscopy. No laryngeal adverse effects were ...
Schwager K - - 1999
Partial laryngeal resection often results in major aspiration problems, making larynx preservation during surgical removal of tumors of the oropharynx and hypopharynx impossible. However, free flaps can be used to reconstruct perilaryngeal tissue, thus preserving the larynx and ensuring a better quality of life for patients. We present the results ...
Bliss D Z - - 1998
BACKGROUND: Clostridium difficile is the most common infectious cause of nosocomial diarrhea, but its role in diarrhea associated with tube feeding has not been rigorously investigated. OBJECTIVE: To determine the incidence of C. difficile acquisition and C. difficile-associated diarrhea in tube-fed and non-tube-fed patients. DESIGN: Prospective cohort study. SETTING: A ...
Asai T - - 1998
Insertion of the conventional laryngeal mask is more difficult or impossible when the patient's head and neck are in either the neutral or flexed position. The intubating laryngeal mask is best inserted when the patient's head is supported by a pillow, without placing the head and neck into the Magill ...
So J B - - 1998
BACKGROUND: Percutaneous Endoscopic Gastrostomy (PEG) is a relatively new method to deliver nutrition to patients with inadequate caloric intake who have a functionally intact gastrointestinal tract. METHODS: This is a retrospective review of 58 consecutive patients who were referred to the Surgical Endoscopy Unit, Massachusetts General Hospital for placement of ...
Kim E S - - 1998
We evaluated the effects of smoking history and albuterol treatment on the amplitude and frequency of cough during emergence from anesthesia. Before induction of anesthesia, 68 patients were randomized to receive two puffs of a placebo or two puffs of albuterol via a metered dose inhaler. Anesthesia was then induced ...
Durward A D - - 1998
The diagnoses, transfer, management and outcome of patients with upper airway obstruction (UAO) admitted from district general hospitals (DGH) to a regional paediatric intensive care unit were retrospectively reviewed over a 3.5-year period. Sixty-seven patient episodes were analysed. Fifty-two cases (78%) underwent tracheal intubation prior to transport with a low ...
Sing R F - - 1998
Airway control is the initial priority in the management of the injured patient. The purpose of this investigation was to evaluate the experience of an aeromedical transport team in the utilization of rapid sequence induction (RSI) for endotracheal intubation in the prehospital setting. Records of a consecutive series of injured ...
Cook T M - - 1998
A modified laryngeal mask airway was used to facilitate nasotracheal intubation with a fibreoptic laryngoscope. A size 4 laryngeal mask airway was modified by creating a defect at the base of the stem and removing the bars to allow passage of the fibreoptic laryngoscope from the nasopharynx to the larynx. ...
Muehlberger T - - 1998
BACKGROUND: A significant proportion of burn patients with inhalation injuries incur difficulties with airway protection, dysphagia, and aspiration. In assessing the need for intubation in burn patients, the efficacy of fiberoptic laryngoscopy was compared with clinical findings and the findings of diagnostic tests, such as arterial blood gas analysis, measurement ...
Gelly A L AL Centre Hospitalier Anna Laberge, - - 1998
Thirty-seven patients underwent gastroscopy under pharyngeal anaesthesia with benzocaine-tetracaine (Endospray; Axcan Pharma). Patients recorded their perception of intubation, of the rest of the procedure, of taste and of throat well-being on visual analogue scales. Throat well-being and taste scores were better for men than for women. There was a strong ...
Gujjar A R - - 1998
OBJECTIVE: To compare the incidence, indication, and timing of intubation and outcome in patients with cerebral infarction (ISCH) and intracerebral hemorrhage (HEM) requiring mechanical ventilation (MV). BACKGROUND: Poor outcomes have been reported for ISCH patients requiring MV. Because the target population, pathophysiology, and management of ISCH and HEM patients differ ...
Reed R L RL - - 1998
BACKGROUND: Enteral nutrition is less expensive and often preferred to parenteral nutrition in the critically ill or injured patient. Gastric feedings are poorly tolerated in some patients, however, and postpyloric access is frequently difficult to obtain. In this report, we describe our experience with a new technique for bedside endoscopic ...
Asai T - - 1998
We studied the efficacy of the cuffed oropharyngeal airway in 100 patients. Insertion of the airway after induction of anaesthesia with propofol was easy in 95 of 100 patients, moderately difficult in four patients and failed in one patient. Complications, such as coughing, gagging or body movement, occurred during induction ...
Menzel L K - - 1998
OBJECTIVES: The purpose of the study was to examine the relationships among the intensity of intubated patients' negative emotional responses to being unable to speak and selected personal and situational variables. DESIGN: Prospective correlational. SETTING: Four intensive care units in a midwestern, university-affiliated medical center. PATIENTS: A convenience sample of ...
D'Antonio L L - - 1998
OBJECTIVE: This study described the occurrence and expression of pharyngeal and laryngeal anomalies in a population of patients with oculo-auriculo-vertebral spectrum (OAVS). DESIGN: Cross-sectional study using chart review, physical examination, and endoscopic evaluation of the pharynx and larynx, and perceptual and aerodynamic evaluation of speech for assessment of vocal tract ...
