8,664 results match your criteria difficult airway

Difficult Central Venous Cannulation under Laryngeal Mask Airway Anesthesia in Adolescent.

Kathmandu Univ Med J (KUMJ) 2020 Oct.-Dec.;18(72):428-429

Department of Anesthesia, Aga Khan University, Stadium Road, Karachi, Pakistan.

We report a case of difficult central venous cannulation under general anesthesia with laryngeal mask airway in a young female child. Our case demonstrated a difficulty in surgically finding the right internal jugular vein due to neck veins displacements by laryngeal mask airway, which caused morbidity such as prolonged surgical duration and excessive blood loss. Once the laryngeal mask airway was replaced with endotracheal tube, the internal jugular vein appeared on surface and procedure was successfully completed in a few minutes. Read More

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Airway events in obese vs. non-obese elective surgical patients: a cross-sectional observational study.

Anaesthesia 2021 Jun 22. Epub 2021 Jun 22.

University College Hospital London, London, UK.

Obesity is an increasingly prevalent comorbidity within the UK population. The aim of this study was to determine the proportion of obese patients in an elective surgical population. The second aim was to determine the choice of airway equipment and incidence of airway events in obese vs. Read More

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Multivariable prediction models for difficult direct laryngoscopy: Systematic review and literature metasynthesis.

Rev Esp Anestesiol Reanim 2021 Jun 18. Epub 2021 Jun 18.

Departamento de Medicina Interna, Universidad Nacional de Colombia, Bogotá, Colombia.

Context: The difficult airway is an important scenario in anaesthesia due to the impact of its potential complications, and the difficulty in predicting its presence in current clinical practice.

Methods: Systematic review of articles in English and Spanish retrieved from MEDLINE (Ovid), LILACS and Embase up to March 2018. The search strategy was defined by the authors. Read More

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Differential effects of acute cerebellectomy on cough in spontaneously breathing cats.

PLoS One 2021 21;16(6):e0253060. Epub 2021 Jun 21.

Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, United States of America.

The role of the cerebellum in controlling the cough motor pattern is not well understood. We hypothesized that cerebellectomy would disinhibit motor drive to respiratory muscles during cough. Cough was induced by mechanical stimulation of the tracheobronchial airways in anesthetized, spontaneously breathing adult cats (8 male, 1 female), and electromyograms (EMGs) were recorded from upper airway, chest wall, and abdominal respiratory muscles. Read More

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Emergency Airway Management Outside the Operating Room: Current Evidence and Management Strategies.

Anesth Analg 2021 Jun 21. Epub 2021 Jun 21.

Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Emergency airway management outside the operating room (OR) is often associated with an increased risk of airway related, as well as cardiopulmonary, complications which can impact morbidity and mortality. These emergent airways may take place in the intensive care unit (ICU), where patients are critically ill with minimal physiological reserve, or other areas of the hospital where advanced equipment and personnel are often unavailable. As such, emergency airway management outside the OR requires expertise at manipulation of not only the anatomically difficult airway but also the physiologically and situationally difficult airway. Read More

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Pre-hospital emergency anaesthesia in trauma patients treated by anaesthesiologist and nurse anaesthetist staffed critical care teams.

Acta Anaesthesiol Scand 2021 Jun 21. Epub 2021 Jun 21.

Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden.

Background: Prehospital tracheal intubation in trauma patients has recently been questioned. However, not only the trauma and patient characteristics but also airway provider competence differ between systems making simplified statements difficult.

Method: The study is a subgroup analysis of trauma patients included in the PHAST study. Read More

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Physiological Factors Affecting Lung Deposition.

Chong S Kim

J Aerosol Med Pulm Drug Deliv 2021 Jun;34(3):147-154

Senior Research Scientist, Public Health and Integrated Tocxicology Division, Center for Public Health and Environmental Effects, U.S. Environmental Protection Agency, Reserach Triangle Park, North Carolina, USA.

Ventilation and mechanics of breathing are an integral part of respiratory physiology that directly affect aerosol transport and deposition in the lung. Although natural breathing pattern varies widely among individuals, breathing pattern is controllable, and by using an appropriate breathing pattern, aerosol deposition can be substantially modified for desired purposes. Effects of breathing pattern have been investigated under carefully controlled inhalation conditions covering a wide range of tidal volumes (V) and breathing frequencies (f) or respiratory times (T = 1/f). Read More

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Pulmonary complications in children with Down syndrome: A scoping review.

