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Preoxygenation

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https://www.readbyqxmd.com/read/29665981/endotracheal-suction-in-intensive-care-a-point-prevalence-study-of-current-practice-in-new-zealand-and-australia
#1
Eileen Gilder, Rachael L Parke, Andrew Jull
BACKGROUND: Despite the evidence and available guidelines about endotracheal suction (ETS), a discrepancy between published guidelines and clinical practice persists. To date, ETS practice in the adult intensive care unit (ICU) population across New Zealand and Australia has not been described. OBJECTIVE: To describe ICU nurses' ETS practice in New Zealand and Australia including the triggers for performing endotracheal suction. METHODS: A single day, prospective observational, binational, multicentre point prevalence study in New Zealand and Australian ICUs...
April 14, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29643554/effectiveness-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-traditional-preoxygenation-followed-by-apnoeic-oxygenation-in-delaying-desaturation-during-apnoea-a-preliminary-study
#2
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Dilesh Kadapamannil, Jerry Paul, Lakshmi Kumar
Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to <90% during apnoea with THRIVE versus traditional preoxygenation followed by apnoeic oxygenation. Methods: This prospective, randomised, single-blinded study was conducted in 10 adult patients presenting for direct laryngoscopy under general anaesthesia without endotracheal intubation...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628590/comparison-of-arterial-oxygenation-and-acid-base-balance-with-the-use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-tidal-volume-breathing-with-continuous-positive-airway-pressure-for-preoxygenation-and-apneic-ventilation
#3
Nandhini Joseph, Sunil Rajan, Pulak Tosh, Dilesh Kadapamannil, Lakshmi Kumar
Background: Preoxygenation and apneic ventilation prolong apnea time without desaturation. Aims: The primary objective of this study is to compare arterial oxygenation during the periods of apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with continuous positive airway pressure (CPAP) versus with transnasal humidified rapid-insufflation ventilatory exchange (THRIVE). Settings and Designs: This prospective randomized study was conducted in 20 adult patients at a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628587/effects-of-preoxygenation-with-tidal-volume-breathing-followed-by-apneic-oxygenation-with-and-without-continuous-positive-airway-pressure-on-duration-of-safe-apnea-time-and-arterial-blood-gases
#4
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Jerry Paul, Lakshmi Kumar
Background: Application of continuous positive airway pressure (CPAP) helps to recruit collapsed areas of the lung, which improves the oxygen reserve. Aim of the Study: To compare the time to desaturate to 90% during apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with and without the application of CPAP. Settings and Design: This prospective randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29622329/pediatric-emergency-noninvasive-ventilation
#5
REVIEW
Chad D Viscusi, Garrett S Pacheco
Noninvasive ventilation (NIV) has emerged as a powerful tool for the pediatric emergency management of acute respiratory failure (ARF). This therapy is safe and well tolerated and seems to frequently prevent both the need for invasive mechanical ventilation and the associated risks/complications. Although NIV can be the primary treatment of ARF resulting from multiple respiratory disease states, it must be meticulously monitored and, when unsuccessful, may aid in preoxygenation for prompt endotracheal intubation and invasive mechanical ventilation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29576128/non-invasive-positive-pressure-ventilation-with-positive-end-expiratory-pressure-counteracts-inward-air-leaks-during-preoxygenation-a-randomised-crossover-controlled-study-in-healthy-volunteers
#6
J-L Hanouz, F Le Gall, J-L Gérard, N Terzi, H Normand
BACKGROUND: During preoxygenation, the lack of tight fit between the mask and the patient's face results in inward air leak preventing effective preoxygenation. We hypothesized that non-invasive positive-pressure ventilation and positive end-expiratory pressure (PEEP) could counteract inward air leak. METHODS: Healthy volunteers were randomly assigned to preoxygenated through spontaneous breathing without leak (SB), spontaneous breathing with a calibrated air leak (T-shaped piece between the mouth and the breathing system; SB-leak), or non-invasive positive inspiratory pressure ventilation (inspiratory support +6 cm H2 O; PEEP +5 cm H2 O) with calibrated leak (PPV-leak)...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29530653/implementation-of-a-clinical-bundle-to-reduce-out-of-hospital-peri-intubation-hypoxia
#7
Jeffrey L Jarvis, John Gonzales, Danny Johns, Lauren Sager
STUDY OBJECTIVE: Peri-intubation hypoxia is an important adverse event of out-of-hospital rapid sequence intubation. The aim of this project is to determine whether a clinical bundle encompassing positioning, apneic oxygenation, delayed sequence intubation, and goal-directed preoxygenation is associated with decreased peri-intubation hypoxia compared with standard out-of-hospital rapid sequence intubation. METHODS: We conducted a retrospective, before-after study using data from a suburban emergency medical services (EMS) system in central Texas...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29507780/association-of-homocysteine-and-smoking-with-cerebral-microemboli-in-patients-with-mechanical-heart-valves-a-transcranial-doppler-study
#8
Alicia Mattia, M Reza Azarpazhooh, Claudio Munoz, Chrysi Bogiatzi, Mackenzie A Quantz, J David Spence
Objectives: Microembolic signals (MES) on transcranial Doppler (TCD) predict stroke and cognitive decline. Plasma levels of total homocysteine (tHcy), a prothrombotic factor, are higher in patients with microemboli in carotid stenosis and in patients with paradoxical embolism. In this study we assessed the association between the level of tHcy and the number of MES in patients with mechanical heart valves (MHVs). Methods: TCD monitoring was performed to detect MES before and after breathing 100% oxygen and repeated every 2-4 weeks up to six times...
