Airway Extubation: Removal of an endotracheal tube from the patient.Ventilator Weaning: Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation.Intubation, Intratracheal: A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.Airway Obstruction: Any hindrance to the passage of air into and out of the lungs.Airway Remodeling: The structural changes in the number, mass, size and/or composition of the airway tissues.Laryngeal Edema: Abnormal accumulation of fluid in tissues of any part of the LARYNX, commonly associated with laryngeal injuries and allergic reactions.Device Removal: Removal of an implanted therapeutic or prosthetic device.Airway Resistance: Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow.Respiration, Artificial: Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).Anesthesia Recovery Period: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Respiratory Insufficiency: Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI.Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about.Positive-Pressure Respiration: A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.Bronchial Hyperreactivity: Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory.Airway Management: Evaluation, planning, and use of a range of procedures and airway devices for the maintenance or restoration of a patient's ventilation.Respiratory Distress Syndrome, Newborn: A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause.Continuous Positive Airway Pressure: A technique of respiratory therapy, in either spontaneously breathing or mechanically ventilated patients, in which airway pressure is maintained above atmospheric pressure throughout the respiratory cycle by pressurization of the ventilatory circuit. (On-Line Medical Dictionary [Internet]. Newcastle upon Tyne(UK): The University Dept. of Medical Oncology: The CancerWEB Project; c1997-2003 [cited 2003 Apr 17]. Available from: http://cancerweb.ncl.ac.uk/omd/)Respiratory Mucosa: The mucous membrane lining the RESPIRATORY TRACT, including the NASAL CAVITY; the LARYNX; the TRACHEA; and the BRONCHI tree. The respiratory mucosa consists of various types of epithelial cells ranging from ciliated columnar to simple squamous, mucous GOBLET CELLS, and glands containing both mucous and serous cells.

Risk factors and outcomes after unplanned extubations on the ICU: a case-control study. (1/49)

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Unplanned extubation in the ICU: a marker of quality assurance of mechanical ventilation. (2/49)

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Adaptive support ventilation for faster weaning in COPD: a randomised controlled trial. (3/49)

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Endotracheal tube extubation force: adhesive tape versus endotracheal tube holder. (4/49)

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Are guidelines for non-invasive ventilation during weaning still valid? (5/49)

Noninvasive ventilation (NIV) has gained increasing acceptance over the years to reduce endotracheal intubation, pneumonia and to prevent or treat respiratory failure in patients with different diagnoses. The international consensus conference, and the British society guidelines on NIV ventilation have analyzed its use during the weaning phase concluding that there were still conflicting results of its use. However, recent clinical trials have shown clear clinical benefits on the use of NIV in several patient populations during the weaning period. Acute respiratory failure (ARF) during the weaning process is the main object of recently published studies. The latest published randomized trials on the application of NIV for acute respiratory failure following extubation failed to demonstrate any favorable outcome. Even so, the use of NIV during the process of weaning in patients experiencing multiple weaning failure or as a preventive therapy in patients at higher risk of respiratory deterioration showed improved clinical outcomes only in chronic obstructive pulmonary disease and in particular in hypercapnic patients. Reduced invasive mechanical ventilation, tracheostomy and lower mortality rate at 90 days were the major advantages.  (+info)

Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. (6/49)

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Bioresorbable distraction device for the treatment of airway problems for infants with Robin sequence. (7/49)

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Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery. (8/49)

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*Positive airway pressure

In these patients, PAP ventilation can prevent the need for tracheal intubation, or allow earlier extubation. Sometimes ... "VPAP" or "BPAP" (variable/bilevel positive airway pressure) provides two levels of pressure: inspiratory positive airway ... If these small airways and alveoli are allowed to collapse, significant pressures are required to re-expand them. This can be ... Positive airway pressure (PAP) is a mode of respiratory ventilation used in the treatment of sleep apnea. PAP ventilation is ...

*Tracheal intubation

... of the safety of tracheal extubation using a pediatric airway exchange catheter for patients with a known difficult airway" ( ... The Airway Cam Guide to Intubation and Practical Emergency Airway Management (1st ed.). Wayne, Pennsylvania: Airway Cam ... Life-threatening airway obstruction may occur when a foreign body becomes lodged in the airway; this is especially common in ... Airway obstruction is also common in people who have suffered smoke inhalation or burns within or near the airway or ...

*Double aortic arch

After extubation, it might be necessary to maintain positive airway pressure by appropriate flows of a humidified oxygen/air ... The obstructive airway symptoms may be worse in the first postoperative weeks. Only a few patients have immediate relief of ... When the airway obstruction is significant there may be episodes of severe cyanosis ("blue baby") that can lead to ... Symptoms are caused by vascular compression of the airway, esophagus or both. Presentation is often within the first month ( ...

*Henrik Verder

... (born 1942) is a pediatrician and the inventor of the INSURE (Intubation Surfactant Extubation) method combined ... "Nasal continuous positive airway pressure and early surfactant therapy for respiratory distress syndrome in newborns of less ... "Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure". The New England Journal of ... "Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. Danish- ...

*Rapid shallow breathing index

... and a patent upper airway are other criteria that should be met to increase extubation success. Patients should be assessed ...

*Ludwig's angina

Methods of airway management range from conservative airway management - consisting of close observation and intravenous ... Extubation, which is the removal of endotracheal tube to liberate the patient from mechanical ventilation, should only be done ... Airway management has been found to be the most important factor in treating patients with Ludwig's Angina, i.e. it is the " ... Airway control is compulsory if a surgical procedure is required.Flexible nasotracheal intubation require skills and experience ...

*Laryngospasm

As the airway reopens, breathing may cause a high-pitched sound called stridor. The episode seldom lasts over a couple of ... The spasm can happen often without any provocation, but tends to occur after tracheal extubation. In children, the condition ...

*Heated humidified high-flow therapy

... maintains oxygenation and airway patency during management of the obstructed airway: an observational study". BJA: British ... Use and a neonatal early extubation protocol". Journal of Perinatology. 27 (12): 776-81. doi:10.1038/sj.jp.7211825. PMID ... The constant flush of the upper airway creates a reservoir that reduces room-air entrainment to such an amount that it becomes ... Its mechanism of action is the application of mild positive airway pressure and lung volume recruitment. HFT, the clinician can ...

*Tracheal tube

Other tubes (such as the Bivona Fome-Cuf tube) are designed specifically for use in laser surgery in and around the airway. ... which can be used for suction of the nasopharngeal area and above the cuff to aid extubation (removal). This allows suctioning ... Tracheal tubes are commonly used for airway management in the settings of general anesthesia, critical care, mechanical ... who often wear this device during waking hours and remove it while sleeping to ensure a patent airway and reduce the risk of ...

*Joseph O'Dwyer

The cause of death was usually asphyxia due to an obstructed airway. A tracheotomy was often a necessary procedure to save a ... His tubes and the accompanying instruments for intubation and extubation, with his methods for the care of these patients, came ... experimented with various approaches to keep the laryngeal airway open. At first, O'Dwyer experimented with his device on ...

*Epinephrine (medication)