Polak J F - - 1998
OBJECTIVE: We studied factors that affect satisfaction of patients who have undergone placement of peripherally inserted central venous catheters (PICCs) by interventional radiologists and patients' willingness to undergo placement of future PICCs. SUBJECTS AND METHODS: This longitudinal prospective consecutive cohort study included 85 patients referred for PICC placement. A record ...
Huncke K - - 1998
OBJECTIVE: We evaluated a combined technique designed for procedures requiring intraoperative language mapping. We planned to induce general anesthesia with endotracheal intubation and hyperventilation and then to awaken and extubate the patient for speech testing. After the latter, endotracheal reintubation and general anesthesia were planned. METHODS: With the patient under ...
Verghese C - - 1998
We conducted a clinical comparison of the laryngeal mask airway (LMA) and the new single use PVC LMA (LMA-Unique) in 100 fasted adult patients undergoing elective surgery. Patients were allocated to one of two groups: group 1 (n = 50) was managed by two consultants and group 2 by two ...
Chui P T - - 1998
Ninety patients were assigned randomly in a double-blind manner to receive 0.9% sodium chloride, mivacurium 0.04 mg.kg-1 or mivacurium 0.08 mg.kg-1 intravenously, followed by propofol 2.5 mg.kg-1. A laryngeal mask airway (LMA) was inserted 90 s later. The LMA was positioned correctly during the first attempt in 87% of patients ...
Parr M J - - 1998
The use of the intubating laryngeal mask in three patients is described. In two patients for whom tracheal intubation using traditional techniques had failed, the intubating laryngeal mask was used to achieve successful tracheal intubation. The trachea of one of these patients was subsequently re-intubated for a second procedure using ...
Kakuya F - - 1998
The delivery of nitric oxide (NO) via a nasopharyngeal tube is an alternative to endotracheal intubation. A male infant with end-stage pulmonary hypertension (PH) due to a severe hypoplastic lung developed a PH crisis on day 145 and received NO inhalation via a nasopharyngeal tube. Clinical improvement was maintained for ...
Kleiner G I - - 1998
This two-year-old boy presented with a two-day history of vomiting and fever. He was diagnosed with acute otitis media four days before this incident. Repeated questioning revealed removal of a percutaneous enterostomy tube two weeks earlier with failure to pass the internal bumper in his stool. The child was in ...
Thomas B W - - 1998
BACKGROUND: Inadvertent insertion of nasogastric tubes into the trachea and distal airways is reported to range from 0.3% to 15% of insertions. Critically ill, mechanically ventilated patients are at a higher risk for such complications, some of which can be fatal. OBJECTIVE: This preliminary prospective clinical investigation was designed to ...
Taylor I N - - 1998
The success rate for insertion of the laryngeal mask airway was assessed in 60 patients using a target-controlled infusion of propofol. Eleven of 15 patients who received a target propofol concentration of 5 micrograms.ml-1 had the laryngeal mask inserted successfully within 3 min of induction of anaesthesia. Fourteen of 15 ...
Blostein P A - - 1998
OBJECTIVE: To characterize the use of the esophageal tracheal combitube (ETC) in trauma patients who fail orotracheal rapid sequence intubation (RSI). DESIGN: Prospective protocol design and retrospective chart review. MATERIALS AND METHODS: Flight nurses were trained in the use of the ETC by mannequin simulation, videotape review, and didactic sessions. ...
Samarkandi A H - - 1998
PURPOSE: It has been suggested that it is safer to remove the Laryngeal Mask Airway (LMA) in paediatric patients when they are deeply anaesthetised than when they are awake. However, the evidence regarding this recommendation is contradictory. The purpose of the study was to compare the incidence of complications (laryngeal ...
Nunez J - - 1998
Previous studies reported that complications associated with removal of the laryngeal mask were more frequent in awake patients than in anaesthetised patients; however, these studies did not comply with the method described in the manufacturer's instruction manual. The reported incidences of regurgitation during the use of the laryngeal mask also ...
Wulffraat N M - - 1998
In this Grand Round, two children are described with atypical generalized scleroderma and severe failure to thrive. Neither had Raynaud's phenomenon nor evidence of gastrointestinal (GI) disease. Treatment with non-steroidal anti-inflammatory drugs, prednisone, D-penicillamine, alpha and gamma interferon was unsuccessful in reversing the sclerodermatous changes and growth arrest. Dietary intake ...
Krasna M J - - 1998
OBJECTIVE: 48 patients underwent TSSYM. Charts of patients undergoing thoracoscopy were reviewed to assess the safety and efficacy of thoracoscopic sympathectomy (TSSYM). DESIGN: A retrospective review was undertaken at four United States medical centers. RESULTS: TSSYM was performed for reflex sympathetic dystrophy in 27 patients, hyperhydrosis palmaris in 15 patients, ...
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