December 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/29473652/in-vitro-evaluation-of-ecg-synchronized-pulsatile-flow-using-the-i-cor-diagonal-pump-in-neonatal-and-pediatric-ecls-systems
#9
Morgan Moroi, Madison Force, Shigang Wang, Allen R Kunselman, Akif Ündar
The objective was to assess the i-cor electrocardiogram-synchronized diagonal pump in terms of hemodynamic energy properties for off-label use in neonatal and pediatric extracorporeal life support (ECLS) circuits. The neonatal circuit consisted of an i-cor pump and console, a Medos Hilite 800 LT oxygenator, an 8Fr arterial cannula, a 10Fr venous cannula, 91 cm of 0.6-cm ID arterial tubing, and 91 cm of 0.6-cm ID venous tubing. The pediatric circuit was identical except it included a 12Fr arterial cannula, a 14Fr venous cannula, and a Medos Hilite 2400 LT oxygenator...
February 23, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29411722/gabapentin-pretreatment-for-propofol-and-rocuronium-injection-pain-a-randomized-double-blind-placebo-controlled-study
#10
M Y Cakirgöz, I Demirel, E Duran, A B Özer, U A Türkmen, A Ersoy, A Aksu, V Hancı
AIM: This prospectively-planned, randomized, double-blind and placebo-controlled study aims to evaluate the effect of 1200 mg gabapentin premedication on the incidence and severity of propofol and rocuronium injection pain. METHOD: One hundred patients, between 18-60 years of age and ASA I-II for elective surgery planned under general anaesthetic, were randomized and divided into two groups. Two hours before the operation, the patients were given either a placebo tablet (Group P, n = 50) or 1200 mg gabapentin tablet (Group G, n = 50)...
January 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29406184/effect-of-preoxygenation-using-non-invasive-ventilation-before-intubation-on-subsequent-organ-failures-in-hypoxaemic-patients-a-randomised-clinical-trial
#11
C Baillard, G Prat, B Jung, E Futier, J Y Lefrant, F Vincent, A Hamdi, E Vicaut, S Jaber
BACKGROUND: Previous data showed that non-invasive ventilation (NIV) applied for 3 min before tracheal intubation ensured better oxygenation compared with using a non-rebreather bag-valve-mask. We aimed to determine whether preoxygenation using NIV is effective in reducing the incidence of organ dysfunction in hypoxaemic, critically ill patients in intensive care. METHODS: A multicentre, randomised, open-label trial evaluating 100% FiO2 administered with NIV (99 patients) vs with face mask (102 patients) for 3 min before tracheal intubation...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29405806/delayed-sequence-intubation-by-intensive-care-flight-paramedics-in-victoria-australia
#12
Jacinta Waack, Matthew Shepherd, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Delayed sequence intubation (DSI) involves the administration of ketamine to facilitate adequate preoxygenation in the agitated patient. DSI was introduced into the Clinical Practice Guideline for Intensive Care Flight Paramedics in Victoria in late 2013. We aimed to describe the clinical characteristics of patients receiving DSI. METHODS: A retrospective analysis was undertaken of patients who received DSI between January 1, 2014, and December 31, 2016, during both primary response and retrieval missions...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29287673/-efficacy-of-preoxygenation-using-tidal-volume-breathing-a-comparison-of-mapleson-a-bain-s-and-circle-system
#13
Suman Arora, Priyanka Gupta, Virender Kumar Arya, Nidhi Bhatia
BACKGROUND: Efficacy of preoxygenation depends upon inspired oxygen concentration, its flow rate, breathing system configuration and patient characteristics. We hypothesized that in actual clinical scenario, where breathing circuit is not primed with 100% oxygen, patients may need more time to achieve EtO2 ≥90%, and this duration may be different among various breathing systems. We thus studied the efficacy of preoxygenation using unprimed Mapleson A, Bain's and Circle system with tidal volume breathing at oxygen flow rates of 5L...