For example, high levels of epinephrine causes smooth muscle relaxation in the airways but causes contraction of the smooth ... Davies MW, Davis PG (2002). "Nebulized racemic epinephrine for extubation of newborn infants". The Cochrane Database of ... Racemic adrenaline works by stimulation of the alpha adrenergic receptors in the airway, with resultant mucosal ...
Macht M; Wimbish T; Clark BJ; Benson AB; Burnham EL; Williams A; Moss M Crit Care; 15(5): R231, 2011. INTRODUCTION: Dysphagia is common among survivors of critical illness who required mechanical ventilation during treatment. The risk factors associated with the development of postextubation dysphagia, and the effects of dysphagia on patient outcomes, have been relatively…
Initial RSBI was similar in Extubation Success and Extubation Failure groups (77.0 ± 4.8, 77.0 ± 4.8, p = ns). Nevertheless, RSBI tended to remain unchanged or decreased in the Extubation Success group; in contrast RSBI tended to increase in the Extubation Failure group because of either increased RR and/or decreased VT (p , 0.001 for mean percent change RSBI over time), indicating worsening of the respiratory pattern. Quantitatively, only 7/63 subjects of the Extubation Success group demonstrated increased RSBI ≥20% at any time during the SBT. In contrast, in the Extubation Failure group, RSBI increased in all subjects during the SBT, and eight of nine subjects demonstrated an increase greater than 20%. Thus, with a 2-h SBT the optimal threshold was a 20% increase (sensitivity = 89%, specificity = 89%). Similar results were obtained at 30 min (threshold = 5% increase). Percent change of RSBI predicted successful extubation even when initial values were ≥105.. ...
Sustained-release morphine sulfate (SRMS) is a painkiller used in oncology. The purpose of our study was to assess its efficacy on postoperative morphine requirements in elective spine surgery. This was a placebo-controlled, randomized, double-blind study. Adults scheduled for spine surgery under general anesthesia were orally administered SRMS (30 mg) or a placebo 2 h before surgery. Primary endpoint was postoperative cumulated morphine consumption through patient-controlled analgesia (PCA) during the 12 h following extubation. Statistical analysis was performed using a sequential method, the triangular test. The study was stopped after the sixth analysis (51 patients had been included; placebo: 26, SRMS: 25). Age, weight, sex ratio, type of surgery, intra-operative sufentanil consumption, anesthesia duration and time to extubation were similar in the two groups. Morphine consumption through PCA during the 12 h following extubation was significantly lower in the SRMS group (mean +/- SD: 10.5 ...
This project was initiated with a voice of the customer survey to assess cultural readiness for change. During the define phase of this process improvement, the NICU moved from an open bay design to private rooms. The walking distance between patients and the size of the new single-patient room NICU (4 times the square footage of the open unit) required the staff to adjust to new workflows. This transition presented some initial difficulty, especially with the simultaneous implementation of some of the improvements. We anticipated that the 2 caregivers to turn model would be the most difficult to implement, but staff were able to adapt. Survey results demonstrated to our process improvement team that the culture did not support the perception that unplanned extubations were always an unpreventable event. The majority of respiratory and nursing staff reported that at least some of the unplanned extubations were preventable. The free text portion of the survey provided a number of comments from ...
Patients with failed extubation stay significantly longer in an intensive care unit (ICU) and have a higher mortality rate, than those intubated successfully. Reintubation is associated with life-threatening complications and a poor prognosis. Functional respiratory tests are frequently used as weaning parameters, however, they are not accurate enough to predict extubation failure. The incidence of swallowing dysfunction is underestimated, mainly among patients whose intubation lasts longer than 48 h.We previously observed that the assessment of the swallowing function and oropharyngeal motricity, conducted by the physiotherapist before extubation could be helpful for making decisions to extubate patients intubated for over 6 days. The objective of this study is to validate a scale previously devised and used for physiotherapist bedside evaluation of the swallowing function and oropharyngeal motricity, among patients intubated for over 6 days, to determine whether this scale is a good predictor ...
Study Objectives: Following extubation in the intensive care unit (ICU), upper airway (UA) edema and respiratory depressants may promote UA dysfunction. We tested the hypothesis that opioids increase the risk of sleep apnea early after extubation. Methods: 56 ICU patients underwent polysomnography the night after extubation. Airflow limitation during wakefulness was identified using bedside spirometry. Correlation and ordinal regression analyses were used to quantify effects of pre-extubation opioid dose on post-extubation Apnea-Hypopnea-Index (AHI) and severity of sleep apnea and whether or not inspiratory airway obstruction (ratio of maximum expiratory and inspiratory flow at 50% of vital capacity (MEF50/MIF50)≥1) during wakefulness predicts airway obstruction during sleep ...
Retrospective Clinical Studies: Using Existing Data to Inform Current Research (WEB2800): Online ASHA CEU course highlighting the article: "Postextubation Dysphagia in Critical Patients: A First Report from the Largest Step- Down Intensive Care Unit in Greece, by Malandraki, Markaki, Georgopoulos, Psychogios, & Nanas. Available at: https://shar.es/1RHdZh. Kantarcigil, C. & Malandraki, G.A. (2016). The Rise of Telehealth in the United States: The present and the future of dysphagia telerehabilitation. Invited article on Dysphagia Cafe website. Available at: http://dysphagiacafe.com/2016/08/24/rise-telehealth-united-states-present-future-dysphagia-telerehabilitation/. Purdue I-EaT Swallowing Research Lab Engagement Event Announcement. Pals of Cerebral Palsy. Media coverage by the Purdue Health Sciences media: Available at: http://www.purdue.edu/newsroom/releases/2015/Q2/open-house-event-to-focus-on-swallowing-disorders,-cerebral-palsy.html. Malandraki, G.A. (2014). International Faculty Spotlight ...
That leaves the final piece of the puzzle - that of monitoring - and this happens in the ED when the cardiac arrest victims arrive. Therein lies the weakest link - ourselves. How often, when we receive cardiac arrest victims, do actually think about, monitor, or make subtle changes to improve the quality of CPR? Do we check that the mechanical CPR on the patient is actually providing adequate flow? Or when manual CPR is performed, do we check on its quality? Do we aggressively check compression timing, depth, adequate recoil and minimal hands-off time? Do we routinely use end-tidal CO2 monitoring to guide CPR and assess cardiac output ...
An evaluation of the Global Assessment of Pediatric Patient Safety (GAPPS) trigger tool, which measures hospital-wide rates of adverse events (AE). Reviews of 3814 charts at 16 centers showed that experts agreed with the tool in the identification of an AE 92% of the time. Triggers included medications (e.g., vitamin K after warfarin or hepatotoxic medications with elevated transaminases), hospital care (e.g., pressure ulcer, low O2 sats), healthcare-associated infections, hospital outcomes like readmissions, surgical events (e.g., abrupt drop in hematocrit after surgery, return to surgery), and ICU-related events like unplanned extubations and neonatal IVH.. Landrigan 2016 (Pediatrics) , PubMed 27221286 , Author Search ...
Of course the doc told me everything that could go wrong. And everything he is at risk for due to his history and being hard to extubate. I already had a huge headache. And I didnt even meet the doc who did it, only the anethesiologist. So when it was over no one came in to tell me how it looked. They just called my name and told me I could go back. So I assumed they were able to extubate him ok, if he was in PACU instead of heading to PICU. I got back to him and he was wide awake! I was like, did you guys even take him back yet, this is so not Jaxson. Look at those wide eyes, fingers in the mouth ...
Post-extubation respiratory failure causes between 5-30% of patients to require reintubation, which is associated with increased mortality. Spontaneous breathing trials aim to evaluate when a patient is ready for extubation and involves a trial of T-tube, low level pressure support or continuous positive airway pressure for varying durations ranging from 30 to 120 minutes. It was hypothesised that a rest period after a spontaneous breathing trial will improve extubation rates.. Method. A parallel, two-arm, prospective, randomised controlled trial in 17 Spanish Medical-Surgical ICUs aimed to test this hypothesis. From October 2013 to January 2015, 470 mechanically ventilated patients who had been receiving Mechanical Ventilation for at least 12 hours were enrolled.. If spontaneous breathing trial (SBT) was successful they were either extubated immediately (Control group) or reconnected to the ventilator with the previous ventilator parameters for 1 hour of rest and then extubated (Rest ...
An interesting study by Tulaimat and Mokhlesi1 regarding the accuracy and reliability of extubation decisions that recently appeared in the Journal merits additional comment. The implicit study question is whether an informed decision to extubate following a successful spontaneous breathing trial is any better than random chance. By study design, the clinical vignettes were selected so that, if a decision to extubate was made by coin flip, without any clinical information, the sensitivity and specificity (as defined in the study) would be expected to reach 50%. It was disappointing that, overall, experienced clinicians performed marginally better than a coin flip in predicting extubation success (ie, 57% sensitivity), but they were highly inaccurate in predicting weaning failure (ie, 31% specificity).. In a post hoc analysis, clinicians whose extubation decision-making was relatively aggressive achieved a higher sensitivity (62%), whereas clinicians whose extubation decision-making was ...
BACKGROUND: Patients with cerebral infarction often present impaired consciousness and unsatisfactory extubation. We aimed to assess the respiratory mechanics components that might be associated with the success of extubation in stroke patients. METH
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The average number of hospitalized newborns was 43.4 per day. The average number of newborns under MV was 22.4 per day. The average number of tracheostomized newborns was 4.4 per day, and the average number of intubated (non-tracheostomized) newborns was 17.9 per day. The mean duration of MV prior to UE was 11.2 days (range 1 to 39 days). Most UE (50%) occurred during the first 7 days of MV (Table 1). The following clinical signs suggested the occurrence of UE: audible weeping in 22 cases (26.8%), exteriorization of tubes in 22 cases (26.8%), cyanosis in 19 cases (23.2%), worsening of the respiratory pattern in 10 cases (12.2%), gastric contents in the ETT in six cases (7.3%), and bradycardia in three cases (3.7%). An average of 1.51 clinical signs were suggestive of UE per event. The following primary causes of UE were identified and analyzed in the present study: patient agitation in 30.8% of cases (24); inappropriate handling of patients during the performance of procedures (e.g., blood ...
There are two schools of thought about how to extubate patients at the conclusion of general anesthesia: Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patients head bleats, "Open your eyes! Take a deep breath!" Or: Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence ...
Abstract: Objective: Outcome of staged palliation for hypoplastic left heart syndrome (HLHS) has improved over the past decades. We sought to evaluate the outcome of the second palliative procedure, the superior cavopulmonary anastomosis (SCPA), in a single-centre cohort and to identify risk factors for adverse outcome. Methods: Full data on all 119 HLHS patients who underwent SCPA in our centre between January 1996 and December 2007 were analysed. Results: Early adverse outcome (death or cardiac transplant within 30 days after surgery or before hospital discharge) was 3.4%. Late adverse outcome (death or transplant after hospital discharge but before the next operative procedure) was 8.7%. Postoperative complications occurred in 30% of patients (n =36), with transient arrhythmia (n =11; 9%) and pulmonary artery stenosis or thrombosis (n =10; 8%) being the most common. The presence of more than moderate tricuspid valve regurgitation after surgery proved to be a strong predictor of late adverse ...
