Airway Extubation

Ventilator Weaning

Intubation, Intratracheal

Airway Obstruction

Airway Remodeling

Laryngeal Edema

Device Removal

Airway Resistance

Respiration, Artificial

Anesthesia Recovery Period

Respiratory Insufficiency

Tracheostomy

Anesthesia, General

Bronchi

Respiratory System

Positive-Pressure Respiration

Intensive Care Units

Bronchial Hyperreactivity

Airway Management

Respiratory Distress Syndrome, Newborn

Continuous Positive Airway Pressure

Respiratory Mucosa

Nose Deformities, Acquired

Sleep Apnea, Obstructive

Polysomnography

Catheters, Indwelling

Catheters

Catheterization, Central Venous

Catheterization

Catheterization, Peripheral

Nasal Obstruction

Missouri

Drug Agonism

Tuberculosis, Laryngeal

Colostomy

Cyanosis

Intensive Care Units, Neonatal

Respiratory Care Units

Anesthesiology

Anesthesia

Anesthetics, Dissociative

Authorship

Anesthetics, Inhalation

Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness | Disfagia Brasil

Unplanned Extubations in Intensive Care Unit: evidences for risk factors. A literature review | Acta Biomedica Atenei Parmensis

Intensive Care Medicine: Abstract

EA4275 / UMR INSERM U1246 - SPHERE

Assessment of an Unplanned Extubation Bundle to Reduce Unplanned Extubations in Critically Ill Neonates, Infants, and Children ...

Plus it

Clinical Evaluation of Swallowing Disorders as a Predictor of Extubation Failure - Full Text View - ClinicalTrials.gov

Most recent papers with the keyword procedures in ICU | Read by QxMD

Publications - Purdue I-Eat Research Lab

Venkataraman, Shekhar | Department of Critical Care Medicine

Emergence Phenomena: Are we (EPs) the weakest link in cardiac arrest?

Performance of the Global Assessment of Pediatric Patient Safety (GAPPS) Tool - PEDINFO

Through with flying colors

Reliability of respiratory pressure measurements in ventilated and non-ventilated patients in ICU: an observational study |...

Want to reduce reintubation rates? - ESICM

Plus it

Benefits of early extubation after cardiovascular surgery | Zenaida Carbon | John Muir Health, Concord Medical Center, USA ...

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

International Liver Transplantation Society » Education » Post-transplant Concerns: Early extubation: Risks, benefits and...

Karen S. Sibert, MD

Optiflow FAQs | Fisher & Paykel Healthcare

Optiflow FAQs | Fisher & Paykel Healthcare

Nasal cannulae | definition of nasal cannulae by Medical dictionary

The impact of ultra-brief chest compression-only CPR video training on responsiveness, compression rate, and hands-off time...

Dexmedetomidine in Patients After Intracranial Surgery - Full Text View - ClinicalTrials.gov

Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children | DIAL.pr -...

Preoperative and Intraoperative Predictive Factors of Immediate Extubation After Neonatal Cardiac Surgery<...

Different effects of cardiac and diaphragm function assessed by ultrasound on extubation outcomes in difficult-to-wean patients...

Tidig extubering efter hjärtkirurgi : Intensivvårdssjuksköterskans kunskap om tidig extubering och deras syn på faktorer som...

Article Full Text - Methodist Journal

intubation Archives - RT: For Decision Makers in Respiratory Care

emergency department | The Trauma Pro

Very long, hands-off fermentation suggestions? - pickles | Ask MetaFilter

Leaders must learn to be hands-off | HRD New Zealand

Great Zs: Telebation

Intrapulmonary arteriovenous shunting may be a universal phenomenon in patients with the superior cavopulmonary anastomosis: a...

