Search Our Scientific Publications & Authors

Zhonghua Kou Qiang Yi Xue Za Zhi 2019 Jan;54(1):23-28

Department of General Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.

To discuss the surgical safeness of the cleft palate children with airway stenosis by means of analyzing characteristics of the shape of the upper airway and comparing clinical data of cleft palate children with airway stenosis and non-airway stenosis. Tracing back from Apirl 2015 to Apirl 2017, 126 cleft palate children treated in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, were included (46 male and 80 female, age of 7 to 74 months, median age 18 months). According to the spiral CT scan of neck, patients were categorized to airway-stenosis group (65 patients) and non-airway-stenosis group (61 patients). Read More

Int J Pediatr Otorhinolaryngol 2018 Dec 7;118:6-10. Epub 2018 Dec 7.

Department of ENT, Christian Medical College, Vellore, India.

Study Objectives: To review the key parameters related to the proposed modified pediatric tracheostomy technique with to determine the efficacy, safety and outcomes in a tertiary hospital in south India. Patients and Methods A retrospective chart review of all children aged below 16 years who underwent tracheostomy at a tertiary hospital in south India during the period of August 2014 to August 2016. Data on age, gender, indication for tracheostomy, primary disease condition, duration of intubation, complications and decannulation rate were recorded. Read More

Paediatr Anaesth 2018 Dec;28(12):1148-1153

Scientist (Statistician), DRBRAIRCH, AIIMS, New Delhi, India.

Background: Videolaryngoscopy has an established role in difficult airway management in adults. However, there is limited literature to support their efficacy in children. The Truview Picture Capture Device has shown promising results for endotracheal intubation in infants in the past. Read More

Paediatr Anaesth 2018 Dec 19;28(12):1129-1135. Epub 2018 Nov 19.

Department of Anaesthesia, Great Ormond Street Hospital for Children, London, UK.

Background: A tracheocutaneous fistula is a known complication following tracheostomy decannulation. Although surgical techniques for its repair are well described, there is no consensus about perioperative management and this procedure may generate significant airway and respiratory complications intraoperatively, and in the early postoperative period. We aimed to describe variations in perioperative management in tracheocutaneous fistula closure, estimate the incidence of early airway and respiratory complications, and identify any predisposing factors. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13082

Department of Liver Surgery and State Key Laboratory of Biotherapy, West China Hospital.

Introduction: To systematically compare immediate postoperative tracheal extubation (IPTE) with conventional tracheal extubation (CTE) and to determine whether IPTE can achieve an enhanced recovery for adult patients underwent liver transplantation (LT) without additional risks. We designed a systematic review and meta-analysis.

Methods: The RCTs, cohorts, case-controls, or case series that explored outcomes of IPTE after LT for adults were involved in our study. Read More

Int J Pediatr Otorhinolaryngol 2018 Dec 19;115:58-60. Epub 2018 Sep 19.

Pacific Coast Medical Inc, USA.

A 16-month old female was referred to our practice for laryngotracheal reconstruction (LTR) for acquired subglottic stenosis (SGS) diagnosed at 4 weeks of age due to prolonged intubation. She has a history of open thoracic repair of congenital tracheoesophageal fistula that was complicated by a pneumothorax and phrenic nerve paralysis. We performed a variation of an anterior and posterior cricoid split LTR with tracheal stenting in order to avoid risks of pulmonary morbidity from costochondral cartilage harvesting. Read More

Br J Anaesth 2018 Nov 18;121(5):1173-1178. Epub 2018 Sep 18.

Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland; Department of Anaesthesia, Mater Misericordiae Hospital, Dublin, Ireland; School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. Electronic address:

Background: Evaluation of the anterior neck anatomy is used to identify the cricothyroid membrane (CTM) before front of neck airway access. This has been traditionally performed using palpation which results in misidentification of the CTM in a high proportion of subjects. The 'laryngeal handshake' is currently advocated by the Difficult Airway Society as the method to identify the CTM. Read More

Medicine (Baltimore) 2018 Oct;97(40):e12593

Lazarski University, Warsaw, Poland.

Background: Securing the airway and enabling adequate oxygenation and ventilation is essential during cardiopulmonary resuscitation (CPR). The aim of the study was to evaluate the success rate of blind intubation via the I-Gel and the Air-Q compared with direct laryngoscopy guided endotracheal intubation by inexperienced physician and to measure time to successful intubation.

