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Anestesio

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3 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#1
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/27993308/comparison-of-etomidate-and-ketamine-for-induction-during-rapid-sequence-intubation-of%C3%A2-adult-trauma-patients
#2
Cameron P Upchurch, Carlos G Grijalva, Stephan Russ, Sean P Collins, Matthew W Semler, Todd W Rice, Dandan Liu, Jesse M Ehrenfeld, Kevin High, Tyler W Barrett, Candace D McNaughton, Wesley H Self
STUDY OBJECTIVE: Induction doses of etomidate during rapid sequence intubation cause transient adrenal dysfunction, but its clinical significance on trauma patients is uncertain. Ketamine has emerged as an alternative for rapid sequence intubation induction. Among adult trauma patients intubated in the emergency department, we compare clinical outcomes among those induced with etomidate and ketamine. METHODS: The study entailed a retrospective evaluation of a 4-year (January 2011 to December 2014) period spanning an institutional protocol switch from etomidate to ketamine as the standard induction agent for adult trauma patients undergoing rapid sequence intubation in the emergency department of an academic Level I trauma center...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26866753/head-elevated-patient-positioning-decreases-complications-of-emergent-tracheal-intubation-in-the-ward-and-intensive-care-unit
#3
MULTICENTER STUDY
Nita Khandelwal, Sarah Khorsand, Steven H Mitchell, Aaron M Joffe
BACKGROUND: Based on the data from elective surgical patients, positioning patients in a back-up head-elevated position for preoxygenation and tracheal intubation can improve patient safety. However, data specific to the emergent setting are lacking. We hypothesized that back-up head-elevated positioning would be associated with a decrease in complications related to tracheal intubation in the emergency room environment. METHODS: This retrospective study was approved by the University of Washington Human Subjects Division (Seattle, WA)...
April 2016: Anesthesia and Analgesia
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