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Accurate identification of the cricothyroid membrane (CTM) has paramount importance in the event of a 'cannot intubate, cannot oxygenate' scenario. We sought to determine the ability of anesthesiologists to correctly identify the CTM in obese and non-obese children. Anesthesiologists were asked to mark the entry point of the cricothyroidotomy device with an ultraviolet invisible pen on obese and non-obese (BMI < 95th percentile for age and sex) children aged 7-12 years. A correct estimation was defined as a mark made between the upper and lower borders of the CTM and within the 3-mm midline. Twenty anesthesiologists palpated 30 obese and 50 non-obese children. The CTM was accurately identified with digital palpation in a total 55% of children, and there were no differences inaccurate identification rates of the CTM between obese and non-obese children [57 vs. 54%, respectively; median difference 3%; 95% confidence interval (- 20 to 25%); p = 0.82]. Accuracy was not correlated with any demographic or morphometric features of the children. Percutaneous identification of the CTM in children aged 7-12 years was poor and not significantly different for obese and non-obese children. Pre-procedural ultrasonography may help to identify the landmarks for cricothyroidotomy.

ÖzPurpose: The aim of this study was to investigate the relationship between serum dynamic thiol-disulfide homeostasis (TDH) and sepsis, in adult patients. Materials and Methods: In this observational, prospective, case-control study patients (n=44) diagnosed with sepsis compared with ages and gender-matched healthy controls (n=44). Patients were divided into two subgroups (survivors and non-survivors) dependent variable being remaining alive on the 28th day after ICU admission at the follow-up period. TDH parameters measured using a novel automatic and spectrophotometric method and compared statistically. Results: In patients with sepsis, native thiol, total thiol, and disulfide levels were lower than the control group, and this difference was statistically significant. TDH parameters between surviving and non-surviving patients were similar at the sepsis diagnosis. However, significant differences found in native and total thiol levels at followup via repeated measurement analyses on days 3 and 7 in surviving and non-surviving sub-groups. Conclusion: This study showed that impairment in dynamic TDH in adults with sepsis may be related to negative outcomes.Amaç: Bu gözlemsel, prospektif, vaka kontrol çalışmasında erişkin hastalarda serum dinamik Tiyol-Disülfir Homeostazisi (TDH) ile sepsis arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Sepsis tanısı ile alan 44 hasta, yaş ve cinsiyet uyumlu 44 sağlıklı kontrol ile karşılaştırıldı. Hastalar yoğun bakım ünitesi yatışından sonraki 28. günde sağ-kalan ve hayatını kaybedenler olarak 2 gruba ayrıldı. TDH parametreleri yeni, otomatik ve spektrofotometrik bir yöntem kullanılarak ölçüldü ve sonuçlar istatistiksel olarak karşılaştırıldı. Bulgular: Sepsisli hastalarda, nativ tiyol, total tiyol ve disülfit seviyeleri kontrol grubuna göre daha düşük olarak bulundu ve bu fark istatistiksel olarak anlamlı idi. Başlangıç TDH parametreleri sağ-kalan ve hayatını kaybeden hastalar arasındaki benzer bulundu. Ancak sağ kalan ve ex olan hastaların 3 ve 7. günde tekrarlanan TDH ölçümleri (nativ ve toplam tiyol seviyeleri) arasında anlamlı farklar bulundu. Sonuç: Bu çalışma, erişkin sepsis hastalarında dinamik TDH'deki bozulmanın negatif sonuçlara ilişkili olabileceğini göstermiştir.

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