The patients in our ICU intubated for , 24h and met weaning criteria, will be examined by bronchoscopy. Five ㏇ blood will be collected for checking CRP and cytokines before performing bronchoscopy. The proposed grading of post-extubation vocal cord finding were shown (Figure 1). The patients will be classified to two groups (Figure 2). The first group is these patients without swelling or swelling area ≦50% who will be extubated after bronchoscopic examination. These patients will be followed for 48 hours to monitor the incidence of PES. The second group is those patients who develop laryngeal edema with swelling area ≧50% or swelling in the whole vocal cord. Bosmin 2 ml local injection and Solu-medrol 40 mg I.V. Q6h for 1~4 days will be given. Bronchoscopy will be done if CLV ≧24% or after treatments for 3~4 days even with CLV 424%. The above treatments will be applied again if stridor develops. Extubation will be performed if no presence of laryngeal edema ...
Resuscitation. 2014 Sep;85(9):1287-90. doi: 10.1016/j.resuscitation.2014.06.013. Epub 2014 Jun 28. Randomized Controlled Trial; Research Support, Non-U.S. Govt
BACKGROUND: The use of cuffed tracheal tubes (TTs) in small children is still controversial. The aim of this study was to compare post-extubation morbidity and TT exchange rates when using cuffed vs uncuffed tubes in small children. METHODS: Patients aged from birth to 5 yr requiring general anaesthesia with TT intubation were included in 24 European paediatric anaesthesia centres. Patients were prospectively randomized into a cuffed TT group (Microcuff PET) and an uncuffed TT group (Mallinckrodt, Portex, Rüsch, Sheridan). Endpoints were incidence of post-extubation stridor and the number of TT exchanges to find an appropriate-sized tube. For cuffed TTs, minimal cuff pressure required to seal the airway was noted; maximal cuff pressure was limited at 20 cm H(2)O with a pressure release valve. Data are mean (SD). RESULTS: A total of 2246 children were studied (1119/1127 cuffed/uncuffed). The age was 1.93 (1.48) yr in the cuffed and 1.87 (1.45) yr in the uncuffed groups. Post-extubation stridor ...
Among 60 patients, 29 cases developed respiratory failure within 48 h, and 14 cases were re-intubated or died within 1 week, respectively. Multivariate logistic regression analysis showed that E/Ea (average) after SBT [odds ratio (OR) 1.450, 95% confidence intervals (CI) 1.092-1.926, P = 0.01] and left ventricular ejection fraction were associated with respiratory failure. The AUC of E/Ea (average) after SBT was 0.789, and a cut-off value ≥ 12.5 showed the highest diagnostic accuracy with a sensitivity and specificity of 72.4% and 77.4%, respectively. Furthermore, in the respiratory failure subgroup only DE (average) after SBT was associated with re-intubation (OR 0.690, CI 0.499-0.953, P = 0.024). The AUC of DE (average) after SBT was 0.805, and a cut-off value ≤ 12.6 mm showed the highest diagnostic accuracy with a sensitivity and specificity of 80% and 68.4%, respectively.. CONCLUSIONS ...
Early extubation of cardiac surgery patients has become increasingly important. The assessment of the patient before an early extubation is crucial and the intensive care nurses (ICU nurses) in this estimation is there for very important.. The aim of this study was to examine critical care nurses knowledge of early extubation, and what view ICU nurse has about factors that affect the time to extubation of cardiac surgery patients.. A quantitative approach with descriptive and comparative design was used. Selection was all ICU nurses at a thoracic intensive care unit who were clinically active in patient care.. The study showed that ICU nurses had good knowledge of why an early extubation was essential. However, the knowledge about the units extubation criteria was low. ICU nurses felt that the criteria for the cardiac surgery patients on the unit was adequate. The time target of 90 minutes was reasonable. No relationship existed between professional experience and knowledge of the extubation ...
The cross-clamp is then released, and the remainder of the procedure is performed as the patient is warmed. The PTFE graft that was anastomosed to the inferior caval vein is now carried up to the undersurface of the pulmonary artery, to either the site of the prior atriopulmonary anastomosis or a site more medial, and a patch is placed on the site of the old atriopulmonary anastomosis. As the patient is warmed and started on low-dose inotropic support, the bidirectional superior cavopulmonary anastomosis is performed with running prolene suture. The patient is then ventilated and weaned from cardiopulmonary bypass, and the epicardial pacing system is placed with the heart beating. We have used bipolar steroid eluting leads for the atrial and ventricular lead placement. These are then connected to a dual-chamber device with atrial antitachycardia capabilities.14 The completed operation is shown in Figure 7.12. RESULTS. In our series, the operative mortality was 3 out of 149 patients (2%). One ...
The use of telemedicine here also promises interesting possibilities. If we can treat a patient remotely by telling somebody else what to do, does that mean anesthesiologists can work from home? Imagine hiring some medical student, or even a premed student to sit in the OR for you. Using telemedicine you can have him intubate the patient for you. You can then electronically monitor the patients vitals and tell the student what meds to give. At the end of the case the student will show you the train of fours and then you tell him to reverse and extubate the patient while you are sitting at home in your PJs watching CNBC on your 52 inch LCD. This would be even cheaper for the hospital than hiring a bunch of CRNAs ...
BCPA is increasingly used for interim palliation of complex cyanotic congenital heart disease.2 10 Excellent intermediate term palliation is achieved and the advantages over a systemic to pulmonary arterial shunt are well established.11-13 However, it is well recognised that progressive systemic arterial desaturation occurs and a number of factors have been proposed to explain this.14-16 This includes macroscopic PAVM which have long been recognised as a serious late complication of the cavopulmonary anastomosis.1 The finding of similar abnormalities in chronic liver disease lead to the suggestion that the loss of "hepatic factor" from the pulmonary circulation might be responsible for these changes.4 17If loss or reduced concentrations of hepatic factor are implicated in the development of PAVM, then pulmonary arteriovenous shunting (a right to left shunt) should occur early following BCPA, and PAVM merely represent the end stage of the process.. Various methods are now available for the ...
The question regarding long-term outcome in patients with a functionally univentricular heart undergoing a Fontan procedure based on whether there is right or left ventricular morphological dominance is one that has been investigated for many years. The paper in this issue of the Journal by dUdekem et al. (1) from the Royal Childrens Hospital in Melbourne, Australia, found that in their nearly 30-year series reviewing 499 patients, right ventricular dominance was the single most important risk factor for death. Their other conclusion was that this risk factor seemed to be important only before the bidirectional superior cavopulmonary anastomosis (BSCPA). The interesting speculation is that earlier BSCPA may potentially modify the risk factor of right ventricular morphology. Both of these conclusions are important for clinicians to consider when guiding patients along a Fontan pathway, especially when considering timing of BSCPA and cardiac transplantation as an alternative.. Their review (1) ...
Objectives: To evaluate the impact of a mechanical ventilation protocol applied by a respiratory therapist (RT) on the outcomes in COPD patients.. Methods: A novel mechanical ventilation protocol was initiated by a respiratory therapist. Outcomes of patients during a 6-month period were compared to those of patients treated by physicians without a protocol during the preceding 6 months.. Results: A total of 170 patients were enrolled. Extubation success was higher (98% vs. 78%, p= 0.014) and median durations of weaning, mechanical ventilation (Figure 1) and ICU stay (Figure 2) were shorter in the protocol group (2 vs. 26 hours, log rank p , 0.001, 3.1 vs. 5 days, log rank p , 0.001 and 6 vs. 12 days, log rank p , 0.001 respectively). ...
In this multicenter randomized trial involving neonates ≥28 weeks gestational age undergoing planned noninvasive respiratory support, we found no significant difference between HHHFNC and nCPAP with regard to the primary outcome of intubation within the initial 72 hours of support. In addition, we found no differences between infants randomly assigned to nCPAP compared with HHHFNC for several respiratory outcomes, including duration of oxygen supplementation, diagnosis of BPD, or discharge from the hospital on oxygen. Despite concerns over unregulated/unmonitored pressure delivery during HHHFNC support, we found no differences in the occurrence rate for any form of air leak. The outcome results from this relatively large randomized trial indicate that the use of HHHFNC, as described in this report, appears to be as effective and as safe as nCPAP in this population of infants.. The actual approach to "high-flow" nasal cannula must be carefully considered in evaluating all studies. Some ...
We describe a healthy neonate with abdominal distention, inadequate ventilation, and delayed extubation during anesthesia for minor surgery. Following rectal decompression and successful extubation, extreme abdominal distention recurred postoperative
FIGURE 2 Infants randomly assigned to nCPAP (black line) had significantly shorter duration of study support mode compared with infants randomly assigned to HHHFNC (gray line); P , .01. There were no significant differences between study groups for duration of ventilator support (dotted lines) or time to wean to room air (dashed lines) in the 7 days after study entry. RA, room air. ...
by winnineo , Nov 12, 2015 , Neonatal. In 2018 where do we stand on this question? Upcoming retrospective trials and work by EPIQ-4 may help to resolve this issue. In the meantime what does the existing evidence say?. The decision to extubate an extremely low birthweight infant is one of the most common sources of disagreement and anxiety in the NICU. As a resident, I recall an unwritten rule that "no baby under 750g will have a trial of extubation as they will most certainly fail". As time went on however, studies suggested that not only is this a false statement but also that the duration of intubation was directly correlated with risk of BPD. As Danan described, for infants less than a 1000g, delaying extubation when they had reached minimal settings did not result in lower rates of BPD. Moreover 60 - 70% of infants who have such extubation attempts are not reintubated within a week, so it is possible to have success.. The detractors however express concern about the 30-40% who do require ...
Matthew was weaned from his sedative last night at 6pm. He awoke around 9 pm and he had a rough night. He was awake; but the doctor didnt want to extubate him (I wont go into any details on this other than we had a very frustrated nurse and mom by morning). So all night he coughed and cried and fought the tube. Even though he is intubated, you can tell he is crying by his facial expressions. You cant hear it, but you can tell. So, I didnt sleep well because I was up and down with him trying to comfort him. I was happy when morning came because I was sure they would pull the tube. This morning, his lab work showed that his phenobarbital level (a medication used to control seizures) was still low in his blood. It was a little confusing to the neurologist because he was getting this medication twice a day orally and also daily IV boluses. His blood levels, though would not go up and had even decreased today. So they doubled his IV dose. Immediately after that dose he feel asleep and was ...
27 patients died or were successfully extubated within 48 h, and, as per our study design, were excluded from the study and statistical analysis. Patients receiving no sedation had significantly more days without ventilation (n=55; mean 13·8 days, SD 11·0) than did those receiving interrupted sedation (n=58; mean 9·6 days, SD 10·0; mean difference 4·2 days, 95% CI 0·3-8·1; p=0·0191). No sedation was also associated with a shorter stay in the intensive care unit (HR 1·86, 95% CI 1·05-3·23; p=0·0316), and, for the first 30 days studied, in hospital (3·57, 1·52-9·09; p=0·0039), than was interrupted sedation. No difference was recorded in the occurrences of accidental extubations, the need for CT or MRI brain scans, or ventilator-associated pneumonia. Agitated delirium was more frequent in the intervention group than in the control group (n=11, 20% vs n=4, 7%; p=0·0400 ...
Many cardiac surgery programs support early extubation of suitable CABG patients once they enter intensive care, based on clinical and economic benefits. Now some hospitals have shifted extubation to the cardiac operating room (OR) for a wide range of patients, young and old, with good results.
Comparison of the modifications of the Viennese method of manual perineal protection (VMPP) and hands-off delivery techniques by applying basic principles of mechanics with assessments of tensions within perineal structures using a novel biomechanical model of the perineum. Evaluation of the role of the precise placements of the accoucheur?s posterior (dominant) thumb and index finger in perineal tissue tension when performing a modified Viennese method of MPP ...
