Base de dados : MEDLINE
Pesquisa : E02.041.750 [Categoria DeCS]
Referências encontradas : 6217 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 622 ir para página                         

  1 / 6217 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29287888
[Au] Autor:Espahbodi M; Yan K; Chun RH; McCormick ME
[Ad] Endereço:Medical College of Wisconsin, Department of Otolaryngology & Communication Sciences, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. Electronic address: mespahbodi@gmail.com.
[Ti] Título:Management trends of infantile hemangioma: A national perspective.
[So] Source:Int J Pediatr Otorhinolaryngol;104:84-87, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The primary management of infantile hemangioma (IH) has changed since 2008, with the initiation of propranolol. The change that propranolol has affected on resource utilization is unknown. MATERIALS AND METHODS: The Kids' Inpatient Database (KID) in 2003, 2006, 2009, and 2012 was queried for ICD-9 codes for IH in children under age three. The number of patients undergoing the following procedures of interest: tracheostomy, tracheoscopy and laryngoscopy with biopsy, and excision of skin lesion were evaluated. Data was analyzed for demographics and details on the admission. Trends were identified. Weighted statistical analyses were performed with SAS 9.4. RESULTS: The number of qualified admissions significantly increased over the years (9271 in 2003-12029 in 2012, OR 1.042 per year increase, p < 0.001). The mean age at admission ranged from 26 to 28 days but did not vary over time (p = 0.54). The percentage undergoing tracheostomy significantly decreased from 1.05% in 2003 to 0.27% in 2012 (p = 0.0055), and the percentage undergoing tracheoscopy and laryngoscopy with biopsy significantly decreased from 7.29% in 2003 to 4.20% in 2012 (p = 0.011) among those with IH of unspecified or other sites. The percentage undergoing skin lesion excision also significantly decreased from 1.87% in 2003 to 1.03%, in 2012 (p = 0.0038) among those with IH of skin and subcutaneous tissue. These findings suggest a potential impact of propranolol. After adjusting for inflation, the total hospital charges increased from a mean of $17,838 in 2003 to an adjusted mean of $41,306 in 2012 (p < 0.0001). CONCLUSIONS: Total admissions and hospital charges in children with IH has increased from 2003 to 2012. The percentage of patients undergoing tracheostomy, tracheoscopy and laryngoscopy with biopsy, and skin lesion excision significantly decreased in 2012 compared to 2003, suggesting a potential impact of propranolol. Further studies are needed to examine these changes more closely.
[Mh] Termos MeSH primário: Biópsia/tendências
Endoscopia/tendências
Hemangioma/cirurgia
Traqueostomia/tendências
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Bases de Dados Factuais
Feminino
Hemangioma/tratamento farmacológico
Preços Hospitalares
Hospitalização/estatística & dados numéricos
Seres Humanos
Lactente
Classificação Internacional de Doenças
Tempo de Internação
Masculino
Propranolol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9Y8NXQ24VQ (Propranolol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


  2 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28470921
[Au] Autor:Swol J; Strauch JT; Schildhauer TA
[Ad] Endereço:Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital Würzburg, Germany.
[Ti] Título:Tracheostomy as a bridge to spontaneous breathing and awake-ECMO in non-transplant surgical patients.
[So] Source:Eur J Heart Fail;19 Suppl 2:120-123, 2017 May.
[Is] ISSN:1879-0844
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The tracheostomy is a frequently used procedure for the respiratory weaning of ventilated patients allows sedation free ECLS use in awake patient. The aim of this study is to assess the possibility and highlight the benefits of lowering the impact of sedation in surgical non-transplant patients on ECLS. The specific objective was to investigate the use of tracheostomy as a bridge to spontaneous breathing on ECLS. METHODS AND RESULTS: Of the 95 patients, 65 patients received a tracheostomy, and 5 patients were admitted with a tracheostoma. One patient was cannulated without intubation, one is extubated during ECLS course after 48 hours. 4 patients were extubated after weaning and the removal of ECLS. 19 patients died before the indication to tracheostomy was given. CONCLUSION: Tracheostomy can bridge to spontaneous breathing and awake-ECMO in non-transplant surgical patients. The "awake ECMO" strategy may avoid complications related to mechanical ventilation, sedation, and immobilization and provide comparable outcomes to other approaches for providing respiratory support.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea
Respiração Artificial/métodos
Respiração
Insuficiência Respiratória/terapia
Traqueostomia/métodos
Desmame do Respirador/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1002/ejhf.856


