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"Preoxygenation" OR "Pre-oxygenation" OR "Pre Oxygenation" OR "Pre-Ox" OR "Apnoeic Oxygenation" OR "Ap-Ox"

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https://www.readbyqxmd.com/read/30056844/development-and-testing-of-a-novel-anaesthesia-induction-ventilation-protocol-for-patients-with-cardiogenic-shock-complicating-acute-myocardial-infarction
#1
Athanasios Chalkias, Fotios Pavlopoulos, Effie Papageorgiou, Christos Tountas, Artemis Anania, Maria Panteli, Apostolos Beloukas, Theodoros Xanthos
BACKGROUND: Cardiogenic shock is a life-threatening condition and patients might require rapid sequence induction (RSI) and mechanical ventilation. In this study, we evaluated a new RSI/mechanical ventilation protocol in patients with acute myocardial infarction complicated by cardiogenic shock. METHODS: We included consecutive adult patients who were transferred to the emergency department. The RSI protocol included 5 phases: preoxygenation, pretreatment, induction/paralysis, intubation, and mechanical ventilation (PPIIM)...
August 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30048366/oxygenator-impact-on-ceftaroline-in-extracorporeal-membrane-oxygenation-circuits
#2
Jeffrey J Cies, Wayne S Moore, Nadji Giliam, Tracy Low, Adela Enache, Arun Chopra
OBJECTIVES: To determine the oxygenator impact on alterations of ceftaroline in a contemporary neonatal/pediatric (1/4-inch) and adolescent/adult (3/8-inch) extracorporeal membrane oxygenation circuit including the Quadrox-i oxygenator (Maquet, Wayne, NJ). DESIGN: Quarter-inch and 3/8-inch, simulated closed-loop extracorporeal membrane oxygenation circuits were prepared with a Quadrox-i pediatric and Quadrox-i adult oxygenator and blood primed. Additionally, 1/4-inch and 3/8-inch circuits were also prepared without an oxygenator in series...
July 25, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30037519/end-tidal-oxygen-saturation-with-nasal-cannula-during-noninvasive-positive-pressure-ventilation-a-randomized-crossover-trial
#3
Derek J Brown, Jessica Carmichael, Stephen M Carroll, Michael D April
BACKGROUND: Simultaneous use of nasal cannula (NC) with noninvasive positive pressure ventilation (NIPPV) may help streamline the transition from preoxygenation to intubation with apneic oxygenation in patients with deteriorating respiratory status, but may also compromise preoxygenation by impairing NIPPV mask seal. OBJECTIVES: To demonstrate that end-tidal oxygen (EtO2 ) after NIPPV with NC is noninferior to that of NIPPV without NC. METHODS: We conducted a randomized cross-over noninferiority study using healthy volunteers...
July 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30036274/what-every-anesthesiologist-should-know-about-the-manual-resuscitation-bag
#4
Carolyn S Sivco, Verghese T Cherian
The bag-valve-mask or the manual resuscitation bag is life-saving equipment. This article explains its construction, functioning, and limitations. This article also attempts to clarify some common misconceptions such as whether a resuscitation bag can be used to preoxygenate or provide continuous positive airway pressure or positive end-expiratory pressure and the highest percentage of oxygen that it can deliver.
July 20, 2018: A&A practice
https://www.readbyqxmd.com/read/30020104/novel-preoxygenation-technique-to-deliver-high-flow-oxygen-in-a-patient-with-facial-trauma-a-case-report
#5
Verna M Aykanat, Desmond P McGlade
This case demonstrates a novel preoxygenation technique in a patient with difficult access to the airway after a traumatic facial injury. To find a solution, a fusion of oxygenation equipment was trialed by altering and combining a tracheostomy mask and the tubing of an Optiflow circuit from which the nasal cannula component had been removed. This novel combination delivered high-flow humidified oxygen (60 L/min) orally, avoided further facial injury, and was well tolerated by the patient. Effective preoxygenation was confirmed by arterial gas measurements...
July 16, 2018: A&A practice
https://www.readbyqxmd.com/read/29966108/the-use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-for-pre-oxygenation-in-neurosurgical-patients-a-randomised-controlled-trial
#6
I Ng, R Krieser, P Mezzavia, K Lee, C Tseng, Nwr Douglas, R Segal
This study explored the use of high-flow nasal oxygen (HFNO) in both pre-oxygenation and apnoeic oxygenation in adults who were intubated following a non-rapid sequence induction. Fifty patients were randomised to receive pre-oxygenation via a standard facemask or the Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) device. After five minutes of pre-oxygenation, induction and muscle relaxant agents were given. While waiting for complete paralysis, patients in the standard facemask group received bag-mask ventilation (BMV), whereas patients in the HFNO group received apnoeic oxygenation via the THRIVE device...
