ABSTRACT
During laryngeal laser surgery a 74-year-old male experienced endotracheal tube cuff ignition. This caused severe damage to the trachea. Eventually the patient died after 26 days on the intensive care unit due to a underlying cause. Microlaryngeal and tracheobronchial surgery require a good level of cooperation between the anaesthesiologist and the ENT surgeon, especially when a laser is used. To reduce the risk of an airway fire occurring, a number of precautions can (and must) be taken. Completing a checklist before the laser is used can prove helpful in this respect.
Subject(s)
Larynx/surgery , Laser Therapy/adverse effects , Trachea/injuries , Aged , Fatal Outcome , Humans , Intensive Care Units , Intubation, Intratracheal/adverse effects , MaleABSTRACT
BACKGROUND: We evaluated the reliability and usefulness of the 14C urea breath test (UBT) in confirming eradication of Helicobacter pylori 4 to 6 weeks after cessation of antimicrobial therapy. METHODS: We investigated 57 patients, who underwent both an upper endoscopy with multiple biopsy specimens taken for histopathology, culture and/or CLO test, and a 14C UBT. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the breath test were calculated against the combined biopsy-based test results. Values for sensitivity, specificity, PPV, and NPV were also calculated after excluding results in a grey zone containing equivocal test results. RESULTS: Sensitivity, specificity, PPV, and NPV of the 14C UBT were 92%, 78%, 52%, and 97%, respectively. After introduction of a grey zone concept, these values were 89%, 100%, 100%, and 97% respectively. CONCLUSIONS: We conclude that for research, upper gastrointestinal endoscopy with multiple biopsy specimens and using different diagnostic techniques should remain the 'gold standard' to test for cure.