Liberalism faces an apparent paradox. Its commitments to values such as neutrality and tolerance seem to recommend a hands-off attitude toward a societys ethical life. It seems the state should not regulate the value ...
Archives of Disease in Childhood - Fetal and Neonatal Edition Sep 2017, 102 (5) F434-F438; DOI: 10.1136/archdischild-2016-312300 ...
Bronchiolitis is a common illness affecting the lower (smaller) respiratory airways in infants (younger than 24 months of age). Usually caused by a viral infection, it results in breathing problems, including cough, fast breathing, wheezing and can cause poor feeding. It is a major cause of hospitalisation in infants. Current treatment involves supporting infants to breath until the infection clears. An emerging method to support breathing is using blended, heated, humidified air and oxygen, through nasal cannulae (tubes) at flow rates higher than two litres per minute, which is the maximum for conventional dry oxygen delivery. This is known as high-flow nasal cannula therapy and it allows the comfortable delivery of high flow rates of an air/oxygen blend which may improve ventilation. This may lead to a reduced need for invasive respiratory support (e.g. intubation) and may have a clinical advantage over other treatments by preventing drying of the upper airway. This review assessed the effects ...
Background: Routine preoperative catheterization (CATH) is often performed in patients with single ventricle physiology prior to superior cavopulmonary anastomosis (SCPA) to evaluate candidacy for this procedure. We hypothesized that cardiac magnetic resonance (CMR) can safely and effectively evaluate such patients with similar outcomes following SCPA.. Methods: Single center, prospective, randomized clinical trial comparing CMR to CATH in patients considered for SPCA from 1/2003 to 5/2006. Patients were followed from pre-operative evaluation to 3 months after SPCA.. Results: Of 91 eligible patients, 81 were enrolled based on screening echocardiogram, fulfillment of inclusion criteria, and informed consent. Patients were randomized to CATH (n = 41) or CMR (n = 40). There were no differences between groups in demographics (mean age 5.2 months), ventricular type (52% hypoplastic left heart syndrome), prior operation, oxygen saturation, ventricular function, and AV valve regurgitation. Four ...
Sixty-five children who underwent biventricular repair were extubated early (immediately after chest closure in the operating room) or were extubated later on intensive care unit (ICU). The results of these two different strategies were compared. Early extubation resulted in better cardiac output, fewer pleural effusion, and shorter stay in the ICU and hospital. The authors concluded that early extubation is safe and feasible and has a beneficial effect on the postoperative course.. ...
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Speaker Karsten Roberts MS, RRT, RRT-ACCS Date Mar 16, 2018 1:00 PM The speaker will discuss the Editors Choice of the March 2018 issue of RESPIRATORY CARE "Proactive use of high-flow nasal cannula with critically ill patients: A prospective, two-cohort study". The presentation will focus on the research design and interpretation of the results.. ...
Implementation of a multifaceted quality improvement intervention with daily checklists, goal setting, and clinician prompting did not reduce in-hospital mortality compared with routine care...
Our specimen holders are designed to improve your productivity and allow you to view more than one sample at a time. FIB Holders are reusable holders that secure FIB sample that are held in a specific orientation. Grids for SEM Microscopy.
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This relatively new modality is rapidly gaining popularity in the care of patients with respiratory failure. It not only reliably delivers very high fractions of inspired oxygen but also improves lung mechanics via a PEEP effect and can lower CO2 by washing out the anatomic dead space. Here is a free full text review. This site from a manufacturer, though commercially biased, does a good job of explaining the modality and current indications for its use. ...
This study is the first to comprehensively evaluate quality improvement initiatives aimed at reducing the amount of inappropriate tests performed across common cardiac imaging modalities. First, we have identified components of these interventions that may provide the most consistent benefits in reducing inappropriate testing. Second, we have identified important limitations in the literature to inform further studies, which is directly relevant to determining the most effective methods of designing and evaluating initiatives aimed at reducing unnecessary cardiac testing.. Determining the optimal strategies to reduce inappropriate cardiac testing is important for both improving the quality of cardiac testing and reducing unwarranted health expenditures. Although quality improvement initiatives were associated with an overall reduction in inappropriate cardiac testing, the significant heterogeneity observed between studies in our meta-analysis signifies that the effects of these interventions ...
Chronic kidney disease (CKD) is a common long-term condition, affecting 5 to 10% of the population. CKD is an independent risk factor for cardiovascular disease, established renal failure (ERF) and all cause mortality [1-3]. Patients with CKD are far more likely to die prematurely from cardiovascular disease than progress to ERF requiring dialysis or transplantation. The presence of proteinuria confers additional cardiovascular risk.. CKD is classified into five stages based upon a measurement of kidney function and the estimated glomerular filtration rate (eGFR) determines the class of CKD for the more severe stages (Stage three to five). Stage one and two are the mildest of the five stages of CKD and require evidence of kidney damage, usually the presence of proteinuria, to confirm the diagnosis. Stages three to five CKD can be diagnosed by eGFR alone; and stage three is now often split into stages 3a and 3b, as there are far higher rates of cardiovascular co-morbidity in stage 3b disease. ...
Fair warning - this post is likely to be of interest only to professionals who administer anesthesia or may have to deal with laryngospasm in emergency situations.. There are two schools of thought about how to extubate patients at the conclusion of general anesthesia:. Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patients head bleats, "Open your eyes! Take a deep breath!". Or:. Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence from anesthesia like waking from a nap.. It will not require much subtlety of perception to guess that I prefer option 2. It is quiet, elegant, and people whove seen it done properly often remark that they would prefer to wake from anesthesia that way, given the choice.. There is art and logic to it, which I had the pleasure of learning from British anesthesiologists at the Yale University School of ...
Fair warning - this post is likely to be of interest only to professionals who administer anesthesia or may have to deal with laryngospasm in emergency situations.. There are two schools of thought about how to extubate patients at the conclusion of general anesthesia:. Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patients head bleats, "Open your eyes! Take a deep breath!". Or:. Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence from anesthesia like waking from a nap.. It will not require much subtlety of perception to guess that I prefer option 2. It is quiet, elegant, and people whove seen it done properly often remark that they would prefer to wake from anesthesia that way, given the choice.. There is art and logic to it, which I had the pleasure of learning from British anesthesiologists at the Yale University School of ...
So if all the drooling catatonics want to get into their cars and push a button that takes them straight to the lobotomy party, then let em at it. And you know what? Let me at it now and then, too, because even the most hard-core gearhead has to admit that driving is not all fun all the time.. Traffic jams. Interstates. Stoplight suburbia, speed limit 30. Say, does your commute to work include the Tail of the Dragon? No, it does not. Theres that one nice on-ramp, but the guy in front of you thinks that exceeding 0.15 g is strictly the stuff of daredevils like Cale Yarborough. Even rally races have transit stages, which introduce an extra element of realism by challenging racers to resist road rage when the car in front of them doesnt move even though the light changed five seconds ago.. Those are just some of the reasons why I love adaptive cruise control and its new partner, lane-keeping steering. During Automobile of the Year testing last fall, I drove the Infiniti Q50-or rather, it drove ...
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Baraka [1] described post-extubation laryngospasm after opioid-based anesthesia in a 4-yr-old child. Naloxone terminated the laryngospasm. MacGregor et al. [2] described difficult ventilation after initiation of a fentanyl infusion in an intubated neonate. They extubated the child, fearing an endotracheal tube obstruction. They could not ventilate the extubated child. A cardiorespiratory arrest resulted. Nalaxone was administered and restored the ability to ventilate. They ascribed the difficult ventilation to chest wall rigidity ...
IPI Medical Products (IPI) brings you the et-care, a unique endotracheal tube holder that focuses on airway risk management solutions such as minimizing the occurrence of unplanned extubation and other ventilator associated events such as VAP.
After securing the test board by the board holders clamps, an operator installs a vacuum pick up tip and nozzle suitable for the CSP device. Implementing machines optics, the nozzle is aligned over the component. A pre-established profile is selected from the software library and Start icon is selected. At this point the process is hands-off. Rework station automatically drives the nozzle down to a board and covers the CSP. Machine then activates vacuum pick up tip so as to remove the component once reflow is achieved and the heating cycle is initiated. Figure 2 shows a nozzle covering the device during reflow. Heating is precisely controlled by the software (Figure 3). It mimics an original profile with heat applied from both top and bottom sides of a board. Source of bottom heating is Quartz IR while the top side is forced air or nitrogen convection. As is shown in the video of removal, upon completion of reflow, the machine lifts a CSP off a board and moves nozzle up along Z axis to its ...
Column by Jim Davies.. Exclusive to STR. Many reading this already understand the Self-ownership Axiom; that we each own our own lives by right, and hence that all government is an unnatural and ruinous appendage. Among those who do, though, surprisingly there is disagreement over what to do about it.. Some hold that resistance by such voluntaryists in the present government-saturated environment must never be more than nonviolent non-cooperation, practicing our principle of non-agression while giving the State no assistance than can be avoided--but otherwise taking no particular action to end its malignant existence. Even among the "comments" beneath articles, its not unusual to see posts like "I have no responsibility to reform society." And the fact is, those commenters are not incorrect; we dont. Each has only the responsibility to maximize the happiness of his own life--and that responsibility is only to oneself, not to anybody else.. So that hands-off view stems not so much from a ...
By Freya Bellin. This pilaf proves that a simple grain like rice can be transformed into something pretty complex, without too much work on your part. The Spanish flavors of this dish come through strongly-especially the smoky pimentón, which is a great contrast to the overall sweetness of the dish. I personally found myself digging through the bowl for even more apricots, so you may want to chop up and toss in a few more than the recipe suggests. You could experiment with other dried fruits here as well, like golden raisins.. While most of the cook-time in this recipe is hands-off, brown rice can require some attention. I added more water a few times throughout the simmering process, as the pot was starting to dry out, but the rice was still crunchy. The couscous variation would certainly be useful if youre in a time-bind or if you want to multi-task. The wonderful thing about a recipe like this is that, thanks to the protein from almonds and chickpeas, it can be a meal in and of itself. I ...
By Freya Bellin. This pilaf proves that a simple grain like rice can be transformed into something pretty complex, without too much work on your part. The Spanish flavors of this dish come through strongly-especially the smoky pimentón, which is a great contrast to the overall sweetness of the dish. I personally found myself digging through the bowl for even more apricots, so you may want to chop up and toss in a few more than the recipe suggests. You could experiment with other dried fruits here as well, like golden raisins.. While most of the cook-time in this recipe is hands-off, brown rice can require some attention. I added more water a few times throughout the simmering process, as the pot was starting to dry out, but the rice was still crunchy. The couscous variation would certainly be useful if youre in a time-bind or if you want to multi-task. The wonderful thing about a recipe like this is that, thanks to the protein from almonds and chickpeas, it can be a meal in and of itself. I ...
