Airway management is a common procedure within emergency and critical care medicine. Traditional techniques for predicting and managing a difficult airway each have important limitations. As the field has evolved, point-of-care ultrasound has been increasingly utilized for this application. Several measures can be used to sonographically predict a difficult airway, including skin to epiglottis, hyomental distance, and tongue thickness. Ultrasound can also be used to confirm endotracheal tube intubation and assess endotracheal tube depth. Ultrasound is superior to the landmark-based approach for locating the cricothyroid membrane, particularly in patients with difficult anatomy. Finally, we provide an algorithm for using ultrasound to manage the crashing patient on mechanical ventilation. After reading this article, readers will have an enhanced understanding of the role of ultrasound in airway management.
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http://dx.doi.org/10.15441/ceem.23.094 | DOI Listing |
Rhinology
January 2025
Kuopio, Finland.
Chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) frequently coexist, forming a complex multimorbid condition often referred to as "global airway disease." This concept reflects shared pathophysiological mechanisms of eosinophilic inflammation and underscores the need for integrated treatment strategies targeting both upper and lower airway manifestations (1). The burden of severe CRSwNP, asthma, and N-ERD is substantial, particularly in terms of reduced quality of life, recurrent exacerbations, revision endoscopic sinus surgeries (ESS), and healthcare utilization (2).
View Article and Find Full Text PDFJ Vet Emerg Crit Care (San Antonio)
January 2025
Emergency and Critical Care Department, University of Florida Small Animal Hospital, Gainesville, Florida, USA.
Objective: To describe a novel approach to tracheostomy management in dogs with upper airway trauma.
Case Series Summary: Two dogs with upper airway trauma presented to an emergency department and required immediate intubation. To minimize sedation time, tracheostomy tubes were placed in both dogs.
BMJ Case Rep
January 2025
Department of Rehabilitation Physiotherapy, National Center of Neurology and Psychiatry, Tokyo, Japan.
We report a case of amyotrophic lateral sclerosis (ALS) in a patient in their 50s, presenting with spastic paraparesis and bulbar palsy, treated with lung volume recruitment therapy (LVRT). From early stage in the disease, vital capacity (VC), lung insufflation capacity (LIC) and ALS Functional Rating Scale-Revised scores were regularly measured, and LVRT was continuously performed at home. After 10 years, the patient had complete limb function loss and required nutritional management via gastrostomy and full assistance with daily activities.
View Article and Find Full Text PDFRespir Med
January 2025
Bursa Uludag University Faculty of Medicine, Department of Anesthesiology and Reanimation, Bursa, Turkey.
Purpose: Myasthenia-gravis and Guillain-Barre-syndrome are two of the most common causes of acute and reversible neuromuscular-respiratory-failure(ARNRF), both may worsen respiratory-failure and need for invasive-mechanical-ventilation(IMV) for long-periods due to muscle-weakness. However, approitive IMV-mode for ARNRF patients that better gas-exchange and weaning in ARNRF remain unclear.
Materials And Methods: Critically-ill-patiens with IMV due to ARNRF, who could meet the weaning-criterias (after intubation for more than 7-days; difficult-weaning), between 2013, and 2023 were included in the study.
J Paediatr Child Health
January 2025
WHO Collaborating Centre for Reference and Research on Influenza, VIDRL, Doherty Institute, Melbourne, Victoria, Australia.
Aims: Primary aim was to review severe acute respiratory infections (SARI) hospitalisations caused by respiratory syncytial virus (RSV) in children aged < 2 years in paediatric hospitals in Australia. Secondary aims included RSV subtyping, assessing RSV seasonality and contributing to the World Health Organisation's RSV surveillance programme.
Methods: We prospectively reviewed the medical records of children (< 2 years of age) with a confirmed SARI who were admitted to one of four major Australian paediatric hospitals and had a respiratory sample analysed by Polymerase Chain Reaction (PCR).
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