  3 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28468151
[Au] Autor:Pickrell BB; Meaike JD; Cañadas KT; Chandy BM; Buchanan EP
[Ad] Endereço:*Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine †Department of Otolaryngology, Texas Children's Hospital, Houston, TX.
[Ti] Título:Tracheal Cartilaginous Sleeve in Syndromic Craniosynostosis: An Underrecognized Source of Significant Morbidity and Mortality.
[So] Source:J Craniofac Surg;28(3):696-699, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Tracheal cartilaginous sleeve (TCS) is a rare and previously unrecognized source of morbidity and mortality in patients with certain craniosynostosis syndromes. There is a paucity of reporting on this airway anomaly, and the true incidence of TCS is largely unknown. The purpose of this study was to investigate the incidence of TCS among patients with syndromic craniosynostosis at our institution. Patients with syndromic craniosynostosis who underwent direct bronchoscopy and laryngoscopy were evaluated retrospectively by pediatric otolaryngologists for the presence of TCS and associated anomalies. Among patients with a diagnosis of syndromic craniosynostosis in our craniofacial database, 10 (37%) were found to have previous direct bronchoscopy and laryngoscopy reports. Of these 10 patients, 2 had Crouzon syndrome, 3 had Pfeiffer syndrome, 3 had Apert syndrome, 1 had Muenke syndrome, and 1 had Antley-Bixler syndrome. Eighty percent (8/10) of these patients were found to have some evidence of TCS. The most commonly observed associated findings included the following: tracheostomy dependency (7/10; 70%), hearing loss (6/10; 60%), obstructive sleep apnea (5/10; 50%), cervical spine anomalies (5/10; 50%), developmental delay (5/10; 50%), and enlarged cerebral ventricles (4/10; 40%). Larger multicenter studies are required to further characterize this airway anomaly and its impact on this patient population. Our results confirm the importance of thorough airway evaluation at initial presentation and the need for validated screening protocols.
[Mh] Termos MeSH primário: Anormalidades Múltiplas
Cartilagem/anormalidades
Craniossinostoses/diagnóstico
Apneia Obstrutiva do Sono/epidemiologia
Traqueia/anormalidades
Doenças da Traqueia/congênito
[Mh] Termos MeSH secundário: Cartilagem/cirurgia
Criança
Pré-Escolar
Craniossinostoses/epidemiologia
Craniossinostoses/cirurgia
Feminino
Seres Humanos
Masculino
Morbidade/tendências
Estudos Retrospectivos
Apneia Obstrutiva do Sono/etiologia
Apneia Obstrutiva do Sono/cirurgia
Taxa de Sobrevida/tendências
Traqueia/cirurgia
Doenças da Traqueia/diagnóstico
Doenças da Traqueia/epidemiologia
Traqueostomia/métodos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003489


  4 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28457142
[Au] Autor:Ceriana P; Surbone S; Segagni D; Schreiber A; Carlucci A
[Ad] Endereço:a Pulmonary Rehabilitation Unit, IRCCS Istituti Clinici Scientifici Maugeri , Pavia , Italy.
[Ti] Título:Decision-making for tracheostomy in amyotrophic lateral sclerosis (ALS): a retrospective study.
[So] Source:Amyotroph Lateral Scler Frontotemporal Degener;18(7-8):492-497, 2017 Nov.
[Is] ISSN:2167-9223
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: ALS patients should discuss the issue of tracheostomy before the onset of terminal respiratory failure. While the process of shared decision-making is desirable, there are few data on the practical application of this real-life situation. AIM OF THE STUDY: To determine how a decision-making process is actually carried out, we analysed the episodes of acute respiratory failure preceding tracheostomy. METHODS: We studied the charts of a group of ALS patients after tracheostomy. An interview focusing on the existence of anticipated directives was carried out. Tracheostomies were classified as planned or unplanned according to the presence of a decision plan. RESULTS: A total of 209 ALS patients were cared for during a three-year period. Of these patients, 34 (16%) were tracheotomised. In 38% of cases, tracheostomy was planned, 41% were unplanned, and 21% remained undiagnosed. CONCLUSIONS: A minority of ALS patients make a voluntary decision for tracheostomy before the procedure is conducted. The advising process of care still presents limits that have been thus far poorly addressed. In the future, we will need to develop guidelines for the timing and content of the shared-decision making process.
[Mh] Termos MeSH primário: Esclerose Amiotrófica Lateral/epidemiologia
Esclerose Amiotrófica Lateral/cirurgia
Tomada de Decisão Clínica
Preferência do Paciente/estatística & dados numéricos
Insuficiência Respiratória/epidemiologia
Insuficiência Respiratória/cirurgia
Traqueostomia/utilização
[Mh] Termos MeSH secundário: Esclerose Amiotrófica Lateral/psicologia
Comorbidade
Tomada de Decisões
Feminino
Seres Humanos
Itália/epidemiologia
Masculino
Meia-Idade
Preferência do Paciente/psicologia
Prevalência
Insuficiência Respiratória/psicologia
Estudos Retrospectivos
Medição de Risco/métodos
Traqueostomia/psicologia
Revisão da Utilização de Recursos de Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1080/21678421.2017.1317812