Because of the acknowledged hazards of leather production, the process is being discontinued in most European countries and the U.S., and operations are moving overseas. Bangladesh Tanners Association President M. Harun Chowdhury said, "Most of the European countries and USA are discontinuing leather processing, as [the] leather industry is an environmentally hazardous one."(20) As a result, the health of people in other parts of the world is now being threatened by the tanning industry. In Bangladesh, 90 percent of the leather exported comes from a slum where tanneries wastewater isnt even treated. According to a Human Rights Watch report, the contaminated water flows into the nearby river and "[w]hile the government takes a hands-off approach, local residents fall sick and workers suffer daily from their exposure to harmful tannery chemicals."(21 ...
A universal tool mounting system for a machining centre relates to CNC machine tools, comprising a main drum into which mounts a plurality of tool holder unit stations, these create a platform to attach, mount and interchange tool holder units on each station, where each tool holder unit is chosen from a designed selection which can turn, mill, bore, drill and rapidly machine components with multicut tools or alternately each performs a combination of these operations and each holds a plurality of tools. The main drum is indexed to position the tool holder unit station with the attached tool holder unit to the operative position, then the tool holder unit station is indexed to position a selected tool to the machining position. The tool holder unit stations also provide live tooling functions to any attached live tooling tool holder units. Tool holder unit stations can also be preindexed.
The device of the invention consists of a plurality of tubular cannulae, consisting of stackable segments, which prior to the surgery, are linked together at their distal ends by flexible elements, such as wires or threads. All the threads, the number of which is one less than the number of the used cannulae, are passed through one of the cannulae and the distal ends of the threads are either attached to the walls of other cannulae, at their distal ends, or pulled back through one of the cannula forming the loop at the distal end and fixed at the proximal end of the cannula. During surgery, the cannulae with their distal ends being linked are inserted into the patients body through an incision, then the surgeon makes additional incisions, disconnects some segments from selected cannulae, subcutaneously pulls them to the additional incisions, and reconnects previously disconnected segments. The surgery is then performed using the cannulae for guiding
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This is a tool holder that is located above my table saw it is used to hold the tools I need most at the saw. It holds my Ridgid digital miter guage, small square, pencil holder, 45 degree tool to make measurement marks on two sides of the board,...
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Universal Microtube Holder for TurboMix [ESI-0565] - New and Improved patented removable Microtube Holder for use with the TurboMix Attachment (Part No. SI-0564) on the Vortex-Genie 2 family of products and the Vortex-Genie Pulse, as well as the Disruptor Genie. Accepts 1.5ml or 2.0ml microtubes (snap-top or screw-cap).
The invention is directed to a slide holder for receiving one or more microscope slides. The slide holder includes a generally rectangular frame and at least one slot, each of the slots for receiving one slide. Flexible retaining latches and retaining grooves are provided at each of the slots for facilitating the securing of the slides.
Pompadour Toilet Tissue Holder 231755 from Herbeau Creations, list Price: $210.00, Traditional, Toilet Tissue Holder, Wall-mount, Brass, Brass
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Methods All newborns # 32 GA (n = 250, Jan 2004-Oct 2005) with RDS were intubated, given surfactant, and then extubated to NCPAP. For data analysis, infants were divided into 3 GA groups 23-26, 27-29, and 30-32 weeks. Comparisons within GA groups were made using ANOVA with Students t-test for post hoc analysis. ...
I first met Carol* (name and identifying details have been changed) when she came to my clinic after a severe asthma attack had sent her to the Intensive Care Unit. After a few days, she had been extubated and had acquired a new diagnosis, asthma. When she saw me in clinic, she felt better than…
Introduction: MitraClip therapy has become a therapeutic alternative for high surgical risk patients with symptomatic mitral regurgitation (MR). There are limited data about early and no data about later hemodynamic consequences after MR correction and about the impact of elimination of regurgitant flow on cardiac output state .. Methods: We studied invasive hemodynamic parameters before operation (conscious non-sedated patients, T1), immediately after MitraClip implantation (still under general anaesthesia, T2) and on day 1 (late) after procedure (conscious, extubated patients, T3) using right heart cathetrization.. Results: Of 25 MitraClip patients (72% male; mean age 70y) with functional MR, in 20 were performed invasive measurements in all time points. MitraClip implantation resulted in an increase in cardiac index (CI) from 1.8±0.5 (T1) to 2.4±0.5(T2) and to 3.2±0.5 L/min/m2 (T3), in a decrease in systemic vascular resistance index (SVRI) from 3759±847 (T1) to 2508±551 (T2) and to ...
In the between-group comparison, there was no significant difference between the values for RSBI_MIN (34.78±14.65 and 38.63±12.31). In contrast, the RSBI_ESP was higher in the FG compared to the SG (80.09±20.71 and 60.94±24.64; p,0.05). In the FG, only one patient showed RSBI,105 cycles/min/L at the time of extubation.. Discussion This study compared RSBI measurements obtained with the aid of PSV to measurements obtained in accordance with criteria established by Yang and Tobin7, demonstrating that the use of ventilatory support can change the RSBI value in a population of critically ill patients who required MV for more than 72 hours. In an ICU, it is routine to perform clinical evaluations and daily evaluations of weaning parameters in an attempt to identify patients who are able to conduct an SBT and, thus, be extubated as early as possible to avoid complications associated with the long-term use of MV. Therefore, weaning parameters are used as tools to guide the decision to extubate ...
The Journal of Emergency Medicine Volume lidkcaine, No. Cassuto J, Wallin G, Hogstrom S, et al. Therefore, patients on nonselective beta-blockers should inform any health professional who will be giving them local anesthetics about their beta-blocker therapy.. A literature search was carried out to identify studies in which intravenous lidocaine was used as a pretreatment for RSI in major head injury. Be prepared to extubate the patient and. Otherwise, do not release until placement of the ET tube has been. Pretreatment agents for rapid sequence intubation in adults. Anticipate the needs and.. ...
TABLE-US-00010 [0148] // Abstract base class (`interface`) for holder objects. // // This design allows a holder object to contain a // collection of other holder objects. // // In the translator, there are two basic types of holder objects: // (1) the `base holder`, which is the single top-level // holder that contains a collection of holder objects. // (2) the holder object for a single unit/stream/object. // // The term `base holder` is used in two ways: // (1) the `root` holder which contains the list of all other holders. // (2) the base class from which object-specific holder classes are derived. #include "ITFCommon.h" class ITFHolder { public: ITFHolder( ){ }; virtual ~ITFHolder( ){ }; public: // Call this method when you are done using the mapper // and you want to delete it. // The implementing object should clean up its memory // and call `delete this`. // A `base holder` should remove all holder objects from // its internal collection. virtual int release( ) = 0; ...
This study will assess the residual neuromuscular blockade (NMB) Train-Of-Four (TOF) ratios at tracheal extubation when anesthesiologists have determine
Executive Summary ChecklistFailures of airway management (e.g., inability to mask ventilate or oxygenate, unplanned extubation, failure to intubate) are major causes of inpatient morbidity and mortality. The following steps will establish an institut
Non-invasive ventilation is a type of medical procedure in which the throat is not cut to insert a tracheal breathing tube, but...
In A Christmas Tale, French director Arnaud Desplechins bittersweet deconstruction of the home-for-the-holidays drama, Catherine Deneuve plays the hands-off matriarch Junon, who may not live to
Some patients do have trouble keeping their eyes open, but I find as long as you tell them to keep blinking they get enough of the fluid in. I still think its better than the Morgan lens, as Ive had patients refuse further irrigation after 5-10mins with a Morgan lens due to severe pain (after the LA washes out) which defeats the purpose entirely. Its also much easier to stop the irrigation & top up the local with the nasal cannuale. Some people have suggested adding lignocaine to the bag of Saline with your Morgan lens, which makes sense in theory, but you may as well just use this technique with the nasal cannulae! I also worry about particulate matter being trapped under the morgan lens (eg with pool chlorine powder in the eye) which is less of a concern with a continuous stream running out of the eye.. ...
Hi Eugene! Would something like this work? [code] //Close positions that are not in the new lowest N for(int pos = ActivePositions.Count - 1; pos ,= 0; pos--) { Position p = ActivePositions[pos]; bool keepPosition = ( bar+1 - p.EntryBar ,= days ) ? true : false; foreach(iHolder holder in list) if( holder.symbol == p.Bars.Symbol ) { keepPosition = true; break; } if (!keepPosition) SellAtMarket(bar + 1, p); foreach(iHolder holder in list) { holder.count--; if (SellAtStop( bar+1, p, p.EntryPrice * stop, Stop Loss ) != null) holder.count = TimeOut.ValueInt; level = AveragePrice.Series(p.Bars)[bar] - (ATR.Series(p.Bars, speriod)[bar] * mult); if (ExitAtTrailingStop( bar+1, p, level, Trailing Chandelier + level.ToString( 0.00)) != null) holder.count = TimeOut.ValueInt; } } //Buy new positions foreach(iHolder holder in list) { bool buyPosition = ( ActivePositions.Count == number ) ? false : true; foreach(Position p in ActivePositions) if (p.Bars.Symbol == holder.symbol) { buyPosition = false; ...
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Were (or their designated health care proxy holders) consented prior to the screening.Study Population and Data CollectionAdult patients with ACHBLF who were
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The Solar Slide/Gobo Holder accepts either a 50mm diameter gobo or duplicate 35mm slide and fits any Solar or K Range Effects Projector - past and present.. ...
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BACKGROUND: The most frequent cause of death in patients with Amyotrophic Lateral Sclerosis (ALS) is respiratory failure. Recently, it has been shown that non-invasive ventilation improves survival and quality of life in ALS patients with respiratory failure, but little is known about predictors of non-invasive ventilation adaptation and tolerance. In this study we evaluated the effect of a comprehensive information about non-invasive ventilation use and a prolonged and intensive monitoring on tolerance to this palliative care. METHODS: We prospectively monitored all consecutive ALS patients with chronic respiratory failure and indication to non-invasive ventilation between January 2005 and December 2007. Non-invasive ventilation adaptation was always performed in a hospital setting. RESULTS: Forty-four patients were considered eligible: six declined the non-invasive ventilation proposal and one was excluded due to severe fronto-temporal dementia. Non-invasive ventilation was offered to ...
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Presented by Laura Cavallone, M.D., Washington University School of Medicine in St. Louis, Missouri.. Dear SHANA members,. I would like to share with you the "Extubation Algorithm" that I have developed for major neck and upper airway surgery. I believe it offers a reasonable, pragmatic approach to this high-risk patient population, where early extubation failure may occur in nearly 11% of patients due to postoperative laryngo-pharyngeal edema and airway obstruction.. The "Extubation Algorithm" that is offered for your attention has served me well so far in my practice. Yet, it was developed 2 years ago, and will certainly benefit from your constructive feedback. The recently published Difficult Airway Society Guidelines for the management of tracheal extubation and ASA Practice Guidelines for Management of the Difficult Airway have both advanced our appreciation.... Join SHANA or Log in to view more/discuss on Forum.. ...

