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Bindra, Ashish
- Obese and Tracheostomy Tube:Does one Size Fit All?
Abstract Views :260 |
PDF Views:75
Authors
Affiliations
1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi – 110029, IN
1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi – 110029, IN
Source
Northern Journal of ISA, Vol 1, No 2 (2016), Pagination: 64-66Abstract
Securing airway in obese patients is always challenging and sometimes it is extremely difficult when associated with other difficult airway factors. However, the procedure itself is associated with various complications like subcutaneous emphysema. The present case report describes the airway management in an obese patient on mechanical ventilation that developed subcutaneous emphysema on the second day following percutaneous tracheostomy using a standard length tracheostomy tube.Keywords
Difficult Airway, Subcutaneous Emphysema, Tracheostomy.References
- Dempsey GA, Grant CA, Jones TM. Percutaneous tracheostomy: a 6 yr prospective evaluation of the single tapered dilator technique. Br J Anaesth 2010;105:782–8.
- Goldenberg D, Bhatti N. Management of the impaired airway in the adult. In: Cummings CW, editor. Otolaryngology Head and Neck Surgery. 4th ed. Philadelphia: Mosby; 2005. p. 2441–53.
- Fikkers BG, van Veen JA, Kooloos JG, Pickkers P, van den Hoogen FJ, Hillen B, et al. Emphysema and pneumothorax after percutaneous tracheostomy: case reports and an anatomic study. Chest 2004;125:1805– 14.
- Mansharamani NG, Koziel H, Garland R, LoCicero J 3rd, Critchlow J, Ernst A. Safety of bedside percutaneous dilatational tracheostomy in obese patients in the ICU. Chest 2000;117:1426–9.
- Byhahn C, Lischke V, Meininger D, Halbig S, Westphal K. Peri-operative complications during percutaneous tracheostomy in obese patients. Anaesthesia 2005;60:12–5.
- El Solh AA, Jaafar W. A comparative study of the complications of surgical tracheostomy in morbidly obese critically ill patients. Crit Care 2007;11:R3.
- Hess DR. Tracheostomy tubes and related appliances. Respir Care 2005;50:497–510.
- Szeto C, Kost K, Hanley JA, Roy A, Christou N. A simple method to predict pretracheal tissue thickness to prevent accidental decannulation in the obese. Otolaryngol Head Neck Surg 2010;143:223–9.
- Huge Hydrocephalus in an Infant:Intraoperative Challenges
Abstract Views :273 |
PDF Views:74
Authors
Sandeep Kumar
1,
Varun Jain
1,
Keshav Goyal
1,
Shweta Kedia
2,
Ashish Bindra
1,
Girija Prasad Rath
1
Affiliations
1 Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, IN
2 Department of Neurosurgery, AIIMS, New Delhi, IN
1 Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, IN
2 Department of Neurosurgery, AIIMS, New Delhi, IN
Source
Northern Journal of ISA, Vol 2, No 2 (2017), Pagination: 52-53Abstract
Huge hydrocephalus (head circumference greater than infant's height) is a rare entity. Intraoperative management in children is challenging for both surgery and anaesthesia owing to the altered anatomy and underlying pathophysiology. Increase in Intracranial Pressure (ICP) in these children may lead to herniation, respiratory and cardiac arrest, and possibly, death. Here, we report the largest reported case of hydrocephalus and associated intraoperative challenges.Keywords
Anaesthesia, Congenital Hydrocephalus, Huge Hydrocephalus, Infant, Management.References
- Jouibari MF, Baradaran N, Shams AR, Nejat F, El KM. Huge hydrocephalus: Definition, management, and complications. Childs Nerv Syst. 2011; 27:95–100. crossref PMid:20549215
- Levy ML, Masri LS, McComb JG. Outcome for preterm infants with germinal matrix hemorrhage and progressive hydrocephalus. Neurosurgery. 1997; 41:1111–8. crossref PMid:9361065
- Lorber J. Systematic ventriculographic studies in infants born with meningomyelocele and encephalocele. The incidence and development of hydrocephalus. Arch Dis Child. 1961; 36:381–89. crossref PMid:13763491 PMCid:PMC2012726
- Choudhury AR. Avoidable factors that contribute to the complications of ventriculoperitoneal shunt in childhood hydrocephalus. Childs Nerv Syst. 1990; 6:346–49. crossref PMid:2257549