Fifteen swine cadavers were examined to determine a quick, reliable means of locating the level of the cricothyroid ligament from consistently palpable structures in the head and neck area. From calculations of measurements made on these cadavers, it was discovered that when a 21-43 kg pig was placed in a standard position, the measured length (L) from the angle of the mandible to the manubrium sterni multiplied by a factor of 0.48 equals the parameter Z [L (0.48) = Z]. Z was measured, beginning at the manubrium sterni, along the ventral midline. The endpoint of Z was at the level of the cricothyroid ligament. A catheter inserted at this point through the ligament into the airway provides a means of transtracheal ventilation. This method of ventilation can be used in emergencies to avoid a tracheostomy or as an alternative to endotracheal ventilation. This method was applied successfully to four anesthetized pigs as determined by a series of arterial blood gas samples.
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J Intensive Care Med
January 2025
The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Introduction: Endotracheal tube (ETT) malpositioning can result in a myriad of complications. Daily chest radiographs (CXR) is the gold standard in monitoring these complications. Point-of-care transtracheal ultrasound (TTUS) is an emerging imaging modality for ETT positioning.
View Article and Find Full Text PDFIndian J Otolaryngol Head Neck Surg
December 2024
Department of Cardiothoracic and Vascular Surgery (CTVS), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha India.
Korean J Anesthesiol
September 2024
Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Background: The Rapid-O2 oxygen insufflation device® (Rapid-O2) was designed primarily for rescue oxygenation in cannot intubate, cannot oxygenate (CICO) events; thus, hypercapnia is inevitable. Rapid-O2 was modified to enhance ventilation using the Venturi effect during expiration.
Methods: To determine the most effective combination of inner catheters (20 G, 18 G, 16 G, 14 G, and 2-mm inner diameter [ID] transtracheal catheter [TTC]) and insufflation catheters (16 G, 14 G, and 2-mm ID TTC) for achieving optimum ventilation, insufflating and expiratory flows were measured at an oxygen flow rate of 15 L/min.
Hosp Pediatr
September 2024
Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts.
Objectives: To determine the frequency of children with chronic respiratory failure (CRF) and home ventilator dependence undergoing surgery at a tertiary children's hospital, and to describe periprocedural characteristics and outcomes.
Methods: We conducted a retrospective cohort study of patients with CRF and home ventilator dependence who underwent noncardiac surgery from January 1, 2013, to December 31, 2019. Descriptive statistics were used to report patient and procedural characteristics.
Acta Med Philipp
May 2024
Department of Anesthesiology, ManilaMed Medical Center Manila, Manila, Philippines.
Lung cancer is the leading cause of cancer death worldwide. It may present as airway obstruction in a patient with endobronchial masses. Endobronchial brachytherapy (EBBT) has been shown to provide palliative therapy.
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