Methods: The study was designed as a randomized, cross-over simulation study. Read More

Int J Pediatr Otorhinolaryngol 2018 Nov 1;114:129-133. Epub 2018 Aug 1.

University of Arkansas for Medical Sciences, Department of Otolaryngology, Head and Neck Surgery, Division of Pediatric Otolaryngology, United States.

Posterior glottic stenosis (PGS) describes a laryngeal disorder in which worsening degrees of scarring limit abduction of the vocal folds and/or arytenoids. It can be congenital or acquired. Generally, the acquired form is the result of chronic endotracheal tube trauma to the posterior larynx. Read More

Crit Care 2018 09 23;22(1):236. Epub 2018 Sep 23.

PhyMedExp, University of Montpellier, Anesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, Centre Hospitalier Universitaire Montpellier, 34295, Montpellier, cedex 5, France.

Background: Patients liberated from invasive mechanical ventilation are at risk of extubation failure, including inability to breathe without a tracheal tube (airway failure) or without mechanical ventilation (non-airway failure). We sought to identify respective risk factors for airway failure and non-airway failure following extubation.

Methods: The primary endpoint of this prospective, observational, multicenter study in 26 intensive care units was extubation failure, defined as need for reintubation within 48 h following extubation. Read More

J Thorac Dis 2018 Aug;10(8):4782-4788

Division of Thoracic Surgery, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo. São Paulo, Brazil.

Background: The primary objective of the study was to evaluate the health-related quality of life (HRQL) of patients with benign post-intubation tracheal stenosis considered as unfit for surgical treatment. Secondary objectives were: (I) to determine if clinical variables (gender, age, total treatment time, and type of tracheal device) could influence HRQL and (II) to compare the results with a normal standardized population.

Methods: Prospective study between August-2014 and December-2016 including patients with tracheal stenosis treated with silicone stents, T-Tubes or tracheostomy. Read More

Wilderness Environ Med 2018 09 30;29(3):357-365. Epub 2018 Jun 30.

University of Chicago, Chicago, IL; NorthShore University HealthSystem, Highland Park, IL. Electronic address:

Airway management in the wilderness runs the gamut from basic airway support to endotracheal intubation. Fortunately, direct laryngoscopy is a seldom called upon skill in expedition medicine. However, the medical skills required during a mission or expedition are never truly known in advance. Read More

JIMD Rep 2018 Sep 13. Epub 2018 Sep 13.

Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Background: Inclusion cell disease (I-cell) is a rare autosomal recessive metabolic disease involving multiple organ systems, associated with a severely restricted life expectancy. No curative therapy is currently available, with management aimed at symptom palliation.

Methods: We present a retrospective, single-centre, case series of children referred to a tertiary paediatric metabolic service. Read More

World J Pediatr Congenit Heart Surg 2018 09;9(5):529-536

1 Division of Pediatric and Congenital Cardiothoracic Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Objectives: The objectives were to assess the incidence of immediate tracheal extubation in the operating room after pediatric cardiac surgery and to investigate predictors for subsequent reintubation.

Methods: This is a single institutional retrospective study including all patients who had a cardiac operation with cardiopulmonary bypass from 2011 to 2016. Patients who required preoperative ventilator support, postoperative open chest, or mechanical support were excluded. Read More

Medicine (Baltimore) 2018 Aug;97(34):e11984

Department of Emergency Medicine, Myongji Hospital, Goyang, Korea.

Background: Novice clinicians who have little or no clinical experience in tracheal intubation occasionally need a long time to perform the procedure when using a large curved blade. They also have a lower tracheal intubation success rate, especially in emergency situations, such as cardiac arrest, than experienced practitioners. This study aimed to investigate whether the size of the curved laryngoscope blade affects the outcomes of tracheal intubation performed by incoming interns on a manikin model. Read More

Otolaryngol Head Neck Surg 2018 Oct 21;159(4):698-704. Epub 2018 Aug 21.

1 Department of Otolaryngology, The Ohio State University, Columbus, Ohio, USA.

Objective To determine the incidence of posttracheostomy tracheal stenosis and to investigate variables related to the patient, hospitalization, or operation that may affect stenosis rates. Study Design A combined retrospective cohort and case-control study. Setting Tertiary care academic medical center. Read More

Turk J Med Sci 2018 Aug 16;48(4):768-776. Epub 2018 Aug 16.

