Search results for "Trachea"

Successful tracheal occlusion using ultrathin fetoscopic equipment combined with real-time three-dimensional ultrasound.

2008

<i>Objective:</i> The most common complication of intrauterine tracheal balloon occlusion is the preterm premature rupture of membranes (PPROM) which increases the rate of neonatal morbidity and mortality. Ultrathin fetoscopy may be a method of reducing the risk of PPROM. <i>Materials and Methods:</i> The operation was performed at the 27th week of gestation after sedation and relaxation of a fetus with bilateral congenital diaphragmatic hernia and with the liver lifted upwards into the thorax. An ultrathin sheath with a 1.2-mm fetoscope was used under real-time 3-D ultrasound guidance. The patient delivered in the 38th week of gestation and did not display PPROM aft…

Functional relevance of presynaptic muscarinic autoreceptors.

1993

Pre- and postsynaptic muscarinic receptors have been characterized in the isolated trachea and ileal circular muscle of the guinea pig. The muscarinic autoreceptors mediating inhibition of acetylcholine release in the circular muscle belong to the M1 subtype, whereas those inhibiting acetylcholine release in the trachea are M2 or M4 receptors. In both tissues the postsynaptic muscarinic receptors are M3 receptors. Blockade of the autoreceptors by selective M1 and M2/M4 receptor antagonists leads to facilitation of cholinergic neurotransmission.

Usage of a semi-rigid intubation endoscope is not superior to a video laryngoscope. A prospective, randomised, controlled trial comparing the SensaSc…

2018

Abstract Introduction Numerous guidelines and techniques have been developed to manage difficult airways and to prevent problems in airway management. To achieve an optimal view of the glottis, various video laryngoscopes and video stylets have been developed and introduced in clinical anaesthesia. The aim of this study was to compare the time to place the tracheal tube (TT) with the McGrath™ Series 5 (McG; Medtronic Dublin, Ireland) and the semi-rigid intubation endoscope SensaScope™ (Sc; Acutronic Medical Systems AG, Hirzel, Switzerland) in elective surgery patients. Methods With the approval of the local ethics committee, patients were recruited for this prospective, randomised clinical …

2017

IntroductionThe direct laryngoscopy technique using a Macintosh blade is the first choice globally for most anaesthetists. In case of an unanticipated difficult airway, the complication rate increases with the number of intubation attempts. Recently, McGrath MAC (McGrath) video laryngoscopy has become a widely accepted method for securing an airway by tracheal intubation because it allows the visualisation of the glottis without a direct line of sight. Several studies and case reports have highlighted the benefit of the video laryngoscope in the visualisation of the glottis and found it to be superior in difficult intubation situations. The aim of this study was to compare the first-pass in…

Multidisciplinary Approach for a Relapsing Goiter with Severe Tracheal Stenosis: A Case Report in an Elderly Patient

2012

Summary Total thyroidectomy is considered the gold standard for thyroid benign pathology treatment. Unfortunately, many partial interventions carried out in the past created many complications due to the tendency of the goiter to relapse and the formation of adherences in the anterior region of the neck. A woman 72 years of age with a relapsing goiter and severe respiratory symptomatology underwent thyroidectomy. After thyroid removal, tracheal stenosis persisted, making the positioning of a T silicon prosthesis (Montgomery’s T-tube) necessary. After 60 days, the prosthesis was replaced with a new made out of the same material but with a larger diameter and a softer consistency, which was r…

Characterization of prejunctional muscarinic autoreceptors in the guinea-pig trachea

1991

1. The effects of ten muscarinic antagonists on electrically evoked [3H]-acetylcholine release and muscle contraction were compared in an epithelium-free preparation of the guinea-pig trachea that had been preincubated with [3H]-choline. 2. The M3-selective antagonists UH-AH 37, 4-diphenyl-acetoxy-N-piperidine methobromide and para-fluorohexahydrosiladiphenidol were more potent in reducing the contractile response than in facilitating the evoked [3H]-acetylcholine release. Hexahydrosiladiphenidol did not discriminate between pre- and postjunctional effects. The rank order of the postjunctional potencies of the ten antagonists as well as the postjunctional pA2 values obtained for hexahydrosi…

Release of [3H]acetylcholine from the isolated rat or guinea-pig trachea evoked by preganglionic nerve stimulation; a comparison with transmural stim…

1991

Basal and stimulated outflow of radioactive acetylcholine, phosphorylcholine and choline from rat and guinea-pig isolated tracheae were measured by reverse phase HPLC followed by liquid-scintillation-spectrometry. Tracheae were stimulated either by an electrical field (transmural stimulation) or by a local stimulation of the innervating parasympathetic nerves (preganglionic stimulation). Epithelium was removed in most experiments, as the epithelium inhibits acetylcholine release. The basal tritium efflux (1,600 dpm/3min) from rat isolated tracheae incubated with [3H]choline consisted of 56% [3H]phosphorylcholine and 38% [3H]choline. Preganglionic stimulation (15 Hz, 1,200 pulses) caused a 2…

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

2017

A patient's willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can jeopardize their spontaneous breathing, topical anesthesia of the airway is a popular technique. The spray-as-you-go technique represents one of the simplest opportunities to anesthetize the airway mucosa. The application of local anesthetic through the working channel of the flexible endoscope is a widespread practice for anesthetists as well as pulmonologists. There is neither need for additional devices nor special training as a pre-requisite to perform this technique. However, a known clinical problem is the coughing and gagging reflex tha…

Physiologie und Pathophysiologie des respiratorischen Systems

2006

Positive pressure ventilation in children is associated with problems similar to those in the adults: development of atelectasis and barotrauma. During anesthesia atelectasis develop in up to 90% of patients, requiring the use of higher inspiratory pressure to recruit the collapsed lung regions. Especially in the preterm, newborn and younger infants, prolonged ventilation disturbs the anatomical structure of the soft and vulnerable immature airways and their subsequent growth and development, leading to tracheomegaly, tracheal collapse, and bronchopulmonary dysplasia and predisposing to bronchial obstruction. On the basis of pathophysiologic knowledge and studies of ventilation in children,…

Review of difficult airway management in thoracic surgery

2018

The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers. In both cases, double lumen tubes shou…