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endotracheal intubation complications

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https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#1
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902612/intubation-without-use-of-stylet-for-mcgrath-videolaryngoscopy-in-patients-with-expected-normal-airway-a-randomized-noninferiority-trial
#2
Hyun Jeong Kwak, Sook Young Lee, Su Youn Lee, Yong Beom Kim, Jong Yeop Kim
BACKGROUND: During McGrath videolaryngoscope (VL) intubation, a styletted endotracheal tube maintaining an upward distal tip angle is recommended by some manufacturers. However, a styletted endotracheal tube can elicit rare but potentially serious complications. The purpose of this study was to demonstrate that a nonstyletted tube with exaggerated curvature would be noninferior to a styletted tube for orotracheal intubation using McGrath VL in patients with expected normal airway, by comparing the time to intubation and ease of intubation...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27894764/thoracoscopic-bilateral-t3-sympathectomy-for-primary-focal-hyperhidrosis-in-children
#3
Pablo Laje, Kali Rhodes, Leanne Magee, Mary Kate Klarich
AIM OF THE STUDY: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients. METHODS: Retrospective chart review of all patients operated between 2013 and 2015. RESULTS: We operated and included in the study 28 patients, 22 females and 6 males. Mean age was 14 (6-21) years. All patients had previously tried at least one form of medical therapy with no success...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27886977/can-submandibular-tracheal-intubation-be-an-alternative-to-tracheotomy-during-surgery-for-major-maxillofacial-fractures
#4
Ahmed Gaber Hassanein, Ahmed M A Abdel Mabood
PURPOSE: During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. MATERIALS AND METHODS: This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27875775/bronchoscopic-intubation-is-an-effective-airway-strategy-in-critically-ill-patients
#5
Kevin C Ma, Augustine Chung, Kerri I Aronson, Jamuna K Krishnan, Igor Z Barjaktarevic, David A Berlin, Edward J Schenck
PURPOSE: American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients. METHODS: We performed a retrospective cohort study of patients who underwent endotracheal intubation in the medical intensive care unit of a tertiary urban referral center over 1 academic year...
November 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27871595/a-comparison-of-king-vision-video-laryngoscopy-and-direct-laryngoscopy-as-performed-by-residents-a-randomized-controlled-trial
#6
Jose A Valencia, Katherine Pimienta, Darwin Cohen, Daniel Benitez, David Romero, Oswaldo Amaya, Enrique Arango
STUDY OBJECTIVE: For more than 40 years, direct laryngoscopy (DL) has been used to assure the airway during endotracheal intubation. The King Vision video laryngoscope is one of the latest devices introduced for endotracheal intubation. We hypothesize that, relative to direct laryngoscopy, it improves the intubation success rate with fewer intubation attempts and no difference in intubation time or complications. DESIGN: This randomized controlled clinical trial included...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871543/soft-palate-trauma-induced-during-glidescope-intubation
#7
Joseph P Allencherril, Linda Joseph
The GlideScope (GVL; Saturn Biomedical Systems, Burnaby, British Columbia, Canada) is a rigid indirect video laryngoscope device that facilitates exposure of the larynx for placement of the endotracheal tube. This blade also reduces the requirement for anterior displacement of the tongue. A unique feature is the acutely angled blade which provides an improved glottic view. Herein, we present 2 instances of soft palate trauma, a rare oropharyngeal complication linked to GlideScope use. In the first case, the GlideScope was used for pedagogical purposes for intubation in a knee surgery...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27863823/general-endotracheal-vs-non-endotracheal-regional-anesthesia-for-elective-inguinal-hernia-surgery-in-very-preterm-neonates-a-single-institution-experience
#8
Jean Gurria, Phillip Kuo, Angie Kao, Luisa Christensen, AiXuan Holterman
BACKGROUND: Very pre-term infants (VP) at <32 weeks post menstrual age PMA have a high incidence of bronchopulmonary dysplasia BPD. BPD places them at risk for pulmonary-related perioperative complications from general endotracheal anesthesia GE during elective inguinal hernia repair. METHODS: A retrospective cohort study was done to compare pulmonary-related perioperative risks between VP patients undergoing non-emergent inguinal hernia repair prior to NICU discharge under GE (n=58) vs regional anesthesia RA (n=37)...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27853105/clinical-characteristics-of-patients-who-overdose-on-multiple-psychotropic-drugs-in-tokyo
#9
Satoshi Hori, Kosaku Kinoshita
OBJECTIVE: The purpose of this study was to identify the clinical aspects leading to overdose of multiple psychotropic drugs, in order to determine areas which need attention in the proper treatment of overdose patients. METHODS: Patients who were treated for overdose of psychotropic drugs at our emergency and critical center over two years were targeted. The clinical data was gathered from the medical records and database of all patients, including age, gender, vital signs, and laboratory data, drugs, and medical complications during hospital stay...