Background/aim: We compared the effects of volume-controlled equal ratio ventilation (VC-ERV) and volume-controlled conventional ratio ventilation (VC-CRV) on oxygenation, ventilation, respiratory mechanics, and hemodynamic status during mechanical ventilation with recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) in patients undergoing laparoscopic sleeve gastrectomy.

Materials And Methods: A total of 111 patients scheduled for laparoscopic sleeve gastrectomy were randomized to ventilation with inspiratory to expiratory ratio of 1:1 (Group VC-ERV) or 1:2 (Group VC-CRV) following tracheal intubation. RM (40 cmH2O, 15 s) and PEEP (10 cmH2O) were administered to all patients. Read More

World J Otorhinolaryngol Head Neck Surg 2018 Jun 2;4(2):117-121. Epub 2018 Jun 2.

Department of Otolaryngology - Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.

Objective: To identify the incidence of laryngotracheal stenosis (LTS) in burn patients requiring mechanical ventilation at a regional academic burn center.

Methods: A retrospective review of all burn patients requiring endotracheal intubation or tracheostomy for airway management between 2003 and 2009 was performed. A group of trauma patients requiring similar airway instrumentation during the same period of time was used as a control. Read More

Medicine (Baltimore) 2018 Aug;97(32):e11834

Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Jongno-gu, Seoul, Republic of Korea.

Background: A rigid video-stylet intubation device provides safe and accurate access to the trachea by enabling visualization of the airway structures during tracheal intubation. The primary purpose of this study was to examine the effects of glycopyrrolate premedication on tracheal intubation with a rigid video-stylet.

Methods: In this prospective, randomized, double-blinded study, 78 patients were randomly assigned to the control group (n = 39; no glycopyrrolate administration) or the glycopyrrolate group (n = 39; 0. Read More

World J Emerg Surg 2018 24;13:33. Epub 2018 Jul 24.

Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, 05278 South Korea.

Background: Prediction of difficult airway is critical in the airway management of trauma patients A LEMON method which consists of following assessments; Look-Evaluate-Mallampati-Obstruction-Neck mobility is a fast and easy technique to evaluate patients' airways in the emergency situation. And a modified LEMON method, which excludes the Mallampati classification from the original LEMON score, also can be used clinically. We investigated the relationship between modified LEMON score and intubation difficulty score in adult trauma patients undergoing emergency surgery. Read More

Ann Otol Rhinol Laryngol 2018 Sep 26;127(9):653-656. Epub 2018 Jul 26.

1 Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.

Objectives: To increase awareness of vocal fold mobility impairment secondary to laryngeal mask airway (LMA) use in the operating room.

Methods: We report 2 cases of bilateral vocal fold mobility impairment after LMA use within 7 months of each other. One patient is a 52-year-old female who developed this complication after orthopedic elbow surgery. Read More

Minerva Anestesiol 2018 Jul 20. Epub 2018 Jul 20.

Department of Anesthesiology, Wannan Medical College First Affiliated Hospital, Yijishan Hospital, Wuhu, Anhui, China.

Background: Compared with men, women often have a shorter interincisor distance and a shorter thyromental distance but are less likely to have difficult airway. The hypothesis is that the prediction criteria of difficult airway differ between men and women. The aim of this study was to investigate differences in the prediction criteria of anatomic predictors for difficult airways in men and women. Read More

Br J Anaesth 2018 Aug 5;121(2):453-461. Epub 2018 Jun 5.

Divisions of Emergency Medicine and Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Background: Propofol is used to induce deep sedation or general anaesthesia for procedures in children. Adjuvants, such as ketamine, are routinely added to reduce the dose of propofol required and propofol-related adverse events. We conducted a randomised controlled trial to determine the effective bolus dose of propofol in combination with ketamine that induces adequate depth of anaesthesia in 50% of children (ED) undergoing gastro-duodenoscopy. Read More

BMJ Case Rep 2018 Jul 12;2018. Epub 2018 Jul 12.

Anaesthetics, Royal Derby Hospital, Derby, UK.

We present the case of a 53-year-old man who attended our emergency department with stridor. He had recently undergone investigation for possible glottic cancer. We discuss the airway management of such a case. Read More

Zhonghua Yi Xue Za Zhi 2018 Jun;98(24):1941-1944

Department of Anesthesiology, Beijing Tongren hospital, Capital Medical University, Beijing 100730, China.