  5 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28459759
[Au] Autor:Goff D
[Ad] Endereço:Department of Speech, Voice and Swallowing, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK.
[Ti] Título:Managing dysphagia in trachesotomized patients: where are we now?
[So] Source:Curr Opin Otolaryngol Head Neck Surg;25(3):217-222, 2017 Jun.
[Is] ISSN:1531-6998
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: Tracheostomized patients are medically complex and vulnerable. International attention is now focused on improving the safety and quality of their care. This review summarizes recent evidence in hot-topic areas pertinent to speech and language therapy (SLT) intervention for dysphagia management in tracheostomized patients. RECENT FINDINGS: The management of tracheostomized patients requires a truly multidisciplinary team (MDT) approach. Without this, patients remain tracheostomized and hospitalized for longer and have slower access to MDT members. Patterns of SLT intervention are variable across the United Kingdom, and further work to achieve consensus on best practice is required. Instrumental evaluation of swallowing provides vital information and can facilitate well tolerated oral feeding even prior to cuff deflation. A systematic review suggests that sensitivity of blue-dye testing is poor, but studies are methodologically flawed. The need for tracheostomy-specific quality of life measures is being addressed by the development of a questionnaire. SUMMARY: In this review, the main research themes relevant to speech and language therapists (SLTs) working with tracheostomized patients are discussed. This patient group poses significant challenges to robust study design. However, recent advances in uniting MDT members globally to improve standards of care are encouraging.
[Mh] Termos MeSH primário: Transtornos de Deglutição/etiologia
Transtornos de Deglutição/terapia
Traqueostomia/efeitos adversos
[Mh] Termos MeSH secundário: Seres Humanos
Equipe de Assistência ao Paciente
Qualidade de Vida
Fonoterapia
Inquéritos e Questionários
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1097/MOO.0000000000000355


  6 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29224771
[Au] Autor:Propst EJ
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, 6th Floor, Burton Wing, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Electronic address: Evan.propst@utoronto.ca.
[Ti] Título:Revision repair of type IV laryngotracheoesophageal cleft using multiple long tapered engaging grafts.
[So] Source:Int J Pediatr Otorhinolaryngol;103:80-82, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:An 8 year-old female with esophageal atresia and a type IV laryngotracheoesophageal cleft underwent tracheostomy, gastric pull-up and fundoplication with G-tube insertion at birth. She remained nil per os due to aspiration. The trachealis was separated from the esophagus that was reapproximated and clavicular periosteum was placed. A long posterior costal cartilage graft that engaged behind the cricoid plate and tapered inferiorly was inserted. A second thin cartilage graft was sutured to it distally to extend the length of the repair. This allowed for removal of the tracheostomy and oral feeding while providing a four-layer closure to prevent aspiration.
[Mh] Termos MeSH primário: Atresia Esofágica/cirurgia
Esôfago/anormalidades
Procedimentos Cirúrgicos Reconstrutivos/métodos
Traqueia/anormalidades
[Mh] Termos MeSH secundário: Criança
Anormalidades Congênitas
Endoscopia
Atresia Esofágica/complicações
Esôfago/cirurgia
Feminino
Fundoplicatura
Seres Humanos
Laringe/anormalidades
Reoperação/métodos
Traqueia/cirurgia
Traqueostomia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


