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postintubation hemodynamıc instability

Nathan J Smischney, Mohamed O Seisa, John Cambest, Robert A Wiegand, Kyle D Busack, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to ascertain the frequency of postintubation hypotension in immunocompromised critically ill adults with secondary aims of arriving at potential risk factors for the development of postintubation hypotension and its impact on patient-related outcomes. METHODS: Critically ill adult patients (≥18 years) were included from January 1, 2010, to December 31, 2014. We defined immunocompromised as patients with any solid organ or nonsolid organ malignancy or transplant, whether solid organ or not, requiring current chemotherapy...
January 1, 2017: Journal of Intensive Care Medicine
Pooja Chopra, Madhu Bala Dixit, Aashish Dang, Vibhuti Gupta
BACKGROUND AND AIMS: We undertook this study to assess if a small-dose of dexmedetomidine (DEX) for conscious sedation during awake fiberoptic intubation (AFOI) in simulated cervical spine injury (CSI) patients provides optimum conditions and fulfills the need of postintubation neurological examination required in such patients. The aim was to assess the efficacy of DEX on arousability and patient's comfort during AFOI in simulated CSI patients. MATERIAL AND METHODS: In this prospective, randomized double-blind study, 100 American Society of Anesthesiologists Grade I-II patients aged between 18 and 65 years scheduled for elective surgery under general anesthesia underwent AFOI under conscious sedation with DEX...
January 2016: Journal of Anaesthesiology, Clinical Pharmacology
Sangita Trivedi, Onur Demirci, Grace Arteaga, Rahul Kashyap, Nathan J Smischney
PURPOSE: Preintubation shock index (SI) and modified shock index (MSI) have demonstrated predictive capability for postintubation hypotension in emergency department. The primary aim was to explore this relationship in the critical care environment. The secondary aims were to evaluate the relationship of shock indices with other short-term outcomes like mortality and length of stay in intensive care unit. MATERIALS AND METHODS: This is a nonconcurrent cohort study, conducted in eligible 140 adult intensive care unit (ICU) patients of a tertiary care medical center...
August 2015: Journal of Critical Care
Robert Green, Brian Hutton, Jason Lorette, Dominique Bleskie, Lauralyn McIntyre, Dean Fergusson
OBJECTIVE: Hemodynamic instability following emergent endotracheal intubation (EETI) is a potentially life-threatening adverse event. The objectives of this systematic literature review were to document the incidence of postintubation hemodynamic instability (PIHI), to determine the definitions for PIHI used in the available literature, and to examine factors associated with PIHI in adult patients who require EETI. DATA SOURCE: Articles published in Medline (1966-August 2012)...
January 2014: CJEM
Robert S Green, Janet Edwards, Elham Sabri, Dean Fergusson
OBJECTIVES: Postintubation hemodynamic instability (PIHI) is a potentially life-threatening adverse event of emergent endotracheal intubation. The objectives of this study were to determine the incidence, risk factors, and impact on patient outcomes associated with PIHI in intubations performed in emergency medicine. METHODS: A structured chart audit was performed of all consecutive adult patients requiring emergent endotracheal intubations over a 16-month period at a tertiary care emergency department (ED)...
March 2012: CJEM
P Ferdinande, D O Kim
Laryngotracheal complications after translaryngeal intubation and specifically tracheotomy are a common problem. Surgical correction of PITS is not always successful. Pathogenetic mechanisms of PITS are direct pressure necrosis by overinflated endotracheal tube and cuff material, duration of intubation, macro- and microtrauma during intubation, the specific technique of endotracheal intubation, severity of respiratory failure, infection and poor tissue perfusion due to hemodynamic instability. Following preventive guidelines are proposed: the use of high volume low pressure cuffs, cuff pressure monitoring, ventilatory support with lower airway pressures, prevention of macrotrauma during intubation and microtrauma during maintenance, adapted policy of choice between translaryngeal and tracheotomy techniques, anti-infectious strategy and swift hemodynamic stabilization...
1995: Acta Oto-rhino-laryngologica Belgica
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