To analyze the clinical applications of high frequency jet ventilation(HFJV) in cryotherapy of the trachea and bronchial neoplasms by the rigid bronchoscope. The clinical data of 35 patients who were treated with tracheal neoplasms cryotherapy by the rigid bronchoscopy under HFJV were collected in China-Japan Friendship Hospital from August 2008 to February 2015.Under general anesthesia, HFJV was used in all patients. Read More

Ethiop J Health Sci 2018 Mar;28(2):169-176

Departments of Surgery, Faculty of Clinical Sciences, College of Health Sciences, University of Ilorin and the University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Background: Airway management problems may arise when intubating patients with goitre scheduled for thyroidectomy. Goitres are not uncommon in sub-Saharan Africa, thyroidectomy being the main treatment. The aim of this study was to determine incidences of difficult intubation (DI), failed intubation (FI) and predictors of DI using a modified intubation difficulty score (IDS). Read More

BMC Anesthesiol 2018 Jun 30;18(1):79. Epub 2018 Jun 30.

Department of Anaesthesia, Obstetrics & Gynecology Hospital, Fudan University, 128# Shenyang road, Shanghai, 200090, China.

Background: Obesity is a serious disorder and may bring about many difficulties of perioperative management. A systematic review was conducted to assess the association between obesity and difficult intubation.

Methods: We searched electronic databases for related reviews and references of meta-analyses on August 14, 2017. Read More

Childs Nerv Syst 2018 Nov 29;34(11):2275-2281. Epub 2018 Jun 29.

Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757, Asahimachi-dori, Chuo-ku,, Niigata City, Niigata, 951-8585, Japan.

Objective: Management of cervicomedullary compression due to foramen magnum stenosis in achondroplasia remains controversial, especially for patients with no symptoms or mild symptoms. We examined the effectiveness of polysomnography (PSG) as an indicator for cervicomedullary decompression treatment.

Methods: We retrospectively reviewed nine achondroplasia cases (mean age 1 year and 9 months) treated from 2008 to 2015. Read More

J Cardiothorac Surg 2018 Jun 25;13(1):77. Epub 2018 Jun 25.

Department of Anesthesiology, University Hospital of Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany.

Background: In certain clinical situations the insertion of a double-lumen tube (DLT) for one-lung ventilation (OLV) is not feasible or unfavorable. In these cases, the EZ-Blocker (EZB) may serve as an alternative. The aim of our analysis was to report on the clinical applications and our experience with the EZB for one-lung ventilation in 100 patients undergoing thoracic surgery. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4):324-328

Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham.

Purpose: This study will determine the safety of laryngeal mask airway (LMA) compared with endotracheal tube (ETT) in patients undergoing general anesthesia for dacryocystorhinostomy (DCR) surgery.

Methods: In this retrospective cohort study, intraoperative and postoperative outcomes of patients who underwent DCR at UAB Callahan Eye Hospital using either LMA or ETT were compared.

Results: Over a period of 52 months, 429 patients underwent external DCR surgery. Read More

Medicine (Baltimore) 2018 Jun;97(25):e11190

Department of Anesthesiology, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki.

Background: It is very rare but challenging to perform emergency airway management for accidental extubation in a patient whose head and neck are fixed in the prone position when urgently turning the patient to the supine position would be unsafe. The authors hypothesized that tracheal intubation with a videolaryngoscope would allow effective airway rescue in this situation compared with a supraglottic airway device and designed a randomized crossover manikin study to test this hypothesis.

Methods: The authors compared airway rescue performances of the 3 devices-the ProSeal laryngeal mask airway (PLMA; Teleflex Medical, Westmeath, Ireland) as a reference; the Pentax AWS (AWS; Nihon Kohden, Tokyo, Japan) as a channeled blade-type videolaryngoscope; and the McGRATH videolaryngoscope (McGRATH; Medtronic, Minneapolis, MN) as a nonchanneled blade type in a manikin fixed to the operating table in the prone position. Read More

Crit Care Clin 2018 Jul;34(3):313-324

Division of Pulmonary, Critical Care and Sleep Medicine, Zucker School of Medicine at Hofstra/Northwell, 410 Lakeville Road, Suite 107, New Hyde Park, NY 11040, USA.