2016: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/27846872/challenges-on-non-invasive-ventilation-to-treat-acute-respiratory-failure-in-the-elderly
#10
REVIEW
Raffaele Scala
Acute respiratory failure is a frequent complication in elderly patients especially if suffering from chronic cardio-pulmonary diseases. Non-invasive mechanical ventilation constitutes a successful therapeutic tool in the elderly as, like in younger patients, it is able to prevent endotracheal intubation in a wide range of acute conditions; moreover, this ventilator technique is largely applied in the elderly in whom invasive mechanical ventilation is considered not appropriated. Furthermore, the integration of new technological devices, ethical issues and environment of treatment are still largely debated in the treatment of acute respiratory failure in the elderly...
November 15, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27843784/successful-conservative-management-of-tracheal-injury-after-forceful-coughing-during-extubation-a-case-report
#11
Joo Hyeon Oh, Sung Jun Hong, Sang Soo Kang, Sung Mi Hwang
A-56-year-old woman underwent carpal tunnel release surgery under general anesthesia. Thirty minutes after extubation, the patient complained of chest discomfort with dyspnea. Swelling of the neck and upper anterior chest was observed. Computed tomography of the chest showed tracheal rupture at the brachiocephalic trunk level, and bronchoscopy demonstrated a 5 cm linear tracheal defect in the posterior membranous wall, 6 cm proximal to the carina. Surgical repair of the tracheal injury was impossible due to its location...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27842751/noninvasive-ventilation
#12
REVIEW
Giuseppe Bello, Gennaro De Pascale, Massimo Antonelli
Noninvasive ventilation (NIV) has assumed a prominent role in the treatment of patients with both hypoxemic and hypercapnic acute respiratory failure (ARF). The main theoretic advantages of NIV include avoiding side effects and complications associated with endotracheal intubation, improving patient comfort, and preserving airway defense mechanisms. Factors that affect the success of NIV in patients with ARF are clinicians' expertise, selection of patient, choice of interface, selection of ventilator setting, proper monitoring, and patient motivation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27822309/trends-in-intubation-rates-and-durations-in-ventilated-severely-injured-trauma-patients-an-analysis-from-the-traumaregister-dgu%C3%A2
#13
Khalid Almahmoud, Michel Teuben, Hagen Andruszkow, Klemens Horst, Rolf Lefering, Frank Hildebrand, Hans Christoph Pape, Roman Pfeifer
BACKGROUND: Endotracheal intubation in severely injured patients is known to be a risk factor for systemic complications. We aimed to examine the changes in intubation rates and durations in severely injured trauma patients, and rates of the systemic complications associated with ventilation changes by using a large trauma registry over the period of 13 years. METHODS: Patient demographics, Injury Severity Score (ISS), ventilation days, ventilation free days (VFD), and prevalence of systemic complications (sepsis and multiple organ failure (MOF)) were obtained from the TraumaRegister DGU® and were compared over the study period...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#14
REVIEW
Julian deBacker, Nicholas Hart, Eddy Fan
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the intensive care unit (ICU). Furthermore, changes in the delivery of critical care such as protocolized care pathways, minimizing or interrupting sedation, increased monitoring techniques, and overall improvements in reducing immobility have created a modern, 21st century ICU environment whereby NMBAs may be administered safely...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27816155/respiratory-considerations-including-airway-and-ventilation-issues-in-critical-care-obstetric-patients