July 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29959498/-rapid-sequence-induction-and-intubation-in-patients-with-risk-of-aspiration-recommendations-for-action-for-practical-management-of-anesthesia
#7
C Eichelsbacher, H Ilper, R Noppens, J Hinkelbein, T Loop
BACKGROUND: Induction of general anesthesia in patients with risk for aspiration needs special considerations to avoid the incidence and severity of complications. Since no evidence-based guidelines support the challenge for anesthesiologists various practical recommendations exist in clinical practice for rapid sequence induction and intubation (RSI). The aim of this systematic review is, to summarize the evidence and recommend a decision making process. MATERIAL AND METHODS: Multilevel RAND-delphi-method (RAND: Research and Development) combined with systematic literature research, individual assessment and evaluation, consensus conferences and final common sequence...
June 29, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29866144/standardised-data-reporting-from-pre-hospital-advanced-airway-management-a-nominal-group-technique-update-of-the-utstein-style-airway-template
#8
G A Sunde, A Kottmann, J K Heltne, M Sandberg, M Gellerfors, A Krüger, D Lockey, S J M Sollid
BACKGROUND: Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. We aimed to identify which airway data were most important to report today and to revise and update a previously reported Utstein-style airway management dataset. METHODS: We recruited sixteen international experts in pre-hospital airway management from Australia, United States of America, and Europe...
June 4, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29802903/difficult-intubation-and-extubation-in-adult-anaesthesia
#9
O Langeron, J-L Bourgain, D Francon, J Amour, C Baillard, G Bouroche, M Chollet Rivier, F Lenfant, B Plaud, P Schoettker, D Fletcher, L Velly, K Nouette-Gaulain
OBJECTIVE: To provide an update to French guidelines about "Difficult intubation and extubation in adult anaesthesia 2006". DESIGN: A consensus committee of 13 experts was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independent of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence...
May 23, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29739649/desaturation-times-between-dogs-preoxygenated-via-face-mask-or-flow-by-technique-before-induction-of-anesthesia
#10
Barbara Ambros, Maria Valentina Carrozzo, Teela Jones
OBJECTIVE: To compare time to desaturation after induction of anesthesia following administration of oxygen via face mask or flow-by for 3 minutes. STUDY DESIGN: Randomized crossover study. ANIMALS: A group of six healthy adult dogs weighing 15.0 ± 3.4 kg. METHODS: Dogs were anesthetized twice separated by 14 days. Intramuscular administration of dexmedetomidine (4 μg kg-1 ), acepromazine (0.01 mg kg-1 ) and butorphanol (0...
July 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29720758/ultra-modified-rapid-sequence-induction-with-transnasal-humidified-rapid-insufflation-ventilatory-exchange-challenging-convention
#11
Ketan Sakharam Kulkarni, Nandini Dave, Shriyam Saran, Madhu Garasia, Sandesh Parelkar
During positive pressure ventilation, gastric inflation and subsequent pulmonary aspiration can occur. Rapid sequence induction (RSI) technique is an age-old formula to prevent this. We adopted a novel approach of RSI for patients with high risk of aspiration and evaluated it further in patients undergoing laparoscopic surgeries. We believe that, in patients with risk of gastric insufflation and pulmonary aspiration, transnasal humidified rapid-insufflation ventilatory exchange can be useful in facilitating pre- and apnoeic oxygenation till tracheal isolation is achieved...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29665981/endotracheal-suction-in-intensive-care-a-point-prevalence-study-of-current-practice-in-new-zealand-and-australia
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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/29575097/evaluation-and-comparison-of-hemodynamic-performance-of-three-ecls-systems-in-a-simulated-adult-cardiogenic-shock-model
#18
Akif Ündar, Shigang Wang, Morgan Moroi, Allen R Kunselman, Christoph E Brehm
The objective of this study was to evaluate three commercially available ECLS systems with rotary pumps in terms of circuit pressure, pressure drop, perfusion modes, and hemodynamic energy transmission in a simulated adult cardiogenic shock model. One circuit consisted of a Cardiohelp system, which included a Cardiohelp console and HLS Module Advanced 7.0 tubing set with integrated centrifugal pump and oxygenator. The alternative circuit was composed of a Quadrox-D Adult oxygenator connected in series with either an i-cor diagonal pump and console or a Rotaflow centrifugal pump and console...
March 25, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29560073/nasal-cannula-apneic-oxygenation-prevents-desaturation-during-endotracheal-intubation-an-integrative-literature-review
#19
REVIEW
Joshua M Gleason, Bill R Christian, Erik D Barton
Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e., arterial blood gas level, hemoglobin value, or chest radiograph). During pre-oxygenation, administering high-flow nasal oxygen in addition to a non-rebreather face mask can significantly boost the effective inspired oxygen...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29530653/implementation-of-a-clinical-bundle-to-reduce-out-of-hospital-peri-intubation-hypoxia
#20
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
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