  7 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29180211
[Au] Autor:Maizlin II; Shroyer MC; Beierle EA; Chen MK; Russell RT
[Ad] Endereço:Division of Pediatric Surgery, Children's Hospital of Alabama, University of Alabama, Birmingham, Alabama. Electronic address: ilan.maizlin@childrensal.org.
[Ti] Título:Open versus laparoscopic approach to gastric fundoplication in children with cardiac risk factors.
[So] Source:J Surg Res;220:52-58, 2017 Dec.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gastric fundoplication is the most common noncardiac operation in children with congenital cardiac disease. While prior studies validated safety of laparoscopy in this population, we hypothesize that children with cardiac risk factors (CRFs) are likelier to undergo open fundoplication (OF) but experience greater morbidity than after laparoscopic fundoplication (LF). MATERIALS AND METHODS: Utilizing 2013 National Surgical Quality Improvement Program-Pediatrics Public-Use-File, pediatric patients undergoing LF and OF were stratified to none, minor, major, or severe CRFs. Multivariate logistic regression determined preoperative variables and postoperative outcomes associated with LF or OF. RESULTS: A total of 1501 fundoplication patients were identified with 92% undergoing LF. OF patients were likelier to have minor (odds ratio [OR]: 2.36, P < 0.001), major (OR: 2.41, P = 0.003), and severe CRFs (OR: 4.36, P < 0.001). Children ≤ 1 y (OR: 3.38, P = 0.048) and those with tracheostomy were likelier to have OF (OR: 2.3, P = 0.006). Overall, the OF group had higher postoperative morbidity (OR: 2.41, P < 0.001). Specifically, children with minor or major CRFs experienced more complications following OF compared to LF. CONCLUSIONS: OF is more common in patients ≤1 y old; patients with minor, major, or severe CRFs; and those with tracheostomy. LF should be considered in children with minor and major CRFs, as OF in those patients results in greater pulmonary, infectious, and hematological sequelae.
[Mh] Termos MeSH primário: Fundoplicatura/métodos
Refluxo Gastroesofágico/cirurgia
Cardiopatias Congênitas/complicações
Laparoscopia/métodos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Fundoplicatura/efeitos adversos
Refluxo Gastroesofágico/etiologia
Cardiopatias Congênitas/cirurgia
Seres Humanos
Lactente
Masculino
Morbidade
Estudos Retrospectivos
Fatores de Risco
Traqueostomia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  8 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28973088
[Au] Autor:Yarnell CJ; Fu L; Manuel D; Tanuseputro P; Stukel T; Pinto R; Scales DC; Laupacis A; Fowler RA
[Ad] Endereço:University of Toronto Department of Medicine, Toronto, Ontario, Canada.
[Ti] Título:Association Between Immigrant Status and End-of-Life Care in Ontario, Canada.
[So] Source:JAMA;318(15):1479-1488, 2017 10 17.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: People who immigrate face unique health literacy, communication, and system navigation challenges, and they may have diverse preferences that influence end-of-life care. Objective: To examine end-of-life care provided to immigrants to Canada in the last 6 months of their life. Design, Setting, and Participants: This population-based cohort study (April 1, 2004, to March 31, 2015) included 967 013 decedents in Ontario, Canada, using validated linkages between health and immigration databases to identify immigrant (since 1985) and long-standing resident cohorts. Exposures: All decedents who immigrated to Canada between 1985 and 2015 were classified as recent immigrants, with subgroup analyses assessing the association of time since immigration, and region of birth, with end-of-life care. Main Outcomes and Measures: Location of death and intensity of care received in the last 6 months of life. Analysis included modified Poisson regression with generalized estimating equations, adjusting for age, sex, socioeconomic position, causes of death, urban and rural residence, and preexisting comorbidities. Results: Among 967 013 decedents of whom 47 514 (5%) immigrated since 1985, sex, socioeconomic status, urban (vs rural) residence, and causes of death were similar, while long-standing residents were older than immigrant decedents (median [interquartile range] age, 75 [58-84] vs 80 [68-87] years). Recent immigrant decedents were overall more likely to die in intensive care (15.6% vs 10.0%; difference, 5.6%; 95% CI, 5.2%-5.9%) after adjusting for differences in age, sex, income, geography, and cause of death (relative risk, 1.30; 95% CI, 1.27-1.32). In their last 6 months of life, recent immigrant decedents experienced more intensive care admissions (24.9% vs 19.2%; difference, 5.7%; 95% CI, 5.3%-6.1%), hospital admissions (72.1% vs 68.2%; difference, 3.9%; 95% CI, 3.5%-4.3%), mechanical ventilation (21.5% vs 13.6%; difference, 7.9%; 95% CI, 7.5%-8.3%), dialysis (5.5% vs 3.4%; difference, 2.1%; 95% CI, 1.9%-2.3%), percutaneous feeding tube placement (5.5% vs 3.0%; difference, 2.5%; 95% CI, 2.3%-2.8%), and tracheostomy (2.3% vs 1.1%; difference, 1.2%; 95% CI, 1.1%-1.4%). Relative risk of dying in intensive care for recent immigrants compared with long-standing residents varied according to recent immigrant region of birth from 0.84 (95% CI, 0.74-0.95) among those born in Northern and Western Europe to 1.96 (95% CI, 1.89-2.05) among those born in South Asia. Conclusions and Relevance: Among decedents in Ontario, Canada, recent immigrants were significantly more likely to receive aggressive care and to die in an intensive care unit compared with other residents. Further research is needed to understand the mechanisms behind this association.
[Mh] Termos MeSH primário: Emigrantes e Imigrantes/estatística & dados numéricos
Assistência Terminal/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Ásia/etnologia
Causas de Morte
Estudos de Coortes
Cuidados Críticos/estatística & dados numéricos
Bases de Dados Factuais/estatística & dados numéricos
Diálise/utilização
Nutrição Enteral/utilização
Europa (Continente)/etnologia
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Unidades de Terapia Intensiva/utilização
Masculino
Meia-Idade
Ontário
Distribuição de Poisson
Respiração Artificial/utilização
Distribuição por Sexo
Fatores de Tempo
Traqueostomia/utilização
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.14418