#15
REVIEW
Holly Ende, Dirk Varelmann
Critical care management of the obstetric patient can present unique challenges. Parturients who present with respiratory distress can suffer from a multitude of etiologies, and each diagnosis must be pursued as appropriate to the clinical picture. Normal physiologic changes of pregnancy may obscure the presentation and diagnosis, and irrelevant of the cause, pregnancy may complicate the management of hypoxic and hypercarbic respiratory failure in this patient population. In addition to these concerns, both anticipated and unanticipated difficult airway management, including difficulty ventilating and intubating, are more common during pregnancy and may be encountered during endotracheal tube placement...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27803831/esophageal-perforation-with-unilateral-fluidothorax-caused-by-nasogastric-tube
#16
Lukas P Mileder, Martin Müller, Friedrich Reiterer, Alexander Pilhatsch, Barbara Gürtl-Lackner, Berndt Urlesberger, Wolfgang Raith
Preterm infants are highly susceptible to injuries following necessary and often life-saving medical interventions. Esophageal perforation is a rare, yet serious complication that can be caused by aerodigestive tract suction, endotracheal intubation, or nasogastric tube placement. We present the case of a neonate born at 23 weeks plus three days of gestation with chest radiography showing malposition of the nasogastric feeding tube and massive right-sided effusion of Iopamidol in the pleural cavity due to esophageal perforation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27796041/optimal-anesthetic-regimen-for-ambulatory-laser-microlaryngeal-surgery
#17
Hyub Huh, Seol Ju Park, Hyong Hwan Lim, Kwang Yoon Jung, Seung-Kuk Baek, Seung Zhoo Yoon, Hye Won Lee, Hye Ja Lim, Jang Eun Cho
OBJECTIVES/HYPOTHESIS: Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27788591/chloroform-ingestion-causing-severe-gastrointestinal-injury-hepatotoxicity-and-dermatitis-confirmed-with-plasma-chloroform-concentrations
#18
Dushan Jayaweera, Shawkat Islam, Naren Gunja, Chris Cowie, James Broska, Latesh Poojara, Michael S Roberts, Geoffrey K Isbister
CONTEXT: Poisoning due to chloroform ingestion is rare. The classic features of acute chloroform toxicity include central nervous system (CNS) and respiratory depression, and delayed hepatotoxicity. CASE DETAILS: A 30-year-old female ingested 20-30 mL of 99% chloroform solution, which caused rapid loss of consciousness, transient hypotension and severe respiratory depression requiring endotracheal intubation and ventilation. She was alert by 12 h and extubated 16 h post-overdose...
October 28, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27776162/incidence-clinical-outcome-and-risk-factors-of-intensive-care-unit-infections-in-the-lagos-university-teaching-hospital-luth-lagos-nigeria
#19
Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
https://www.readbyqxmd.com/read/27769694/cuff-pressure-monitoring-by-manual-palpation-in-intubated-patients-how-accurate-is-it-a-manikin-simulation-study
#20
Dr Gian Domenico Giusti, Dr Cecilia Rogari, Dr Alessio Gili, Dr Fulvio Nisi
BACKGROUND: Endotracheal intubation (ETI) for mechanical ventilation has a central role in the Intensive Care Unit (ICU). ETI is one of the main risk factors for the development of ventilator-associated pneumonia (VAP) as its presence reduces the natural defences of the upper airway and allows the micro-suction of secretions in the airways. In order to minimise such complications, it is fundamental to maintain a suitable pressure inside the tube cuff. AIM AND SCOPE: The main objective of the present study is to evaluate the effectiveness and reliability of palpation method, performed with the operators fingers, for detecting the tube cuff pressure...
October 18, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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