Paediatr Respir Rev 2021 May 5. Epub 2021 May 5.

Department of Pediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium; Laboratory of Experimental Medicine and Pediatrics (LEMP), Antwerp University, Belgium.

Context: Down syndrome (DS) is a prevalent chromosomal disorder associated with a wide range of congenital anomalies and other health problems.

Objectives: To give a scoping overview of encountered lower airway problems (both infectious and non-infectious) in DS children.

Data Sources: We systematically searched the MEDLINE and PubMed databases for relevant publications. Read More

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Difficult airway due to angioedema caused after 14 years of taking enalapril.

Rev Esp Anestesiol Reanim 2021 Jun 17. Epub 2021 Jun 17.

Departamento de Anestesiología, Hospital Universitario Vall d'Hebron, Barcelona, España. Electronic address:

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A review of significance of Aspergillus detection in airways of ICU COVID-19 patients.

Mycoses 2021 Jun 18. Epub 2021 Jun 18.

Parasitology-Mycology Unit, Faculty of Medicine, Paris University, European Georges-Pompidou Hospital, Paris, France.

It is now well known that patients with SARS-CoV-2 infection admitted in ICU and mechanically ventilated are at risk of developing invasive pulmonary aspergillosis (IPA). Nevertheless, symptomatology of IPA is often atypical in mechanically ventilated patients and radiological aspects in SARS CoV-2 pneumonia and IPA are difficult to differentiate. In this context, the significance of the presence of Aspergillus in airway specimens (detected by culture, galactomannan antigen, or specific PCR) remains to be fully understood. Read More

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Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient.

Can J Anaesth 2021 Jun 18. Epub 2021 Jun 18.

Department of Emergency Medicine, QEII Health Sciences Centre, Dalhousie University, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada.

Purpose: Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the literature on airway management has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This first of two articles addresses difficulty encountered with airway management in an unconscious patient. Read More

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Difficult airway by hematoma of the thongue in a patient on anticoagulant therapy.

L España Fuente

Rev Esp Anestesiol Reanim (Engl Ed) 2021 May 11;68(5):306-307. Epub 2021 May 11.

Servicio de Anestesiología y Reanimación, Hospital Universitario San Agustín, Avilés, Asturias, Spain. Electronic address:

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Difficult airway in a patient with lymphoma. A case report.

Rev Esp Anestesiol Reanim (Engl Ed) 2021 May 11;68(5):297-300. Epub 2021 May 11.

Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

A 86-year-old male patient, diagnosed with lymphoma, was scheduled for a submaxillectomy to choose his best chemotherapy treatment. He referred recent voice changes and laterocervical adenopathies without respiratory symptoms. There were no additional risk predictors in preoperative airway assessment. Read More

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Real-time ultrasound-guided epidural anesthesia for cesarean section in a parturient with achondroplasia.

J Int Med Res 2021 Jun;49(6):3000605211023701

Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Achondroplasia is a type of disproportionate dwarfism with short limbs and a normal-sized torso. This condition results in a potential spinal abnormality and a difficult airway may increase the anesthetic risk, not only in neuraxial anesthesia, but also in general anesthesia. We report a 25-year-old primigravida with achondroplasia who underwent cesarean section under epidural anesthesia with the assistance of real-time ultrasound guidance. Read More

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Ratios of Height to Thyromental Distance and Height to Sternomental Distance as Predictors of Difficult Airway in Patients Posted for General Anaesthesia.

Asian J Anesthesiol 2021 Jun 15:1-7. Epub 2021 Jun 15.

Department of Anesthesiology, BLDE (Deemed to be University), Shri B. M. Patil Medical College Hospital and Research Center, Vijayapura, India.

Background: Preoperative airway assessment and anticipation of a difficult airway is of utmost critical value in anaesthesiology as failure to secure airway can lead to morbidity and mortality. The study evaluated ratio of height-to-thyromental distance (RHTMD) and ratio of height-to-sternomental distance (RHSMD) as predictors of a difficult airway.

Methods: The prospective observational study evaluated 131 adult participants scheduled for elective surgery under general anaesthesia. Read More

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Report of two cases of endobronchial tumour mass resection in children.

Can J Anaesth 2021 Jun 14. Epub 2021 Jun 14.

Department of Pediatric Anesthesia, Montreal Children's Hospital, 1001 Blvd Decarie, Montreal, QC, H4A 3J1, Canada.

