Abstract：
:For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation should be immediately available. It also is prudent to have a surgeon skilled in performing a tracheotomy and a criothyroidotomy stand by. The intubation should be attempted in the awake state, preferably using the fiberoptic bronchoscope. The more challenging situation is when the difficult airway is confronted unexpectedly. After the first failed attempt at laryngoscopy, head position should be checked and the patient ventilated with oxygen by mask. A smaller styletted tube and possibly a different laryngoscope blade should be selected for a second attempt at intubation. The fiberoptic bronchoscope and other equipment for difficult intubation should be obtained. A second attempt should then be made. If this is unsuccessful, the patient should be reoxygenated, and assistance including a skilled anesthesiologist and surgeon should be summoned. On a third attempt, traction to the tongue can be applied by an assistant, a tube changer could be used to enter the larynx, or one of the other special techniques previously described can be used. If this third attempt fails, it may be helpful to have a physician more experienced in airway management attempt intubation after oxygen has been administered to the patient. If all attempts are unsuccessful, then invasive techniques to secure the airway will have to be performed.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Schwartz DE,Wiener-Kronish JPsubject
Has Abstractpub_date
1991-09-01 00:00:00pages
483-95issue
3eissn
0272-5231issn
1557-8216journal_volume
12pub_type
杂志文章,评审abstract：:Management of acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) is largely supportive, with the use of mechanical ventilation being a central feature. Recent advances in the understanding of ALI/ARDS and mechanical ventilation have revealed that lung-protective ventilation strategies may atten...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2006.06.008
更新日期：2006-12-01 00:00:00
abstract：:The Early Goal-Directed Therapy versus Standard Care for Sepsis trial by Rivers and colleagues in 2001 suggested that a significant mortality reduction may be realized through goal-directed interventions early in the care of patients with septic shock. However, the recent publication of the Protocol-Based Care for Ear...
journal_title：Clinics in chest medicine
pub_type： 评论,杂志文章,评审
doi：10.1016/j.ccm.2016.01.016
更新日期：2016-06-01 00:00:00
abstract：:Controversy over the use of inhaled beta-agonists has dated almost from their introduction as a treatment for asthma. Their effectiveness as bronchodilators is not disputed, but there is concern that they may worsen asthma control if used regularly and that excessive use may increase the risk of death from asthma. Fiv...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:The features of cardiovascular and pulmonary disease in exercise testing are described. In general, ventilatory limitation is the most common factor in lung disease. An early anaerobic threshold and a decreased VO2 mix in the absence of ventilatory limitation is the usual feature of severe heart disease. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：
更新日期：1984-03-01 00:00:00
abstract：:Pleural malignancies are ideal for novel therapeutic approaches because they are invariably fatal. Intrapleural (IP) chemotherapy has only marginal benefit in pleural malignancies, but may prove efficacious with hyperthermic chemotherapy administered in combination with maximal tumor debulking. IP immunotherapies may ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2013.04.007
更新日期：2013-09-01 00:00:00
abstract：:The most common causes for undiagnosed transudative effusions are congestive heart failure and hepatic hydrothorax. Pleural fluid N terminal pro-brain natriuretic peptide levels higher than 1500 pg/mL are virtually diagnostic of congestive heart failure. The most common causes for undiagnosed exudative pleural effusio...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2005.12.002
更新日期：2006-06-01 00:00:00
abstract：:Airway inflammation due to exposure to a wide variety of agents encountered in the workplace is a major cause of occupational asthma. This article reviews major examples of occupational asthma linked to airway inflammation, including their epidemiology, pathophysiology, and clinical course. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1988-12-01 00:00:00
abstract：:In the United States, trauma is the leading cause of death in people under 40 years of age. Chest trauma is a relatively common but potentially lethal injury and requires a high level of suspicion, rapid diagnosis, and appropriate therapy. Methods for the assessment, diagnosis, and treatment of chest trauma are discus...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:This article reviews the basic principles of drug treatment of tuberculosis, individual pharmacologic agents, current treatment recommendations, and several special situations that clinicians are likely to encounter in medical practice. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2005.02.011
更新日期：2005-06-01 00:00:00
abstract：:It has been proposed that invasive carcinoma of the bronchus develops through a transition from preinvasive lesions to overt malignancy. Newer diagnostic technologies have provided a more sensitive way to diagnose preinvasive lesions and a better understanding of the prevalence of such lesions. The natural history of ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2011.08.008
更新日期：2011-12-01 00:00:00
abstract：:Traditional tuberculosis (TB) infection control focuses on the known patient with TB, usually on appropriate treatment. A refocused, intensified TB infection control approach is presented. Combined with active case finding and rapid molecular diagnostics, an approach called FAST is described as a convenient way to cal...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2019.07.010
更新日期：2019-12-01 00:00:00
abstract：:Blood gas analyses are an essential part of modern patient care. Although all blood gas instruments have pH, PCO2, and PO2 electrodes based on the same principles, instruments in current use vary greatly in design, operator dependence, and accuracy. For the clinician to obtain accurate and timely results there must be...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-06-01 00:00:00
abstract：:Pulmonary hypertension is a frequently encountered problem in older patients. True idiopathic pulmonary arterial hypertension can also be seen and requires careful exclusion in older patients. Institution of therapies must be tempered with an appreciation of individual comorbidities and functional limitations that may...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2007.08.006
更新日期：2007-12-01 00:00:00
