Airway management in acute respiratory distress secondary to tracheal stenosis following one time intubation

Govindarajan, Ramasamy; Chaudhry, Rashid; Babalola, Oluwaseun; Nguyen, Nhat Minh; Michael, Rafik; Sultan, Said

doi:10.1007/bf03018253

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…3 4 These changes reduce the patient's functional residual capacity, and make the upper airways more collapsible and therefore more prone to obstruction 5 6 and increase the work of breathing. 7 8 Laryngotracheal stenosis can also be encountered in the rare scenario of an acute respiratory emergency with a presumptive lower airway aetiology 9 being, in fact, the result of central airway obstruction, identified through the anaesthetist's inability to advance a tracheal tube to secure the airway.…”

Section: Accepted For Publication: May 4 2008mentioning

confidence: 99%

Physiological comparison of spontaneous and positive-pressure ventilation in laryngotracheal stenosis

Nouraei

Giussani

Howard

et al. 2008

British Journal of Anaesthesia

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Positive-pressure ventilation through an LMA is an effective method of ventilating patients with laryngotracheal stenosis. Spontaneous ventilation creates negative inspiratory intratracheal pressure that exacerbates an extrathoracic lesion, whereas positive-pressure ventilation generates positive intratracheal pressure that improves ventilation. This helps explain the apparent resolution of airway obstruction after positive-pressure ventilation.

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Section: Accepted For Publication: May 4 2008mentioning

confidence: 99%

Physiological comparison of spontaneous and positive-pressure ventilation in laryngotracheal stenosis

Nouraei

Giussani

Howard

et al. 2008

British Journal of Anaesthesia

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“…This condition is notoriously difficult to detect, and as many as four in five LTS patients are initially misdiagnosed and then unsuccessfully treated for prolonged periods for presumed “resistant” bronchopulmonary pathologies . This phenomenon causes significant morbidity and exposes the patient to ongoing and potentially fatal risk of acute‐on‐chronic respiratory decompensation . Moreover, diagnostic delay increases the risk of treatment failure, the need for open cervicomediastinal surgery in benign diseases and can lead to the loss of the window of curative intervention in central airway cancers…”

Section: Introductionmentioning

confidence: 99%

“…1,3 This phenomenon causes significant morbidity and exposes the patient to ongoing and potentially fatal risk of acute-on-chronic respiratory decompensation. 4 Moreover, diagnostic delay increases the risk of treatment failure, the need for open cervicomediastinal surgery in benign diseases 5,6 and can lead to the loss of the window of curative intervention in central airway cancers. 7 At the heart of this diagnostic shortcoming is the fact that LTS is an uncommon cause 8,9 of a very common clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of laryngotracheal stenosis from routine pulmonary physiology using the expiratory disproportion index

Nouraei

Patel

et al. 2013

The Laryngoscope

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EDI can reliably diagnose LTS using routine lung function data. Its simplicity and clinical utility, first recognized by Duncan Empey, are underpinned by a unique physiology whereby PEFR, being determined by total tracheobronchial tree resistance, falls disproportionately compared with FEV1 , which is determined within small intrathoracic airways. EDI provides valuable information about the presence and extent of LTS particularly in nonspecialist clinical settings and its routine inclusion within standard lung function reports could prevent the prolonged morbidity and mortality that currently result from missed and delayed diagnoses.

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“…Pre Many previous studies have been performed in a controlled situation for the assessment of CO 2 waveform features with asthmatic patients, either asthmatic condition has been steady for some hours, or in histamine challenge test [2][3][4]23,25]. In contrast, this study was performed with the acute attack asthmatic patients presenting to the emergency department (ED).…”

Section: Segmented Part Featuresmentioning

confidence: 99%

“…Measurement of human respired carbon dioxide (CO 2 ) using capnography has demonstrated promises application in numerous areas of medicine, including monitoring of airway patency, quality of CPR efforts, and as indicators of abnormal gas exchange [1][2][3][4][5]. Due to the well-known difference observe with coaching and patient effort, a recommendation for the evaluation of the peak expiratory flow rate (PEFR) and forced expiratory volume in 1-second (FEV1) require consideration of the best of three efforts [6,7].…”

Section: Introductionmentioning

confidence: 99%

Carbon Dioxide Waveform Features During Pre and Post Treatment Asthmatic Patient in Emergency Department

2023

Summer 2023 Int’l Conference Proceedings BSHESS-23, PICEST-23, IIETH-23, ICABE-23, IL2ES2-23 &Amp; IBMEL-23

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Capnography, measured respired carbon dioxide in human respiration, is showing promising use in various areas of medicine, including monitoring of airway patency, quality of CPR efforts, and as indicators of abnormal gas exchange. The quantitative characterization of the carbon dioxide (CO 2 ) waveforms has potentially been shown to indicate changes in respiratory airflow, which may be clinical use in discriminating asthmatic severity. The potential clinical application must be evaluated by identifying CO 2 waveform indices which change significantly during an acute asthmatic attack. Hence, we aim to assess the CO 2 waveform indices (Area and Slope), extracted computationally from three different regions, upward expiratory (4-10 mmHg and 11-15 mmHg) and alveolar phase during pre-and post-treatment using newly developed human respiration, carbon dioxide (CO 2 ) measurement device. We recruited 23 asthmatic patients via convenience sampling method.A signal processing algorithm was applied for automatic segmentation and feature computations, and a paired sample t-test, and Box-whisker plot was performed to know the significant difference of features during the preand -post intervention. We found that both the parameters (Area and Slope) were most notable for lower part of expiratory phase (4-10 mmHg, p<0.05), followed by the alveolar period (p<0.05), while upper part of upward expiratory phase (11-15 mmHg) was insignificant for Area (p > 0.05) and significant for slope (p < 0.05). Thus, the inclusion of the features above into the lately developed device may have the potential for the assessment of respiratory distress conditions like asthma in and out of clinical settings as a patient-independent method.

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Airway management in acute respiratory distress secondary to tracheal stenosis following one time intubation

Cited by 3 publications

References 3 publications

Physiological comparison of spontaneous and positive-pressure ventilation in laryngotracheal stenosis

Physiological comparison of spontaneous and positive-pressure ventilation in laryngotracheal stenosis

Diagnosis of laryngotracheal stenosis from routine pulmonary physiology using the expiratory disproportion index

Carbon Dioxide Waveform Features During Pre and Post Treatment Asthmatic Patient in Emergency Department

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