International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2016
Multicenter Study Comparative StudyReliability of the reflux finding score for infants in flexible versus rigid laryngoscopy.
The Reflux Finding Score for Infants (RFS-I) was developed to assess signs of laryngopharyngeal reflux (LPR) in infants. With flexible laryngoscopy, moderate inter- and highly variable intraobserver reliability was found. We hypothesized that the use of rigid laryngoscopy would increase reliability and therefore evaluated the reliability of the RFS-I for flexible versus rigid laryngoscopy in infants. ⋯ Reliability of the RFS-I was moderate and did not differ between flexible and rigid laryngoscopies. The RFS-I is not suitable to detect signs or to guide treatment of LPR in infants, neither with flexible nor with rigid laryngoscopy.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2016
Residual volume in the cuff of the endotracheal tube when the pilot balloon is torn off instead of deflated using a syringe.
In recent years, there has been a shift in airway management with the use of cuffed endotracheal tubes (ETT) in pediatric patients. While the use of a syringe to deflate the cuff is generally recommended, anecdotal observations suggest that some healthcare practitioners tear off the pilot balloon from ETT to deflate the cuff. This study was conducted to estimate the residual volume in the cuff when the pilot balloon is torn off for deflation. ⋯ Since significant percentage of the volume remained in the cuff after tearing off the pilot balloon tube with one being completely occluded, we would not recommend this method for cuff deflation.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2016
Comparative StudyParents' decisional conflict, self-determination and emotional experiences in pediatric otolaryngology: A prospective descriptive-comparative study.
The aim of this study was to describe the level of decisional conflict experienced by parents considering surgery for their children and to determine if personal characteristics and emotional experiences vary as a function of whether or not parents experienced clinically significant levels of decisional conflict. ⋯ Parental decision-making on whether their child should undergo elective pediatric otolaryngological surgery is a personal and emotional process. Parents' characteristics and experiences should be acknowledged and supported during the surgical consultation. Future research should aim to normalize the decision-making experience for parents, and to allow surgeons to be aware of the importance of decisional needs.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2016
Practice GuidelineInternational Pediatric Otolaryngology Group (IPOG) consensus recommendations: Routine peri-operative pediatric tracheotomy care.
To develop consensus recommendations for peri-operative tracheotomy care in pediatric patients. ⋯ Pediatric peri-operative tracheotomy care consensus recommendations are aimed at improving patient-centered care in this patient population.
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Int. J. Pediatr. Otorhinolaryngol. · Jun 2016
Endotracheal tubes and the cricoid: Is there a good fit?
Choosing an appropriately sized endotracheal tube (ETT) is important in pediatric patients as an inappropriately sized ETT may result in multiple endotracheal intubation attempts or excessive pressure on the tracheal mucosa with the potential for airway damage. Although age-based formulas are generally used with choice of an ETT based on the internal diameter (ID), measurements of the outer diameter (OD) of the ETT would seem to be a more scientific approach to determine the proper size of an ETT. However, the variable OD of the ETT despite the same ID makes the selection of a proper sized ETT more difficult. The current study compares airway dimensions measured using computed tomography (CT) with the OD of ETTs from various manufacturers. ⋯ When choosing an ETT, age-based formulas which use the ID may not be uniformly accurate in ensuring the appropriately-sized ETT given the variation in the OD despite the same ID. These issues further support the use of cuffed ETTs as the variation in fit can be adjusted by inflation of the cuff to provide an adequate tracheal seal.