abstract：:Delirium is a frequent complication in older patients in the ICU and often persists beyond their ICU stay. Delirium in older persons in the ICU is a dynamic and complex process. There is a high prevalence of pre-existing cognitive impairment in patients who are admitted to the medical ICU. This pre-existing cognitive ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(03)00092-3
更新日期：2003-12-01 00:00:00
abstract：:With the increasing threat of pandemic influenza and catastrophic bioterrorism, it is important for intensive care providers to be prepared to meet the challenge of large-scale airborne epidemics causing mass casualty respiratory failure. The severe acute respiratory syndrome outbreak exposed the vulnerability of heal...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2008.01.001
更新日期：2008-06-01 00:00:00
abstract：:Many different therapeutic compounds are associated with pulmonary toxicity. Although the mechanism of injury for many of these compounds is poorly defined, several compounds are believed to produce alterations in normal lung biochemistry. These mechanisms of injury in both clinical and experimental models are discuss...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-03-01 00:00:00
abstract：:The term "steroid-resistant (SR) asthma" has been used to describe a group of asthmatics who demonstrate persistent airway obstruction and inflammation despite treatment with high doses of systemic glucocorticoids. There are at least two forms of SR asthma, that is, primary and acquired types. Type I SR asthma is acqu...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70405-6
更新日期：1997-09-01 00:00:00
abstract：:Biologic drugs have revolutionized the treatment of certain hematologic, autoimmune, and malignant diseases, but they may place patients at risk for reactivation or acquisition of tuberculosis. This risk is highest with the tumor necrosis factor-alpha (TNF-α) inhibitors. Amongst this class of drugs, the monoclonal ant...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2019.07.003
更新日期：2019-12-01 00:00:00
abstract：:Pulmonary rehabilitation is an art of medical practice incorporating many therapeutic modalities with the goal of improving the patient's functional ability. The gains to be realized and the basis for improvement following pulmonary rehabilitation are detailed in this article. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1986-12-01 00:00:00
abstract：:A number of different imaging modalities can be used in the assessment of pleural disease. Although ultrasound has been the more traditional method, CT has found increasing utility for the assessment of the empyema and loculated pleural fluid collections prior to drainage and the evaluation of benign and malignant ple...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70076-9
更新日期：1998-06-01 00:00:00
abstract：:Selected occupational populations are at the highest risk of lung cancer, because they smoke at increased rates and are concurrently exposed to workplace lung carcinogens. Low-dose computed tomography (CT)-based lung cancer screening has an enormous potential to reduce lung cancer mortality in these populations, as sh...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2020.08.016
更新日期：2020-12-01 00:00:00
abstract：:The pathogenesis of O2 toxicity involves intracellular production of partially reduced O2 metabolites, which increases with O2 partial pressure. Cytotoxic O2 metabolites impair enzyme function and inhibit DNA, protein, and surfactant lipid biosynthesis. Compounds used clinically that increase O2 metabolism or that are...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:Lung diffusing capacity for carbon monoxide (Dlco) remains the only noninvasive pulmonary function test to provide an integrated picture of gas exchange efficiency in human lungs. Due to its critical dependence on the accessible "alveolar" volume (Va), there remains substantial misunderstanding on the interpretation o...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2019.02.005
更新日期：2019-06-01 00:00:00
abstract：:Primary graft dysfunction (PGD) is the most important cause of early morbidity and mortality following lung transplantation. PGD affects up to 25% of all lung transplant procedures and currently has no proven preventive therapy. Lung transplant recipients who recover from PGD may have impaired long-term function and a...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2011.02.007
更新日期：2011-06-01 00:00:00
abstract：:Inhaled particles are cleared from the airways by ciliary transport of a discontinuous mucous layer. The effectiveness of this process depends on the viscoelastic properties of the secretion, which in turn depend on the composition and interaction of the glycoprotein constituents. In human airways, two major cell type...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1986-06-01 00:00:00
abstract：:Illicit drug users comprise a substantial and growing proportion of the HIV-infected population. Although they develop pulmonary complications common to all HIV transmission groups, they also have unique respiratory illnesses due to the direct effect of the illicit drugs on the lung. Bacterial infections, tuberculosis...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-5231(05)70348-8
更新日期：1996-12-01 00:00:00
abstract：:This article summarizes the health effects of indoor air pollutants and the modalities available to control them. The pollutants discussed include active and passive exposure to tobacco smoke; combustion products of carbon monoxide; nitrogen dioxide; products of biofuels, including wood and coal; biologic agents leadi...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Both chylothorax and pseudochylothorax are characterized by milky or turbid pleural effusions. The importance of distinguishing these two conditions cannot be overemphasized because the prognosis and management are different. ...
journal_title：Clinics in chest medicine
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:Although primarily a lung disease, chronic obstructive pulmonary disease (COPD) is now recognized to have extrapulmonary effects on distal organs, the so-called systemic effects and comorbidities of COPD. Skeletal muscle dysfunction, nutritional abnormalities including weight loss, cardiovascular complications, metabo...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2013.10.007
更新日期：2014-03-01 00:00:00
abstract：:In therapy for ventilator-associated pneumonia, it is essential to get initial empiric therapy correct; this is challenging because many patients are infected with multidrug-resistant pathogens. The need for achieving appropriate therapy can lead to broad-spectrum empiric therapy, which can represent antibiotic overus...
journal_title：Clinics in chest medicine
pub_type： 杂志文章,评审
doi：10.1016/j.ccm.2011.05.009
更新日期：2011-09-01 00:00:00