Purpose: Anesthesia for endotracheal tumour mass resection in pediatric patients is a rare, complex, and high-risk procedure. The purpose of this case report is to emphasize the importance of multidisciplinary team collaboration and close communication during the perioperative management of shared airway surgery.

Clinical Features: A six-year-old boy with no previous history of comorbidity and a 13-yr-old boy with a six-month history of upper respiratory tract infection, refractory asthma, chronic wheeze, and exercise-related dyspnea presented for acute endobronchial tumour mass resection. Read More

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Useful Ultrasonographic Parameters to Predict Difficult Laryngoscopy and Difficult Tracheal Intubation-A Systematic Review and Meta-Analysis.

Front Med (Lausanne) 2021 28;8:671658. Epub 2021 May 28.

School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.

Unexpected difficult airway management can cause significant morbidity and mortality in patients admitted for elective procedures. Ultrasonography is a promising tool for perioperative airway assessment, nevertheless it is still unclear which sonographic parameters are useful predictors of difficult laryngoscopy and tracheal intubation. To determine the ultrasonographic predictors of a difficult airway that could be applied for routine practice, a systematic review and meta-analysis was conducted. Read More

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Arterial Infusion Chemotherapy for Neoplastic Esophagogastric Anastomotic Strictures After Esophagectomy.

Front Oncol 2021 26;11:668593. Epub 2021 May 26.

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Background: Neoplastic esophagogastric anastomotic strictures after resection of esophageal cancer is a very difficult problem in clinical practice. We aim at to investigate the safety and feasibility of arterial infusion chemotherapy in treatment of neoplastic esophagogastric anastomotic strictures after esophagectomy.

Methods: From October 2014 to December 2019, 50 patients with Neoplastic esophagogastric anastomotic strictures after resection of esophageal cancer were assessed retrospectively. Read More

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Difficult tracheal extubation due to endotracheal tube malfunction: A challenge during the COVID-19 pandemic.

J Taibah Univ Med Sci 2021 Jun 8. Epub 2021 Jun 8.

Department of Surgery, National Hospital, Abuja, Nigeria.

Tracheal extubation is an aerosol-generating medical procedure. A difficult tracheal extubation results in a serious complication that increases the risk of respiratory aerosol and pathogen spread, especially during the COVID-19 pandemic. The management of difficult extubation is potentially even more challenging during the pandemic. Read More

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Clinicians' Perception of Time - Implications for Difficult Airway Management.

Anaesth Crit Care Pain Med 2021 Jun 9:100899. Epub 2021 Jun 9.

Department of Control & Dynamics Caltech Pasadena, CA, USA.

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Impact of Physician Training Level on Neonatal Tracheal Intubation Success Rates and Adverse Events: A Report from National Emergency Airway Registry for Neonates (NEAR4NEOS).

Neonatology 2021 Jun 10:1-9. Epub 2021 Jun 10.

Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

Introduction: Neonatal tracheal intubation (TI) outcomes have been assessed by role, but training level may impact TI success and safety. Effect of physician training level (PTL) on the first-attempt success, adverse TI-associated events (TIAEs), and oxygen desaturation was assessed.

Methods: Prospective cohort study in 11 international NEAR4NEOS sites between October 2014 and December 2017. Read More

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Ratio of height to thyromental distance: a comparison with mallampati and upper lip bite test for predicting difficult intubation in Pakistani population.

J Pak Med Assoc 2021 Jun;71(6):1570-1574

Departments of Anaesthesiology,Aga Khan University Hospital, Karachi.

Objective: To compare the accuracy of three diagnostic tests in predicting difficult laryngoscopy using Cormack and Lehane grade as the gold standard.

Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from August 2014 to August 2015, and comprised patients who required endotracheal intubation for elective surgical procedures. The primary investigator used ratio of height to thyromental distance, upper lip bite test and the modified Mallampati test for assessing the airway correlated with laryngoscopic view based on Cormack and Lehane grading. Read More

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Successful airway management with combined use of a McGRATH MAC videolaryngoscope and fiberoptic bronchoscope in a patient with congenital tracheal stenosis diagnosed in adulthood.

JA Clin Rep 2021 Jun 9;7(1):47. Epub 2021 Jun 9.

Department of Anesthesiology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan.

Background: Most patients with congenital tracheal stenosis (CTS) develop respiratory symptoms early in life. CTS remaining undiagnosed until adulthood is rare.

