检索结果-南通市图书馆

difficult airway due to cervical haemorrhage caused by spontaneous rupture of a parathyroid adenoma: A case report

World Journal of Clinical Cases 2023年第5期11卷 1217-1223页

作者： Yong-Zheng Han Yang Zhou Ying Peng Jin Zeng Yu-Qing Zhao Xiao-Ru Gao Hong Zeng Xiang-Yang Guo Zheng-Qian Li Department of Anesthesiology Peking University Third HospitalBeijing 100191China Beijing Center Quality Control and Improvement on Clinical AnesthesiaBeijing 100191China Department of General Surgery Peking University Third HospitalBeijing 100191China Department of Otorhinolaryngology Head and Neck Surgery Peking University Third HospitalBeijing 100191China Department of Radiology Peking University Third HospitalBeijing 100191China Department of Anesthesiology Haidian Maternal and Child Health Care HospitalBeijing 100191China

BACKGROUND Cervical haemorrhage due to spontaneous rupture of a parathyroid adenoma is a rare complication that may cause life-threatening acute airway compromise.CASE SUMMARY A 64-year-old woman was admitted to the hospital 1 day after the onset of right neck enlargement, local tenderness, head-turning difficulty, pharyngeal pain, and mild dyspnoea. Repeat routine blood testing showed a rapid decrease in the haemoglobin concentration, indicating active bleeding. Enhanced computed tomography images showed neck haemorrhage and a ruptured right parathyroid adenoma. The plan was to perform emergency neck exploration, haemorrhage removal, and right inferior parathyroidectomy under general anaesthesia. The patient was administered 50 mg of intravenous propofol, and the glottis was successfully visualised on video laryngoscopy. However, after the administration of a muscle relaxant, the glottis was no longer visible and the patient had a difficult airway that prevented mask ventilation and endotracheal intubation. Fortunately, an experienced anaesthesiologist successfully intubated the patient under video laryngoscopy after an emergency laryngeal mask placement. Postoperative pathology showed a parathyroid adenoma with marked bleeding and cystic changes. The patient recovered well without complications.CONCLUSION airway management is very important in patients with cervical haemorrhage. After the administration of muscle relaxants, the loss of oropharyngeal support can cause acute airway obstruction.Therefore, muscle relaxants should be administered with caution. Anaesthesiologists should pay careful attention to airway management and have alternative airway devices and tracheotomy equipment available.

关键词： Cervical haemorrhage Parathyroid adenoma Muscle relaxants difficult airway Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Unexpected difficult airway due to severe upper tracheal distortion:A case report

引用

World Journal of Clinical Cases 2022年第26期10卷 9348-9353页

作者： Jian-Wei Zhou Chuan-Guang Wang Gang Chen You-Fa Zhou Jia-Feng Ding Jia-Wei Zhang Department of Anesthesia The Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of Anesthesia Sir Run Run Shaw HospitalHangzhou 310016Zhejiang ProvinceChina Department of Urology The Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina

BACKGROUND difficult airway is a significant cause of anesthesia-associated death and disability.Currently,physical examinations of thyromental distance,mouth opening,Mafampaii classification,etc.combined with X-ray,computed tomography(CT),and other imaging technologies are mainly used to evaluate difficult airways.However,in many special cases,i.e.,emergency surgery,imaging examinations cannot be completed preoperatively.Such patients’airway can only be evaluated through general physical examination,which inevitably increases the likelihood of an unexpected difficult airway during anesthesia.CASE SUMMARY We report a rare case of difficult intubation because of severe upper trachea distortion after induction.Emergency holmium laser lithotripsy was performed under transurethral ureteroscopy because the patient had anuria for 4 d and a creatinine level of 890μmol/L.Due to the urgency of the condition,chest radiography or chest CT was not examined before surgery and the anesthesiologist did not evaluate the airway adequately,resulting in an unexpected difficult airway.CONCLUSION The incidence of tracheal malformation and tracheal stenosis is extremely low,but the risk of hypoxia and even death due to difficult airways is extremely high for such patients.It is recommended to complete preoperative imaging examinations of the airway.For life-threatening emergency patients,a pre-anesthesia reassessment should be performed and surgeons should be prepared to prevent and manage the difficult airway.

关键词： Tracheal distortion difficult airway Management Imaging examination Emergency

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

airway ultrasound for patients anticipated to have a difficult airway:Perspective for personalized medicine

引用

World Journal of Clinical Cases 2023年第9期11卷 1951-1962页

作者： Harumasa Nakazawa Kohji Uzawa Joho Tokumine Alan Kawarai Lefor Akira Motoyasu Tomoko Yorozu Department of Anesthesiology Kyorin University School of MedicineMitaka 181-8611TokyoJapan Department of Surgery Jichi Medical UniversityShimotsuke 329-0498TochigiJapan

airway ultrasound allows for precise airway evaluation,particularly for assessing the difficult airway and the potential for front of neck access.Many studies have shown that identification of the cricothyroid membrane by airway ultrasound is more accurate than digital palpation.However,no reports to date have provided clinical evidence that ultrasound identification of the cricothyroid membrane increases the success rate of cricothyroidotomy.This is a narrative review which describes patients with difficult airways for whom airway ultrasound may have been useful for clinical decision making.The role of airway ultrasound for the evaluation of difficult airways is summarized and an approach to the use of ultrasound for airway management is proposed.The goal of this review is to present practical applications of airway ultrasound for patients predicted to have a difficult airway and who undergo cricothyroidotomy.

关键词： airway ultrasound difficult airway Point-of-care ultrasound Cricothyroidotomy Intubation Mask ventilation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Expert consensus on difficult airway assessment

引用

Hepatobiliary Surgery and Nutrition 2023年第4期12卷 545-566页

作者： Ming Xia Wuhua Ma Mingzhang Zuo Xiaoming Deng Fushan Xue Denise Battaglini Vivek Aggarwal Giustino Varrassi Vladimir Cerny Ida Di Giacinto Rita Cataldo Daqing Ma Toru Yamamoto Martina Rekatsina Alessandro De Cassai Andrea Carsetti Marvin G.Chang Edwin Seet Daniel P.Davis Michael G.Irwin Yuguang Huang Hong Jiang Department of Anesthesiology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Anesthesiology The First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina Department of Anaesthesiology Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijingChina Department of Anesthesiology Plastic Surgery HospitalCAMS and PUMCBeijingChina Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijingChina Anesthesia and Intensive Care San Martino Policlinico HospitalIRCCS for Oncology and NeuroscienceGenoaItaly Department of Conservative Dentistry&Endodontics Jamia Millia IslamiaNew DelhiIndia Paolo Procacci Foundation RomaItaly Department of Anaesthesiology and Intensive Care Medicine University Hospital Hradec KraloveHradec KraloveCzech Republic Unit of Anesthesia and Intensive Care Mazzoni HospitalAscoli PicenoItaly Unit of Anaesthesia Intensive Care and Pain ManagementDepartment of MedicineUniversitàCampus Bio-Medico of RomeRomaItaly Division of Anaesthetics Pain Medicine&Intensive CareDepartment of Surgery&CancerFaculty of MedicineImperial College Londonand Chelsea and Westminster HospitalLondonUK Division of Dental Anesthesiology Graduate School of Medicine and Dental SciencesNiigata UniversityNiigataJapan Department of Anaesthesiology National and Kapodistrian University of AthensAthensGreece Institute of Anesthesia and Intensive Care Unit University Hospital of PaduaPaduaItaly Department of Biomedical Sciences and Public Health UniversitàPolitecnica delle MarcheAnconaItaly Anesthesia and Intensive Care Unit Azienda Ospedaliero Universitaria delle MarcheAnconaItaly Department of Anesthesia Critical Careand Pain MedicineMassachusetts General HospitalBostonMAUSA Lee Kong Chian School of Medicine Nanyang Technological UniversitySingaporeSingapore Department of Anaesthesia Yong Loo Lin School of Medic

Background:Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room(OR)and non-operation room sites.There are no guidelines or expert consensus focused on the assessment of the difficult airway before,so this expert consensus is developed to provide guidance for airway assessment,making this process more standardized and accurate to reduce airway-related complications and improve safety.Methods:Seven members from the airway Management Group of the Chinese Society of Anaesthesiology(CSA)met to discuss the first draft and then this was sent to 15 international experts for review,comment,and approval.The Grading of Recommendations,Assessment,Development and Evaluation(GRADE)is used to determine the level of evidence and grade the strength of recommendations.The recommendations were revised through a three-round Delphi survey from experts.Results:This expert consensus provides a comprehensive approach to airway assessment based on the medical history,physical examination,comprehensive scores,imaging,and new developments including transnasal endoscopy,virtual laryngoscopy,and 3D printing.In addition,this consensus also reviews some new technologies currently under development such as prediction from facial images and voice information with the aim of proposing new research directions for the assessment of difficult airway.Conclusions:This consensus applies to anesthesiologists,critical care,and emergency physicians refining the preoperative airway assessment and preparing an appropriate intubation strategy for patients with a potentially difficult airway.

关键词： Expert consensus difficult airway airway management

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Anesthesia management in a pediatric patient with complicatedly difficult airway:A case report

引用

World Journal of Clinical Cases 2023年第11期11卷 2482-2488页

作者： Jia-Xiang Chen Xiao-Li Shi Chang-Sheng Liang Xing-Gang Ma Liang Xu Department of Anesthesiology Shenzhen Children's HospitalShenzhen 518038Guangdong ProvinceChina Department of Anesthesiology Shenzhen Pediatrics Institute of Shantou University Medical CollegeShenzhen 518038Guangdong ProvinceChina

BACKGROUND Reports on perioperative anesthesia management in pediatric patients with difficult airways are scarce.In addition to relatively more difficulties in the technique of endotracheal intubation,the time for manipulation is restricted compared to adults.Securing the airways safely and avoiding the occurrence of hypoxemia in these patients are of significance.CASE SUMMARY A 9-year-old boy with spastic cerebral palsy,severe malnutrition,thoracic scoliosis,thoracic and airway malformation,laryngomalacia,pneumonia,and epilepsy faced the risk of anesthesia during palliative surgery.After a thorough preoperative evaluation,a detailed scheme for anesthesia and a series of intu-bation tools were prepared by a team of anesthesiologists.Awake fiberoptic intubation is the widely accepted strategy for patients with anticipated difficult airways.Given the age and medical condition of the patient,we kept him sedated with spontaneous breathing during endotracheal intubation.The endotracheal intubation was completed on the second attempt after the failure of the first effort.Fortunately,the surgery was successful without postoperative complications.CONCLUSION Dealing with difficult airways in the pediatric population,proper sedation allows time to intubate without interrupting spontaneous breathing.The appropriate endotracheal intubation method based on the patient’s unique characteristics is the key factor in successful management of these rare cases.

关键词： Pediatric anesthesia difficult airway Spastic cerebral palsy Awake fiberoptic intubation Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

difficult airway for Patients Undergoing Spine Surgeries

引用

Chinese Medical Journal 2016年第6期129卷 749-750页

作者： Lu-Lu Ma Xue-Rong Yu Bo Zhu Yu-Guang Huang Jian-Xiong Shen Jian-Guo Zhang Department of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China Department of Orthopedics Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China

INTRODUCTION The “cannot intubate, cannot ventilate” situation although rare is a nightmare for anesthesiologists. difficult airway is defined as difficult facemask or supraglottic airway （SGA） ventilation, difficult SGA placement, laryngoscopy, tracheal intubation, or failed intubation. We presented three cases of difficult airway and their airway management.

关键词： Ankylosing Spondylitis difficult airway Klippel-Feil Syndrome

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Induction of Anesthesia with Dexmedetomidine and Sevoflurane for a Pediatric difficult airway

引用

Chinese Medical Journal 2017年第16期130卷 1997-1998页

作者： Ling-Xin Wei Xiao-Ming Deng Jing-Hu Sui Lei Wang Department of Anesthesiology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100144 China

difficult airway is a challenge frequently faced by anesthesiologists. For children recovering from burns with severe scarring contracture in the neck and chest wall, the best strategy is to maintain spontaneous breathing during the induction of anesthesia and to insert a laryngeal mask airway to secure the airway as early as possible.

关键词： Children Dexmedetomidine difficult airway

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Anesthesia management for cesarean section in a pregnant woman with odontogenic infection:A case report

引用

World Journal of Clinical Cases 2022年第14期10卷 4563-4568页

作者： Yan-Li Ren Yu-Shan Ma Department of Anesthesiology West China Second University HospitalSichuan UniversityChengdu 610000Sichuan ProvinceChina

BACKGROUND In recent years,people have paid more attention to oral health with the development of stomatology.Due to the various physiological changes during pregnancy,such as changing hormone levels and immune functions,oral diseases have a high incidence during pregnancy,and the prevention and treatment of oral diseases have also received the attention of both dentists and obstetricians.However,the anesthetic management of pregnant patients with oral disease,especially severe maxillofacial infections,and patients who need surgical treatment or have obstetric emergencies and need to terminate their pregnancy is not clear.CASE SUMMARY This article describes a parturient patient with a severe masseteric space infection who had an emergency cesarean section.CONCLUSION This case report aims to discuss the important anesthetic considerations for these patients.

关键词： Anesthesia Cesarean section difficult airway Maxillofacial infections Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Aspiration as the first-choice procedure for airway management in an infant with large epiglottic cysts: A case report

引用

World Journal of Clinical Cases 2022年第23期10卷 8249-8254页

作者： Jian-Qiao Zheng Li Du Wei-Yi Zhang Department of Anesthesiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Anesthesiology Sichuan Cancer Hospital and InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610041Sichuan ProvinceChina

BACKGROUND Epiglottic cysts is a rare but potentially lethal supraglottic airway pathology in infants due to the high risk of cannot intubation or cannot ventilation.Awake fiberoptic intubation appeared to be the safest technique,but it is very challenging in infants with large epiglottic cysts.Even it has the risk of airway loss.We report that cyst aspiration is an effective treatment as the first-choice procedure for airway management in an infant with large epiglottic cysts.CASE SUMMARY A 46-day-old male infant weighing 2.3 kg presented to the emergency room with difficulty feeding,worsening stridor,and progressive respiratory distress.Epiglottic cysts was diagnosed,but fibro bronchoscopy examination failed,as the fiberoptic bronchoscope was unable to cross the epiglottic cysts to the trachea.The infant was transferred to the operating room for emergency cystectomy under general anesthesia.Spontaneous respiration was maintained during anesthesia induction,and cyst aspiration was performed as the first procedure for airway management under video laryngoscopy considering that the preoperative fibro bronchoscopy examination failed.Then,the endotracheal tube was intubated successfully.Cystectomy was performed uneventfully,and the infant was safely transferred to the intensive care unit after surgery.The infant was extubated smoothly on the third postoperative day and discharged on the eighth day after surgery.On follow-up 1 year after the surgery,a normal airway was found by fibro bronchoscopy examination.CONCLUSION Epiglottic cyst aspiration can be considered the first procedure for airway management in infants with large epiglottic cysts.

关键词： Epiglottic cysts Infant airway management difficult airway Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Emergent use of tube tip in pharynx technique in“cannot intubate cannot oxygenate”situation:A case report

引用

World Journal of Clinical Cases 2022年第34期10卷 12631-12636页

作者： Tzu-Chiao Lin Yu-Wen Lai Shang-Hung Wu Department of Anesthesiology China Medical University HospitalTaichung City 404Taiwan

BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx(TTIP)technique.CASE SUMMARY A 43-year-old man was diagnosed with parotid tumor for>10 years.Computed tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the oropharynx.Tumor excision was arranged.However,we encountered CICO during anesthesia induction.An endotracheal tube was used as an emergency supraglottic airway device(TTIP)to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult airway.The patient did not experience desaturation despite sudden loss of definite airway.During tracheostomy,the pulse oximetry remained 100%with our technique of ventilating the patient.The arterial blood gas analysis revealed PaCO_(2)35.7 mmHg and PaO2242.5 mmHg upon 50%oxygenation afterward.CONCLUSION Using an endotracheal tube as a supraglottic airway device,patients may have increased survival without experiencing life-threatening desaturation.

关键词： Tube tip in pharynx difficult airway difficult intubation Cannot intubate cannot oxygenate Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：