Home - Critical Care Airway ManagementCritical Care Airway ManagementHome - Critical Care Airway ManagementCritical Care Airway Management

Extubation and airway exchange. Equipment and strategies, including the staged extubation kit and airway exchange catheters ... Airway management out of the comfort zone. Airway management out of the anaesthetic room: difficult airways, sick patients, ... Critical Care Airway Management is a 2-day, practical, hands-on course covering advanced airway management when the going gets ... Airway Trolley. Know your kit and how it can be organised to decrease stress and increase patient safety ...
more infohttps://www.ccam.net.au/

Design and Implementation of an Educational Program in Advanced Airway Management for Anesthesiology ResidentsDesign and Implementation of an Educational Program in Advanced Airway Management for Anesthesiology Residents

Continuous airway access for the difficult extubation: the efficacy of the airway exchange catheter. Anesthesia and Analgesia. ... Teaching management of the airway: the UCSD airway rotation. In: Benumof JL, editor. Airway Management: Principles and Practice ... Staged extubation strategy: is an airway exchange catheter the answer? Anesthesia and Analgesia. 2007;105(5):1182-1185. [PubMed ... perform an awake intubation in the predicted difficult airway, and perform a surgical airway in the failed airway ("cannot ...
more infohttp://pubmedcentralcanada.ca/pmcc/articles/PMC3299292/?lang=en-ca

Bivona® Adult TTS™ Adjustable Neck Flange Hyperflex™ Tracheostomy Tubes, Tracheostomy Tubes and Kits | Smiths MedicalBivona® Adult TTS™ Adjustable Neck Flange Hyperflex™ Tracheostomy Tubes, Tracheostomy Tubes and Kits | Smiths Medical

Adjustable neck flange for instant customization without extubation. *Longer shaft lengths to accommodate most unusual airway ... Adjustable neck flange for instant customization without extubation. *Longer shaft lengths to accommodate most unusual airway ... The adjustable nature of the tube provides a secure airway until a proper length, fixed neck flange tube can be obtained. The ... The adjustable nature of the tube provides a secure airway until a proper length, fixed neck flange tube can be obtained. The ...
more infohttps://www.smiths-medical.com/en-au/products/tracheostomy/silicone-tracheostomy-tubes/silicone-adult-tracheostomy-tubes/bivona-adult-tts-adjustable-neck-flange-hyperflex-tracheostomy-tubes

Retrospective Review of Propofol versus Etomidate during Rapid Sequence Intubation in the Emergency Department at a Tertiary...Retrospective Review of Propofol versus Etomidate during Rapid Sequence Intubation in the Emergency Department at a Tertiary...

