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Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P226, 2022.
Article in English | EMBASE | ID: covidwho-2064405


Introduction: Extracorporeal membrane oxygenation (ECMO) can be used during difficult airway surgery because it provides an unobstructed operative field while ensuring adequate oxygenation without need for ventilation. We present a case of utilizing ECMO to perform urgent tracheostomy on a COVIDpositive patient with a large oropharyngeal mass causing critical airway narrowing. Method(s): A 62-year-old man presented with 6 months of worsening dyspnea. Computed tomography imaging and flexible laryngoscopy showed a large oropharyngeal mass extending into the nasopharynx and larynx causing critical airway narrowing and severely distorted upper airway anatomy. Traditional methods to secure the airway including transnasal vs transoral intubation vs awake tracheostomy were considered inadequate due to tumor location/friability, trismus, inability to lie flat, and unclear tracheal landmarks on palpation. In addition, on the day of surgery, the patient tested positive for COVID. We decided ECMO was the safest method to safely perform tracheostomy while minimizing COVID aerosolization. Result(s): The thoracic surgery team proceeded with bifemoral cannulation, and ECMO was initiated in less than 30 minutes. Standard tracheostomy was performed, and biopsies of the oropharyngeal mass were obtained. The patient was weaned off ECMO after <1 hour and awakened without any issues. There were no complications from bi-femoral venous access. Conclusion(s): Multiple methods to secure this patient's difficult airway were considered. Fiber-optic nasal intubation would require navigating the bronchoscope around the large tumor partially obstructing the nasopharynx and larynx. Awake tracheostomy was considered risky due to his large neck circumference, significant coughing episodes, and inability to lay supine. Both of these options would also be associated with high levels of COVID aerosolization. The use of ECMO allowed for apneic tracheostomy while minimizing the risk of COVID infection to all operating room personnel. In the era of COVID, ECMO is an unconventional but powerful tool that should be added to the armamentarium of highrisk airway surgery.

IEEE Sensors Journal ; 2021.
Article in English | Scopus | ID: covidwho-1574574


This paper describes a wearable, open-source wrist temperature monitoring system that enables the reliable identification of slowly-varying skin temperature patterns that may be indicative of infections. The hardware platform uses a Bluetooth Low Energy (BLE) wireless interface and includes three skin temperature sensors, a thermally-isolated ambient temperature sensor, an inertial measurement unit (IMU), and a Galvanic skin response (GSR) sensor. A template-matching algorithm is used to detect weak but long-lived anomalous temperature patterns that deviate from the normal circadian rhythm are thus may be driven by infections. Experimental and simulation results confirm that small temperature anomalies (peak value <0.4°C) extending over 2-3 weeks can be detected with a total error rate <10%. IEEE