Critical care airway management is associated with a variety of complications, including severe oxygen desaturation, life-threatening hypotension, and death. This article reviews aspects of airway management that are relevant to intensivists and emergency medicine clinicians tasked with improving the quality of urgent endotracheal intubation in the critically ill patient. Read More

J Spec Oper Med Summer 2018;18(2):90-96

Background: Airway management is a critical skill that may be essential in the battlefield. The aim of this study was to determine if combat life savers and medics with no or limited clinical experience could provide airway control using the disposable laryngeal suction tube (LTS-D) and the Ambu® AuraOnce ™ disposable laryngeal mask (LMA).

Methods: Eight military medics with limited clinical experience and no airway management experience secured the airway on 19 intrahospital anesthetized patients using the LTS-D and the LMA. Read More

Adv Neonatal Care 2018 Aug;18(4):267-275

Division of Neonatology, Department of Pediatrics, University of Washington, Seattle.

Background: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines.

Purpose: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF. Read More

J Laparoendosc Adv Surg Tech A 2018 Oct 6;28(10):1243-1247. Epub 2018 Jun 6.

1 Department of General Surgery and Urology, Faculty of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology , Irbid, Jordan .

Background: Headscarf use is becoming more common throughout the world. Many articles describe the problem of aspirated headscarf pins but few if any give technical details for retrieval or innovative methods of removal if traditional bronchoscopy fails particularly in the pediatric population. Herein, we describe our method of deep sedation with laryngeal mask airway (LMA) and flexible bronchoscopy (FB) and retrieval with a stepwise algorithm if traditional FB fails. Read More

Cochrane Database Syst Rev 2018 06 4;6:CD009975. Epub 2018 Jun 4.

Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street (WT 6-104), Houston, TX, USA, 77030.

Background: Establishment of a secure airway is a critical part of neonatal resuscitation in the delivery room and the neonatal unit. Videolaryngoscopy has the potential to facilitate successful endotracheal intubation and decrease adverse consequences of delay in airway stabilization. Videolaryngoscopy may enhance visualization of the glottis and intubation success in neonates. Read More

Int J Pediatr Otorhinolaryngol 2018 Jul 25;110:61-66. Epub 2018 Apr 25.

Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, No.639 Zhizaoju Road, Shanghai, 200011, China; Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1665 Kongjiang Road, Shanghai, 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, No. 390 Yanqiao Road, Shanghai, 200125, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, No. 390 Yanqiao Road, Shanghai, 200125, China. Electronic address:

Objectives: To investigate the outcomes of rigid endoscope-assisted orotracheal intubation (REI) in neonates and young infants with difficult airway conditions as an alternative intubation technique when more specific airway instruments are not available in most developing countries, and to evaluate the safety and advantages of this method.

Methods: Neonatal and young infantile patients undergoing vallecular cyst surgery with a Cormack-Lehane Grade 3 or 4 glottic view between June 2013 and June 2015 were studied. Fifteen patients were intubated using rigid endoscopic assistance. Read More

Medicine (Baltimore) 2018 Jun;97(22):e10907

Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China.

Rationale: Tracheobronchomalacia (TBM) refers to the weakening trachea or the trachea loss of structural integrity of airway cartilaginous structures. It causes tracheal stenosis, resulting in significantly high rates of mortality. Bronchoplasty by high-pressure balloon dilation under general anesthesia is a simple but effective and safe method to treat tracheobronchial stenosis. Read More

Korean J Anesthesiol 2018 Aug 30;71(4):289-295. Epub 2018 May 30.

Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore.

Background: The ideal emergency cricothyroidotomy technique remains a topic of ongoing debate. This study aimed to compare the cannula-to-Melker technique with the scalpel-bougie technique and determine whether yearly training in cricothyroidotomy techniques is sufficient for skill retention.

Methods: We conducted an observational crossover bench study to compare the cannula-to-Melker with the scalpel-bougie technique in a porcine tracheal model. Read More

Zhonghua Yi Xue Za Zhi 2018 May;98(18):1424-1429

Department of Anesthesiology, Yuyao People's Hospital of Zhejiang Province, Yuyao 315400, China.

By observing the clinical effect of ultrasound, fiberoptic bronchoscopy and traditional standard in positioning the general anesthesia of laryngeal mask ventilation in elderly patients, the superiority of laryngeal mask positioning with visualization technique of ultrasound and fiberoptic bronchoscope on airway management in elderly patients with general anesthesia was analyzed. One hundred and twenty cases of elderly patients with general anesthesia of laryngeal mask ventilation from the People's Hospital of Yuyao city from October 2016 to October 2017 were selected and randomly divided into 3 groups(=40)according to American Society of Anesthesiologists (ASA) grading criteria Ⅰ-Ⅲ. Group A: traditional standard positioning laryngeal mask group. Read More

Anaesth Crit Care Pain Med 2018 Dec 23;37(6):639-651. Epub 2018 May 23.

