OBJECTIVE To determine what practices are used by hospitals to prevent ventilator-associated pneumonia (VAP) and, through qualitative methods, to understand more fully why hospitals use certain practices and not others. DESIGN Mixed-methods, sequential explanatory study. METHODS We mailed a survey to the lead infection control professionals at 719 US hospitals (119 Department of Veterans Af...

BACKGROUND Clearing subglottic secretions has been proved to reduce ventilator-associated pneumonia. A manual method named the rapid flow expulsion maneuver was developed to clear subglottic secretions. This study evaluates its safety and effectiveness and analyzes the influential factors. METHODS This study was composed of 2 parts. In an in vitro study, secretions were instilled directly to ...

The "cannot ventilate, cannot intubate" scenario during anesthesia induction can be lethal. We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an undiagnosed subglottic tumor. A 93-year-old woman was brought to the operating room for repair of a femoral neck fract...

Background Subglottic stenosis can lead to life-threatening difficult tracheal intubation during general anesthesia. We report a case of difficult tracheal intubation in an 11-month-old female who had unrecognized subglottic stenosis. Case presentation The patient was scheduled for elective correction of a right accessory auricle. She was suspected of having first and second branchial arch sy...

OBJECTIVES/HYPOTHESIS To evaluate the endoscopic surgical management of adult subglottic stenosis and describe treatment outcomes. STUDY DESIGN Retrospective review. METHODS Ten-year review of adult patients with subglottic stenosis. RESULTS Ninety-two adults (23 male, 69 female) with subglottic stenosis underwent 247 endoscopic dilations between 2001 and 2010. The mean age was 48 years a...

OBJECTIVE Partial cricotracheal resection has become a more popular procedure in the pediatric population as a treatment for severe subglottic stenosis. We describe a new technique for the posterior cricoid anastomosis. STUDY DESIGN AND SETTING This is a case series of 4 pediatric patients with a Myer-Cotton grade III or IV subglottic stensosis. SETTING Tertiary care hospital with a pediatr...

OBJECTIVE Describe the management of subglottic stenosis in a patient with Wegener's granulomatosis. MATERIAL AND METHOD Case report. RESULTS We report the case of a 26-year-old woman who presented Wegener granulomatosis and subglottic stenosis, with renal, skin, oropharyngeal, nasal, and paranasal locations. Medical treatment had cured all the locations except the subglottic stenosis. An e...

The number needed to treat can be calculated for ventilator-associated pneumonia reduction strategies such as subglottic secretion drainage technology based on previous work establishing its relative risk reduction. Assuming an incidence of 4%, employing subglottic secretion drainage in 33 patients will prevent one case of ventilator-associated pneumonia, and thus potentially 4 cases annually i...