  9 / 6217 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28958272
[Au] Autor:Lee SK; Rosenthal AA; Davare DL; Kiffin C; Sanchez R; Hurtado M; Carrillo EH
[Ti] Título:Inclusion of the Acute Care Surgeon in the Difficult Airway Protocol: A Nine-Year Experience.
[So] Source:Am Surg;83(9):943-946, 2017 Sep 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality. Our protocol involves early coordination between anesthesia and the Acute Care Surgery/Trauma Service for patients with a potentially difficult airway. If anesthesia is unable to intubate the patient, a surgical airway is performed. Patients are preemptively taken to the operating room (OR) if stable for transport. There were 43 surgical airways performed during the study period. All patients had a failed attempt with oral endotracheal intubation. The most common factors associated with these patients were history of tracheostomy, angioedema, or difficult anatomy. Nineteen (44%) of the surgical airways were performed in the OR. Three deaths (7%) occurred from cardiac or respiratory arrest despite the emergency procedure. No immediate deaths occurred in the patients taken to the OR. Early coordination in patients with a difficult airway is another hospital resource that the acute care surgeon can provide to improve patient outcomes.
[Mh] Termos MeSH primário: Manuseio das Vias Aéreas
Protocolos Clínicos
Cuidados Críticos
Serviços Médicos de Emergência
[Mh] Termos MeSH secundário: Seres Humanos
Intubação Intratraqueal
Respiração Artificial
Estudos Retrospectivos
Fatores de Risco
Traqueostomia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE


  10 / 6217 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28885335
[Au] Autor:Chang HY; Man KM; Liao KH; Chiang YY; Chen KB
[Ad] Endereço:aDepartment of Anesthesiology of China Medical University Hospital bDepartment of Life Sciences, National Chung Hsing University cChina Medical University Hospital, Taichung, Taiwan.
[Ti] Título:Rescue patient from tracheal obstruction by dislocated bronchial stent during tracheostomy surgery with readily available tools: A case report.
[So] Source:Medicine (Baltimore);96(36):e7841, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Airway stenting is a well-established method that relieves symptoms and maintains airway patency in patients with airway obstruction. Serious complications caused by airway stents such as stent dislocation and airway obstruction during surgery are life-threatening. PATIENT CONCERNS: An 80-year-old man was treated with bronchial stent for left bronchus obstruction caused by metastatic esophageal cancer. During tracheostomy surgery, he suffered from acute tracheal obstruction caused by dislocated bronchial stent. DIAGNOSES: Esophageal cancer, left bronchus obstruction, respiratory failure, tracheal obstruction. INTERVENTIONS: Threading a 5.0-sized endotracheal tube combined with an Eschmann tracheal tube introducer to prop up the collapsed stent. OUTCOMES: The bronchial stent was re-expanded and threaded into right main bronchus and ventilation restored. LESSONS: Patient with airway stent undergoing surgery with airway involved should be performed under the support of a backup physician and equipment that are capable of handling potentially life-threatening complications of airway stent. If not, in the emergent situation of tracheal obstruction due to tracheal/bronchial stent, protruding through the stent with a suitable, small-sized endotracheal tube with Eschmann tracheal tube introducer may be an alternative skill for saving life weighted with possible complications.
[Mh] Termos MeSH primário: Obstrução das Vias Respiratórias/etiologia
Stents/efeitos adversos
Traqueostomia/efeitos adversos
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007841



página 1 de 622 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde