scholarly journals Intraoperative management for ex-utero intrapartum treatment: focusing on the fetus

2021 ◽  
Vol 16 (4) ◽  
pp. 329-337
Author(s):  
Woosuk Chung ◽  
Chaeseong Lim
Keyword(s):  
Cesarean Section ◽  
Airway Management ◽  
Airway Obstruction ◽  
Nursing Staff ◽  
Ex Utero Intrapartum Treatment ◽  
Intraoperative Management ◽  
Life Threatening

Ex-utero intrapartum treatment (EXIT) is a method of securing the airway of a fetus while maintaining umbilical circulation for newborns who are experiencing life-threatening airway obstruction. Cesarean section is completed only after ensuring the neonate’s safety. However, managing the airway of a neonate while maintaining umbilical circulation is a major challenge for anesthesiologists. Anesthesiologists must understand the physiology of both the mother and fetus, and extensive discussions with obstetricians, pediatricians, otolaryngologists, and nursing staff prior to the procedure are essential. This review provides an overview of the EXIT and details of airway management for neonates.

scholarly journals Life-threatening oral mucositis following chemotherapy in a pediatric patient

2021 ◽  
Author(s):  
Kaoru Tsuboi ◽  
Norihiko Tsuboi ◽  
Kenichi Sakamoto ◽  
Akira Takebayashi ◽  
Daisuke Tomizawa ◽  
...  
Keyword(s):  
Airway Management ◽  
Airway Obstruction ◽  
Oral Mucositis ◽  
Pediatric Patients ◽  
Clinical Course ◽  
Upper Airway ◽  
Individual Case ◽  
Life Threatening ◽  
Severe Oral Mucositis ◽  
Case Basis

Pediatric patients undergoing chemotherapy may present upper airway obstruction due to severe oral mucositis. Although reversible, its clinical course correlates with the course of neutropenia and may be complicated. Thus, airway management in these patients must be determined on an individual case basis.

scholarly journals Failed videolaryngoscopy in an infant with giant vallecular cyst managed successfully with a ‘three-person technique’ of fibre-optic intubation

2019 ◽  
Vol 12 (9) ◽  
pp. e231035
Author(s):  
Anju Gupta ◽  
Nishkarsh Gupta
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Airway Management ◽  
Airway Obstruction ◽  
Muscle Relaxants ◽  
Rare Entity ◽  
Fibre Optic ◽  
Present Case Report ◽  
Rescue Technique ◽  
Life Threatening

Vallecular cysts are a rare entity but can complicate the airway management due to the physical impediment and distortion of the laryngeal inlet. It can lead to fatal life-threatening airway obstruction postinduction of anaesthesia. Infancy compounds the risks due to lack of cooperation and physiological reserves. The literature review suggested most anaesthesiologists avoided muscle relaxants and aspiration of the cyst was used as a rescue technique. The present case report illustrates the successful airway management of an infant with a huge vallecular cyst using fibre-optic intubation by a ‘three-person’ technique after paraglossal videolaryngoscopy failed to secure the airway.

scholarly journals Ticagrelor-Induced Angioedema: A Rare and Unexpected Phenomenon

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Rajeev Seecheran ◽  
Valmiki Seecheran ◽  
Sangeeta Persad ◽  
Sasha Lalla ◽  
Naveen Anand Seecheran
Keyword(s):  
Case Report ◽  
Hypersensitivity Reaction ◽  
Airway Management ◽  
Airway Obstruction ◽  
Antiplatelet Therapy ◽  
Heart Team ◽  
Respiratory Involvement ◽  
Absolute Indication ◽  
Life Threatening ◽  
Emergent Airway Management

Angioedema can cause potentially life-threatening airway obstruction. This case report describes an exceedingly rare episode of ticagrelor-induced hypersensitivity reaction, manifesting as angioedema with periorbital and likely respiratory involvement. The heart team should be vigilant for this precarious condition which may require emergent airway management. Desensitization protocols and alternative regimens (e.g., clopidogrel, prasugrel, and addition of an adjunctive anticoagulant) should be considered when there is an absolute indication for antiplatelet therapy.

scholarly journals Congenital high airway obstruction syndrome: prenatal ultrasound diagnosis and literature review