March 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29275345/preoxygenation-with-non-invasive-ventilation-versus-high-flow-nasal-cannula-oxygen-therapy-for-intubation-of-patients-with-acute-hypoxaemic-respiratory-failure-in-icu-the-prospective-randomised-controlled-florali-2-study-protocol
#14
Jean-Pierre Frat, Jean-Damien Ricard, Rémi Coudroy, René Robert, Stéphanie Ragot, Arnaud W Thille
INTRODUCTION: Endotracheal intubation in intensive care unit (ICU) is a procedure at high risk of life-threatening complications. Among them, severe oxygen desaturation, usually defined as a drop of pulse oxymetry (SpO2 ) below 80%, is the most common. Preoxygenation enables delaying oxygen desaturation occurring during apnea induced by anaesthetic drugs. Data suggest that non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) oxygen therapy could further increase PaO2 before intubation procedure and prevent oxygen desaturation episodes as compared with standard oxygen...
December 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29261566/cardiac-arrest-and-mortality-related-to-intubation-procedure-in-critically-ill-adult-patients-a-multicenter-cohort-study
#15
Audrey De Jong, Amélie Rolle, Nicolas Molinari, Catherine Paugam-Burtz, Jean-Michel Constantin, Jean-Yves Lefrant, Karim Asehnoune, Boris Jung, Emmanuel Futier, Gérald Chanques, Elie Azoulay, Samir Jaber
OBJECTIVES: To determine the prevalence of and risk factors for cardiac arrest during intubation in ICU, as well as the association of ICU intubation-related cardiac arrest with 28-day mortality. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Sixty-four French ICUs. PATIENTS: Critically ill patients requiring intubation in the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During the 1,847 intubation procedures included, 49 cardiac arrests (2...
April 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29210925/frequency-of-desaturation-and-association-with-hemodynamic-adverse-events-during-tracheal-intubations-in-picus
#16
Simon Li, Ting-Chang Hsieh, Kyle J Rehder, Sholeen Nett, Pradip Kamat, Natalie Napolitano, David A Turner, Michelle Adu-Darko, J Dean Jarvis, Conrad Krawiec, Ashley T Derbyshire, Keith Meyer, John S Giuliano, Joana Tala, Keiko Tarquinio, Michael D Ruppe, Ronald C Sanders, Matthew Pinto, Joy D Howell, Margaret M Parker, Gabrielle Nuthall, Michael Shepherd, Guillaume Emeriaud, Yuki Nagai, Osamu Saito, Jan Hau Lee, Dennis W Simon, Alberto Orioles, Karen Walson, Paula Vanderford, Asha Shenoi, Anthony Lee, Geoffrey L Bird, Michael Miksa, Ana Lia Graciano, Jesse Bain, Peter W Skippen, Lee A Polikoff, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. DESIGN: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network's quality improvement project from January 2012 to December 2014...
January 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29209787/-different-levels-of-experience-with-anesthetic-agents-of-german-emergency-physicians-results-of-an-online-survey
#17
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
January 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29176376/anticipated-and-unanticipated-difficult-airway-management
#18
Zeping Xu, Wuhua Ma, Douglas L Hester, Yandong Jiang
PURPOSE OF REVIEW: Management of difficult airway is far from optimal despite of continuous progress in science and technology. The purpose of this review is to summarize the current research in the field and bring readers up to date. RECENT FINDINGS: New technologies for intubation make providers more confident to handle difficult airways, but there is lack of evidence indicating the reduction in incidence of 'cannot intubate cannot ventilate (CICV)'. Optimization of mask ventilation should reduce the incidence of difficult mask ventilation but it is greatly underappreciated...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29176373/obstructive-sleep-apnea-and-bariatric-surgical-guidelines-summary-and-update
#19
Christel A L de Raaff, Nico de Vries, Bart A van Wagensveld
PURPOSE OF REVIEW: Increasing numbers of bariatric surgical procedures and the high prevalence of obstructive sleep apnea (OSA) in this population have resulted in a growing interest in the perioperative management of OSA in bariatric surgery. This review provides a summary of the first consensus guideline on this topic as well as an update of the newest literature available. RECENT FINDINGS: All bariatric patients should be screened for OSA and obesity hypoventilation syndrome (OHS) to reduce the risk of perioperative complications...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29161401/the-evolution-of-airway-management-new-concepts-and-conflicts-with-traditional-practice
#20
A F McNarry, A Patel
In the last 25 yr, there have been several advances in the safe management of the airway. Videolaryngoscopes and supraglottic airways, now in routine use by new trainees in anaesthesia, have had their genesis in the recent past. The 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society published in 2011 a seminal report that has influenced airway management worldwide . Understanding how the report's recommendations were constructed and how clinical guidelines compliment rather than contradict them is important in understanding the tenets of safe airway management...
December 1, 2017: British Journal of Anaesthesia
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