11.6%, p , 0.004). We found that a large majority of patients in both groups needed to be intubated for airway protection (44.1 ... Both agents had similar rates of oral trauma, failed intubations, time to intubation, and time to extubation. The mean dose of ... After completion of the procedure, time to extubation was defined as 1) ≤24 hours, 2) ,24 hours, and 3) ≥48 hours. Other data ... Minor outcomes assessed included time to intubation, time to extubation, ICU length of stay, hospital length of stay, and in- ...
more infohttps://www.scirp.org/journal/paperinformation.aspx?paperid=77684

Stroke-Related Early Tracheostomy Versus Prolonged Orotracheal Intubation in Neurocritical Care Trial (SETPOINT) | StrokeStroke-Related Early Tracheostomy Versus Prolonged Orotracheal Intubation in Neurocritical Care Trial (SETPOINT) | Stroke

In our reasoning, the size and location of the vascular lesion is more relevant for airway and ventilation compromise than the ... Patients allocated to the standard group received a PDT between day 7 and 14 from intubation if extubation, although aimed for ... Acknowledged advantages of a short tracheal cannula compared with a long orotracheal tube include less airway dead space and ... as well as more long-term disadvantages related to an indwelling artificial airway. It is widely agreed that TT should be ...
more infohttp://stroke.ahajournals.org/content/44/1/21.long

Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation.Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation.

We investigated whether it also has the ability to attenuate airway and circulatory reflexes during emergence from anaest ... bolus injection of dexmedetomidine before tracheal extubation attenuates airway-circulatory reflexes during extubation.. ... during and after tracheal extubation. The time from tracheal extubation and emergence from anaesthesia were recorded. RESULTS: ... HR, SAP and DAP increased at extubation in both groups (P,0.05), but the increase was less significant with dexmedetomidine. ...
more infohttp://www.biomedsearch.com/nih/Single-dose-dexmedetomidine-attenuates-airway/16095449.html

Cuff Leak Test Good at Ruling In Post-Extubation Airway Obstruction | Anesthesia ExpertsCuff Leak Test Good at Ruling In Post-Extubation Airway Obstruction | Anesthesia Experts

Cuff Leak Test Good at Ruling In Post-Extubation Airway Obstruction. December 7, 2018. by Dr. Clemens Leave a Comment ... "Post-extubation laryngeal edema can result in rapid progression to acute respiratory failure due to upper airway obstruction-a ... Because of its high specificity, a cuff leak test is better at ruling in than ruling out post-extubation airway obstruction in ... They updated a meta-analysis of the diagnostic accuracy of the CLT to predict post-extubation airway obstruction in adults in ...
more infohttp://anesthesiaexperts.com/uncategorized/cuff-leak-test-good-ruling-post-extubation-airway-obstruction/

A randomized controlled trial of two nasal continuous positive airway pressure levels after extubation in preterm infants.  -...A randomized controlled trial of two nasal continuous positive airway pressure levels after extubation in preterm infants. -...

To compare extubation failure rate with two ranges of nasal continuous positive airway pressure (NCPAP) in oxygen dependent ... A randomized controlled trial of two nasal continuous positive airway pressure levels after extubation in preterm infants.. ... No infant developed pneumothorax during 96 hours post-extubation.. CONCLUSIONS: Extubation failure in preterm infants with ... Rates of extubation failure per criteria (24% vs 43%, P = .04, OR and 95% CI: 0.39 [0.16-0.96]) and re-intubation (17% vs 38%, ...
more infohttps://www.ncbi.nlm.nih.gov/pubmed/24094879?dopt=Abstract

A randomised controlled trial of two methods of delivering nasal continuous positive airway pressure after extubation to...A randomised controlled trial of two methods of delivering nasal continuous positive airway pressure after extubation to...

1998) Randomised, controlled trial of nasal continuous positive airway pressure in the extubation of infants weighing 600 to ... A randomised controlled trial of two methods of delivering nasal continuous positive airway pressure after extubation to ... A randomised controlled trial of two methods of delivering nasal continuous positive airway pressure after extubation to ... 2000) Nasal continuous positive airways pressure immediately after extubation for preventing morbidity in preterm infants. ...
more infohttp://fn.bmj.com/content/85/2/F82

Respiratory and hemodynamic outcomes following exchange extubation with laryngeal mask airway as compared to traditional awake...Respiratory and hemodynamic outcomes following exchange extubation with laryngeal mask airway as compared to traditional awake...

Respiratory and hemodynamic outcomes following exchange extubation with laryngeal mask airway as compared to traditional awake ... and hemodynamic outcomes following exchange extubation with laryngeal mask airway as compared to traditional awake extubation ... and that following exchange extubation of ETT by using a laryngeal mask airway (LMA).,/p,,p,,b,SETTINGS AND DESIGN: ,/b,This ... in traditional extubation while it was only 36.7% in exchange extubation group (P , 0.001). Hemodynamic response measured ...
more infohttps://www.amrita.edu/publication/respiratory-and-hemodynamic-outcomes-following-exchange-extubation-laryngeal-mask-airway

A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver...A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver...

CPAP for the post-extubation management of preterm infants with respiratory distress syndrome (RDS). STUDY DESIGN: A total ... To compare the efficacy and safety of bubble continuous positive airway pressure (CPAP) and Infant Flow Driver (IFD) ... A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver ... Continuous Positive Airway Pressure / instrumentation*, methods*. Enterocolitis, Necrotizing / mortality. Female. Humans. ...
more infohttp://www.biomedsearch.com/nih/randomized-controlled-trial-post-extubation/19230906.html

Extubation of the difficult airway by Khaldoun Faris, Maksim Zayaruzny et al."Extubation of the difficult airway" by Khaldoun Faris, Maksim Zayaruzny et al.

In this article, we will provide a framework for identifying a difficult airway, criteria for safe extubation, as well as ... Difficult airway may be a consequence of patients anatomy or airway edema developed during the ICU stay and mechanical ... The incidence of failed airways and of cardiac arrest related to airway instrumentation in the ICU is much higher than that of ... Proficiency in identifying a potentially difficult airway and thorough familiarity with strategies and techniques of securing ...
more infohttps://escholarship.umassmed.edu/anesthesiology_pubs/18/

Airway Management of  At-Risk Extubation  in Intensive Care [Eurasian J Pulmonol]Airway Management of At-Risk Extubation' in Intensive Care [Eurasian J Pulmonol]

Keywords: At-risk extubation, difficult airway, intensive care. Fatma Y ld r m, Iskender Kara, Cengiz Bekir Demirel. Airway ... Airway Management of At-Risk Extubation in Intensive Care. Fatma Y ld r m1, Iskender Kara2, Cengiz Bekir Demirel2. 1Department ... upper airway surgery and cervical column operations are hazardous conditions affecting extubation success. Upper airway ... Extubation failure due to airway problems is rare in critically ill patients. Intensive care mortality and morbidity among ...
more infohttp://eurasianjpulmonol.com/jvi.aspx?pdir=eurasianjpulmonol&plng=eng&un=EJP-00922

Pulmonary Ultrasound and Diaphragmatic Shortening Fraction Combined Analysis for Extubation-Failure-Prediction in Critical Care...Pulmonary Ultrasound and Diaphragmatic Shortening Fraction Combined Analysis for Extubation-Failure-Prediction in Critical Care...

30min of support pressure and continuous positive airway pressure of zero cmH2O). Besides, we evaluated the DSF at the end of ... We defined extubation failure when the patient required endotracheal tube reinsertion in the 48h since extubation. A study- ... times more odds to exhibit extubation failure. Every additional zone with B-lines increases extubation failure odds by 5.91 ( ... Our rate of extubation failure coincides with the reported by other authors.10 In agreement with the described in the ...
more infohttps://archbronconeumol.org/en-pulmonary-ultrasound-diaphragmatic-shortening-fraction-articulo-S1579212919300655

Incidence and primary causes of unplanned extubation in a neonatal intensive care unitIncidence and primary causes of unplanned extubation in a neonatal intensive care unit

Keywords: Airway extubation; Physical therapy modalities; Incidence; Infant, newborn; Intensive care units, neonatal ... The number of days the patients were maintained with an artificial airway was termed "patient-days with artificial airway". The ... extubation.(2,3) Patient maintenance using artificial airways is currently a safe practice, but it is not free from ... and motives/causes of the event on the day of the unplanned extubation event. RESULTS: Fifty-four unplanned extubations ...
more infohttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2012000300005&lng=en&nrm=iso&tlng=en

Extubation Algorithm for Major Neck and Upper Airway Surgery (Preview) | Society for Head and Neck AnesthesiaExtubation Algorithm for Major Neck and Upper Airway Surgery (Preview) | Society for Head and Neck Anesthesia

I would like to share with you the "Extubation Algorithm" that I have developed for major neck and upper airway surgery. I ... The recently published Difficult Airway Society Guidelines for the management of tracheal extubation and ASA Practice ... The "Extubation Algorithm" that is offered for your attention has served me well so far in my practice. Yet, it was developed 2 ... of patients due to postoperative laryngo-pharyngeal edema and airway obstruction. ...
more infohttp://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery-preview

Journal of Neonatal-Perinatal Medicine - Volume 9, issue 4 - Journals - IOS PressJournal of Neonatal-Perinatal Medicine - Volume 9, issue 4 - Journals - IOS Press

Keywords: Respiratory therapy, premature, suction, airway extubation, oxygen, NICU DOI: 10.3233/NPM-16915140 ... Use of naloxone to minimize extubation failure after premedication for INSURE procedure in preterm neonates ... and reports the rates of successful extubation within 30 minutes of surfactant administration with and without the use of ... in reversing the respiratory depressive effect of analgesic premedication and in turn facilitates expeditious extubation in ...
more infohttps://content.iospress.com/journals/journal-of-neonatal-perinatal-medicine/9/4