2020 ◽  
Vol 1 (2) ◽  
pp. 144-148
Author(s):  
Bashiru B Jimah ◽  
Teresa A Mensah ◽  
Kofi Ulzen-Appiah ◽  
Benjamin D Sarkodie ◽  
Edwin Gwira-Tamattey ◽  
...  
Keyword(s):  
Literature Review ◽  
Airway Obstruction ◽  
Second Trimester ◽  
Upper Airways ◽  
Fetal Demise ◽  
True Incidence ◽  
Laryngeal Atresia ◽  
Ex Utero Intrapartum Treatment ◽  
Threatening Condition ◽  
Life Threatening

Congenital high airway obstruction syndrome (CHAOS) is a rare congenital anomaly involving the upper airways (trachea, larynx). It is a life-threatening condition whose true incidence is unknown. The obstruction may be due to tracheal/laryngeal atresia, stenosis, or the presence of a mass lesion. Prognosis is poor, generally resulting in stillbirth or intrauterine fetal demise. Ex utero intrapartum treatment (EXIT) is possible if the condition is detected early. We present a case of CHAOS diagnosed during a second-trimester anomaly scan with postmortem confirmation and literature review.

A dangerous cause of airway obstruction: deep neck infection

2020 ◽  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Deep Neck Infection ◽  
Jugular Vein Thrombosis ◽  
Neck Infection ◽  
Vein Thrombosis ◽  
Lethal Complications ◽  
Life Threatening ◽  
Fascial Spaces ◽  
Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals 187 Improving Awareness of Managing Post-Operative Haemorrhage in Patients Undergoing Thyroid and Parathyroid Surgery: The SCOOP Protocol

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Bhattacharya ◽  
J Jegadeeson ◽  
J Ramsingh ◽  
P Truran
Keyword(s):  
Nursing Staff ◽  
Simulation Training ◽  
Clinical Signs ◽  
Skin Wound ◽  
Junior Doctors ◽  
Parathyroid Surgery ◽  
Surgical Department ◽  
Life Threatening ◽  
Clinical Questions ◽  
Life Threatening Complication

Abstract Introduction Post-operative haemorrhage is a rare but potentially life-threatening complication of thyroid surgery and occurs in 1 in 100 patients. Our aim was to assess current levels of awareness of post-operative haemorrhage in the surgical department and to improve confidence in managing this. Method Questionnaires with a combination of clinical questions were distributed amongst nurses, foundation doctors, senior house officers and registrars in the surgical department. Results There was a clear gap in awareness in all grades. The British Association of Endocrine and Thyroid surgeons (BAETS) have guidance on the management of these patients and in particular the acronym SCOOP (Steristrips removed, Cut subcuticular sutures, Open skin wound, Open strap muscles, Pack wound). 18/24 of participants had not heard of the SCOOP protocol. Most nurses (6/12) all junior doctors (8/8) showed lack of confidence in managing patients with suspected bleeding. Conclusions An informative poster was created for relevant clinical areas as per the BAETS recommendation. These posters outlined the steps in the SCOOP acronymas well as the main clinical signs of haemorrhage. BAETS recommend that all first responders, including nursing staff, junior doctors and the crash team should be aware of the SCOOP protocol. Simulation training sessions are in progress for these members of staff.

Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report

2021 ◽  
Vol 42 (4) ◽  
pp. 102977
Author(s):  
Alexander N. Goel ◽  
Andrey Filimonov ◽  
Julie Teruya-Feldstein ◽  
Christian Salib ◽  
Joseph J. Rousso ◽  
...  
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Burkitt Lymphoma ◽  
Life Threatening

scholarly journals Acute upper airway obstruction as a life-threatening complication of ventral bulla osteotomy: report of two consecutive cases

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692110059
Author(s):  
Michal Vlasin ◽  
Richard Artingstall ◽  
Barbora Mala
Keyword(s):  
Airway Obstruction ◽  
Clinical Signs ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Single Session ◽  
Inflammatory Polyp ◽  
Case Summary ◽  
First Case ◽  
Life Threatening

Case summary This paper presents two cases of acute postoperative upper airway obstruction following ventral bulla osteotomy (VBO) in cats. The first cat underwent a unilateral left-sided VBO for a suspected inflammatory polyp. The second cat underwent a single-session bilateral VBO procedure for bilateral otitis media. In the first case, immediate re-intubation and a gradual lightening of the anaesthetic plane resolved the clinical signs; in the second case, the patient deteriorated and went into acute cardiorespiratory arrest and received cardiopulmonary resuscitation. Both patients recovered well and were discharged home 3 days after surgery. Both cases were reported to show no further clinical signs on postoperative follow-up 3 weeks and 4 months after surgery, respectively. Relevance and novel information Upper airway obstruction should be regarded as a potential complication of VBO in cats.

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