Case Presentation: A 51-year-old female was scheduled for cardiovascular surgery. Read More

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Anesthesia for Obstetric Disasters.

Adv Anesth 2020 Dec;38:229-250

Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA.

Over the past 30 years, maternal mortality has increased in the United States to 18 deaths per 100,000 live births. Obstetric emergencies, including hemorrhage, hypertensive disorders in pregnancy, HELLP syndrome, and amniotic fluid embolism, and anesthesia complications, including high neuraxial blockade, local anesthetic systemic toxicity, and the difficult obstetric airway, contribute to maternal cardiac arrest and maternal and fetal morbidity and mortality. Expeditious intervention by the obstetric anesthesiologist is critical in these emergent scenarios, and knowledge of best practices is essential to improve maternal and fetal outcomes. Read More

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December 2020

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 2. Planning and implementing safe management of the patient with an anticipated difficult airway.

Can J Anaesth 2021 Jun 8. Epub 2021 Jun 8.

Department of Anesthesia & Perioperative Medicine, Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, 339 Windermere Rd., LHSC- University Hospital, London, ON, N6A 5A5, Canada.

Purpose: Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the published airway management literature has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This second of two articles addresses airway evaluation, decision-making, and safe implementation of an airway management strategy when difficulty is anticipated. Read More

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Early diagnosis of diaphragm palsy after pediatric cardiac surgery and outcome after diaphragm plication - A single-center experience.

Ann Pediatr Cardiol 2021 Apr-Jun;14(2):178-186. Epub 2021 Feb 16.

Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.

Objective: The aims of our prospective observational study were to evaluate the (1) reliability of clinical signs in the early detection of diaphragm palsy (DP); (2) reliability of ultrasonography using echo machine as a bedside tool for the diagnosis of DP; and (3) does early diaphragm plication result in the improved outcome? We also sought to determine the incidence and predominant risk factors for DP and diaphragm plication at our center.

Materials And Methods: This prospective observational study included patients with suspected DP from January 2015 to December 2018. Patients with suspected DP were initially evaluated by bedside ultrasonography using echo machine and confirmed by fluoroscopy. Read More

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February 2021

Study comparing different airway assessment tests in predicting difficult laryngoscopy: A prospective study in geriatric patients.

Indian J Anaesth 2021 Apr 15;65(4):309-315. Epub 2021 Apr 15.

Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.

Background And Aims: Limited studies are available comparing diagnostic accuracy of various airway predictors in geriatric patients. We conducted this study with primary aim to evaluate and validate the predictive value of 'standard airway predictors' like modified Mallampati test, thyromental distance (TMD), sternomental distance, neck movement (NM), mouth opening (MO), dentition and 'new airway predictors' like upper lip bite test (ULBT), ratio of height to thyromental distance and thyromental height test (TMHT) for predicting difficult laryngoscopy in geriatric patients.

Methods: This prospective, observational study was conducted on 140 patients above 65 years of age of either sex, scheduled for elective surgery under general anaesthesia requiring endotracheal intubation. Read More

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Heparin-binding protein in lower airway samples as a biomarker for pneumonia.

Respir Res 2021 Jun 8;22(1):174. Epub 2021 Jun 8.

Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden.

Objectives: Ventilator-associated pneumonia (VAP) is difficult to diagnose using clinical criteria and no biomarkers have yet been proved to be sufficiently accurate. The use of the neutrophil-derived Heparin-binding protein (HBP) as a biomarker for pneumonia was investigated in this exploratory case-control study in two intensive care units at a tertiary referral hospital.

Methods: Patients with clinical signs of pneumonia were recruited and bronchoalveolar lavage fluid (BALF) or bronchial wash (BW) samples were collected. Read More

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Infrared flashing light through the cricothyroid membrane to guide flexible bronchoscopic tracheal intubation.

Anaesth Rep 2021 Jan-Jun;9(1):114-117. Epub 2021 Jun 1.

Department of Anaesthesiology Centre of Head and Orthopaedics, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark.

Flexible bronchoscopic tracheal intubation is a fundamental technique in the management of the difficult airway but requires specific skills which may be both difficult to achieve and maintain. Therefore, techniques to improve its success should be developed. We present two cases, one where the ear, nose and throat surgeon could not view the glottis due to laryngeal pathology, and one where pathology in the oropharynx obscured access to the trachea during attempts at flexible bronchoscopic and videolaryngoscopic tracheal intubation. Read More

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