Language: English | Search Results | Academic CommonsLanguage: English | Search Results | Academic Commons

Critical care medicineChest--SurgeryAirway extubationIntensive care unitsHeart--Surgery. ... Association of Overnight Extubation with Outcomes after Cardiac Surgery in the Intensive Care Unit ...
more infohttps://academiccommons.columbia.edu/search?f%5Blanguage_ssim%5D%5B%5D=English&page=2&per_page=50&sort=Best+Match

Academic Unit: Epidemiology / Type: Articles | Search Results | Academic CommonsAcademic Unit: Epidemiology / Type: Articles | Search Results | Academic Commons

Critical care medicineChest--SurgeryAirway extubationIntensive care unitsHeart--Surgery. ... 3. Association of Overnight Extubation with Outcomes after Cardiac Surgery in the Intensive Care Unit ...
more infohttps://academiccommons.columbia.edu/search?f%5Bdepartment_ssim%5D%5B%5D=Epidemiology&f%5Bgenre_ssim%5D%5B%5D=Articles&page=1&per_page=20&sort=Best+Match

PaO2, PaCO2, RR, and mean arterial pressure profile for | Open-iPaO2, PaCO2, RR, and mean arterial pressure profile for | Open-i

Airway Extubation/methods*/trends. *Noninvasive Ventilation/methods*/trends. *Respiratory Distress Syndrome, Adult/diagnosis*/ ... Mentions: Mean PaCO2 after 15 minutes from extubation was 34.56 ± 3.43 mm Hg in the NIV group and 38.31 ± 4.74 mm Hg in the OM ... Mentions: Mean PaCO2 after 15 minutes from extubation was 34.56 ± 3.43 mm Hg in the NIV group and 38.31 ± 4.74 mm Hg in the OM ... Included patients met extubation criteria with at least 72 hours of mechanical ventilation due to acute respiratory failure, ...
more infohttps://openi.nlm.nih.gov/detailedresult.php?img=PMC3672522_cc12549-3&req=4

塚本 真規 - 研究成果
     - 九州大学塚本 真規 - 研究成果 - 九州大学

Airway management for a pediatric patient with a tracheal bronchus. Tsukamoto, M., Hirokawa, J., Hitosugi, T. & Yokoyama, T., 3 ... Alternative methods for nasotracheal intubation and extubation in a patient with Apert syndrome. Tsukamoto, M. & Yokoyama, T., ... Airway management with a rigid external distractor in place. Tsukamoto, M., Hitokawa, J. & Yokoyama, T., 8 2017, : : Indian ... Airway spray efficacy of local anesthetic with fiberscope. Tsukamoto, M., Hirokawa, J. & Yokoyama, T., 8 1 2017, : : Journal of ...
more infohttps://kyushu-u.pure.elsevier.com/ja/persons/masanori-tsukamoto/publications/

Anesthesia E-ssential, August 9, 2018Anesthesia E-ssential, August 9, 2018

Cuff Leak Test Good at Ruling in Post-Extubation Airway Obstruction. Researchers say a cuff leak test (CLT) is a viable option ... From "Cuff Leak Test Good at Ruling in Post-Extubation Airway Obstruction" Anesthesiology News (08/02/18) Rosenthal, Thomas. ... "Given the considerable burden associated with extubation failure, it is useful and reasonable for a cuff leak test to rule in ... Researchers found that, based on its high specificity (89 percent), the cuff leak test accurately predicts post-extubation ...
more infohttps://www.aana.com/publications/anesthesia-e-ssential/anesthesia-e-ssential-august-9-2018

塚本 真規 - 研究成果
     - 九州大学塚本 真規 - 研究成果 - 九州大学

Airway management for a pediatric patient with a tracheal bronchus. Tsukamoto, M., Hirokawa, J., Hitosugi, T. & Yokoyama, T., 3 ... Alternative methods for nasotracheal intubation and extubation in a patient with Apert syndrome. Tsukamoto, M. & Yokoyama, T., ... Anesthetic management of a dental patient with repeated convulsions and difficult airway management. Tsukamoto, M., Hitosugi, T ... Postoperative pneumonia in a patient with preoperative upper airway infection. Miyazawa, Y., Tsukamoto, M., Asami, T., ...
more infohttps://kyushu-u.pure.elsevier.com/ja/persons/masanori-tsukamoto/publications/?type=%2Fdk%2Fatira%2Fpure%2Fresearchoutput%2Fresearchoutputtypes%2Fcontributiontojournal%2Farticle

Su, Y.<...Su, Y.<...

Su, Y-H., Huang, W. C., Huang, H. T., Huang, Y. J., Sue, Y-K., Huynh, T. T., Hsiao, M., Liu, T. Z., Wu, TH. A. & Lin, C-M., 五月 31 2016, 於 : Oncotarget. 7, 22, p. 33246-33256 11 p.. 研究成果: 雜誌貢獻 › 文章 ...
more infohttps://tmu.pure.elsevier.com/zh/persons/yen-hao-su

Liu, F-L.<...Liu, F-L.<...

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  • Critical Care Airway Management is a 2-day, practical, hands-on course covering advanced airway management when the going gets tough. (ccam.net.au)
  • The course consists of interactive discussions and hands-on skills stations with expert Faculty, followed by fully immersive high-fidelity simulated scenarios with expert debriefing, covering all aspects of advanced airway management in critical care. (ccam.net.au)
  • The adjustable neck flange allows for horizontal and vertical modification to obtain the best fit when your patient has an abnormal airway anatomy and correct tube size cannot be determined. (smiths-medical.com)
  • The adjustable nature of the tube provides a secure airway until a proper length, fixed neck flange tube can be obtained. (smiths-medical.com)
  • The adjustable neck flange also allows for adjustment without extubation. (smiths-medical.com)
  • CCAM is not about the routine patient in the anaesthetic room, this course will teach you the skills and mindset for when the airway is difficult, the patient sick, the environment challenging, or all of the above. (ccam.net.au)
  • The CCAM course has been endorsed by the College of Intensive Care Medicine as fulfilling the requirements for the Transition year 'difficult airway course', and by the Australian and New Zealand College of Anaesthetists as a 'Can't Intubate, Can't Oxygenate' (CICO) course. (ccam.net.au)
  • The long and flexible silicone shaft is wire-reinforced and designed to accommodate difficult airway anatomy providing a temporary, secure airway. (smiths-medical.com)
  • The Faculty consists of passionate airway experts from all of the specialities outlined above. (ccam.net.au)
  • Traditional awake extubation leads to respiratory complications and hemodynamic response which are detrimental in neurosurgery, ENT surgery and patients with comorbidities. (amrita.edu)
  • Respiratory complications such as bucking, coughing, desaturation and the need for airway maneuvers and hemodynamic response were noted in both groups. (amrita.edu)
  • Exchange extubation with LMA decreases respiratory complications and hemodynamic stress response when compared to traditional awake extubation. (amrita.edu)
  • The incidence of failed airways and of cardiac arrest related to airway instrumentation in the ICU is much higher than that of elective intubations performed in the operating room. (umassmed.edu)
  • This study established the incidence and primary causes of unplanned extubation in newborns in the neonatal intensive care units of the Hospital Sofia Feldman, Belo Horizonte (Minas Gerais). (scielo.br)
  • The incidence of unplanned extubation in the investigated neonatal intensive care units was low during the study period compared to previously reported data. (scielo.br)
  • Nevertheless, the assessment of the quality of procedures, the continuous follow-up of newborns, and the monitoring of the causes of extubation are required to further reduce this incidence. (scielo.br)
  • Although these treatments may be life saving, prolonged ventilation is associated with the development of chronic lung disease, pulmonary and systemic infections, and damage to the upper airways. (bmj.com)
  • Some authors (4,6) report the premature removal of the intratracheal cannula associated with AE, and other authors (8,9) suggest that UE involves the premature removal of the intratracheal cannula by the patient's own actions (i.e., self-extubation or deliberate spontaneous extubation). (scielo.br)
  • And having difficult airway training will at some point save your patient's life. (theairwaysite.com)
  • Patients were randomized immediately before elective extubation, being randomly allocated to one of the study groups: NIV or OM. (nih.gov)
  • We investigated whether it also has the ability to attenuate airway and circulatory reflexes during emergence from anaesthesia. (biomedsearch.com)
  • (2,3) Patient maintenance using artificial airways is currently a safe practice, but it is not free from complications. (scielo.br)
  • UE is defined as any unexpected extubation that occurs at unplanned times due to patient agitation or as a result of patient handling by the healthcare staff. (scielo.br)
  • The "Extubation Algorithm" that is offered for your attention has served me well so far in my practice. (shanahq.com)
  • Unplanned extubations and their primary causes were assessed using an adverse events form. (scielo.br)
  • The course emphasizes airway assessment and decision-making to build within course participants the capacity to manage all airway situation they encounter - and to do so with great confidence. (theairwaysite.com)
  • Hemodynamic response measured immediately at extubation in terms of heart rate, systolic blood pressure (BP), diastolic BP, mean arterial pressure, and rate pressure product were all significantly lesser in exchange group when compared to traditional extubation. (amrita.edu)