Department of anaesthesia and intensive care, centre hospitalier universitaire de Bordeaux, université de Bordeaux, 33000 Bordeaux, France.

Objective: To provide an update to French guidelines about "Difficult intubation and extubation in adult anaesthesia 2006".

Design: A consensus committee of 13 experts was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. Read More

Br J Anaesth 2018 Jun 4;120(6):1381-1393. Epub 2018 Apr 4.

Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Cohort studies have indicated that avoidance of neuromuscular blocking agents (NMBA) is a risk factor for difficult tracheal intubation. However, the impact of avoiding NMBA on tracheal intubation, possible adverse effects, and postoperative discomfort has not been evaluated in a systematic review of randomised trials. We searched several databases for trials published until January 2017. Read More

Cochrane Database Syst Rev 2018 05 15;5:CD008874. Epub 2018 May 15.

Department of Emergency Medicine, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria, A-1090.

Background: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Read More

Rev Bras Ter Intensiva 2018 Mar;30(1):86-97

Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, Buenos Aires, Argentina.

Instrumentation of the airways in critical patients (endotracheal tube or tracheostomy cannula) prevents them from performing their function of humidify and heating the inhaled gas. In addition, the administration of cold and dry medical gases and the high flows that patients experience during invasive and non-invasive mechanical ventilation generate an even worse condition. For this reason, a device for gas conditioning is needed, even in short-term treatments, to avoid potential damage to the structure and function of the respiratory epithelium. Read More

Br J Neurosurg 2018 Apr 28:1-5. Epub 2018 Apr 28.

b Departmrnt of Neurological Surgery , Nippon Medical School , Tokyoto , Japan.

Objective: This study was performed to identify risk factors for neck haematoma requiring re-exploration after carotid endarterectomy. Neck haematoma is a well-known complication after carotid endarterectomy, but there has been little discussion about intraoperative techniques for its prevention. We also investigated an intraoperative neck flexion technique for prevention of neck haematoma. Read More

J Korean Med Sci 2018 Apr 30;33(17):e77. Epub 2018 Jan 30.

Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Background: Standardized postoperative airway management is essential for patients undergoing anterior cervical spine surgery (ACSS). The paucity of clinical series evaluating these airway complications after ACSS has been resulted in a significant limitation in statistical analyses.

Methods: A retrospective cohort study was performed regarding airway distress (intubation for more than 24 hours or unplanned reintubation within 7 days of operation) developed after ACSS. Read More

J Emerg Med 2018 07 22;55(1):e15-e18. Epub 2018 Apr 22.

Service de Réanimation Polyvalente, CHU La Réunion site Félix Guyon, Allée des Topazes, Saint Denis de La Réunion, France.

Background: Iatrogenic tracheal rupture is a rare but life-threatening complication. If suspected by clinical examination or chest radiograph, a computed tomography scan can confirm the diagnosis, but the criterion standard is a bronchoscopy. There is no consensus on its management. Read More

Anesth Analg 2018 Aug;127(2):450-454

Harborview Medical Center, Seattle, Washington.

Background: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Read More

A A Pract 2018 Sep;11(6):151-154

From the Departments of Anesthesiology.

This case describes a parturient with Barnes syndrome, a rare disorder characterized by subglottic stenosis, thoracic dystrophy, and small pelvic inlet, who underwent cesarean delivery of a neonate diagnosed with Barnes syndrome. Live simulation training was performed by multidisciplinary team to prepare for the spinal anesthetic, personnel flow between 2 operating rooms, and management of various airway scenarios for the newborn. After delivery, the neonate underwent laryngoscopy-bronchoscopy with successful intubation in the operating room because of labored breathing. Read More

Thorac Surg Clin 2018 May;28(2):219-226

The Canadian Medical Protective Association, PO Box 8225, Station T, Ottawa, ON K1G3H7, Canada. Electronic address:

The ability to remove longer segments of airway and to extend resections into the larynx proper has managed to create novel situations that will require attention to postoperative management. This article deals with prophylactic measures to prevent the requirement of assisted ventilation. It, however, also emphasizes various bronchoscopic and intubation techniques, which if required, will help to avoid trauma to the airway anastomosis. Read More