High-flow nasal cannula therapy for support of breathing in children | Cochrane

Valor de la fracción de espacio muerto (Vd/Vt) como predictor de éxito en la extubación

The Functionally Univentricular Heart | JACC: Journal of the American College of Cardiology

Plus it

Heated, Humidified High-Flow Nasal Cannula Versus Nasal CPAP for Respiratory Support in Neonates | Articles | Pediatrics

BPD | All Things Neonatal

Just the 6 of us

Notes from Dr. RW: July 2010

Breathing Easy Using Extubation in the OR | Cardiovascular Business

Západočeská univerzita - Publikace

Enigma 2020 Conference Program | USENIX

Labor<...

Easy Crock Pot BBQ Chicken Wings | eHow

How to Boil Chicken: 13 Steps (with Pictures) - wikiHow

Black Creek Canal orthohantavirus

Tracheobronchitis

Double aortic arch

Henrik Verder

Tracheal intubation

Intubation granuloma

Ludwig's angina

Rapid shallow breathing index

Positive airway pressure

Tracheal intubation

Heated humidified high-flow therapy

Dexmedetomidine

Laryngospasm

Tracheotomy

Tracheal tube

Joseph O'Dwyer

Aerosol-generating procedure

Postoperative residual curarization

Recurrent laryngeal nerve

Epinephrine (medication)

Epinephrine (medication)

Laryngospasm

Post-extubation23

• No infant developed pneumothorax during 96 hours post-extubation. (nih.gov)
• These findings suggest the need for higher distending pressure post-extubation in the more immature infants who are still oxygen dependent. (nih.gov)
• A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver continuous positive airway pressure in preterm infants with respiratory distress syndrome. (biomedsearch.com)
• OBJECTIVE: To compare the efficacy and safety of bubble continuous positive airway pressure (CPAP) and Infant Flow Driver (IFD) CPAP for the post-extubation management of preterm infants with respiratory distress syndrome (RDS). (biomedsearch.com)
• Because of its high specificity, a cuff leak test is better at ruling in than ruling out post-extubation airway obstruction in adults who are mechanically ventilated, a meta-analysis has concluded. (anesthesiaexperts.com)
• Although it has excellent specificity, the moderate sensitivity of the cuff leak test (CLT) may mean other options with higher sensitivity to predict post-extubation airway obstruction may be preferred. (anesthesiaexperts.com)
• Our systematic review of 21 diagnostic accuracy studies found that the sensitivity and specificity of the cuff leak test to predict post-extubation laryngeal edema was 69% and 89%, respectively," said Akira Kuriyama, MD, MPH, Emergency and Critical Care Center, Kurashiki Central Hospital, in Kurashiki, Japan, and the study's lead author. (anesthesiaexperts.com)
• The cuff leak test can predict post-extubation laryngeal edema in the presence of cuff leak, given excellent sensitivity. (anesthesiaexperts.com)
• They updated a meta-analysis of the diagnostic accuracy of the CLT to predict post-extubation airway obstruction in adults in their analysis of studies in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials. (anesthesiaexperts.com)
• Pooled results of prospective studies indicate that only about one in 14 unselected intubated ICU patients will develop post-extubation laryngeal edema and only one in 28 will require reintubation due to upper airway obstruction. (anesthesiaexperts.com)
• Restricting the use of the CLT to patients at higher risk of post-extubation laryngeal edema should reduce the likelihood that patients with a falsely abnormal CLT (no leak) will be kept intubated unnecessarily. (anesthesiaexperts.com)
• Post-extubation laryngeal edema is what we would like to avoid and, given the moderate sensitivity of the cuff leak test, we may need to seek some other options to rule it out," Dr. Kuriyama said. (anesthesiaexperts.com)
• Nursing staff can optimise patient safety and comfort during, and post-extubation. (rch.org.au)
• Objective of our prospective study: to compare parameters measured just before extubation, then in post-extubation, between COPD patients who have benefitted from NIPSV (group I) to those who did not necessitate NIPSV (group II) after weaning with pressure support (PS) ventilation. (beds.ac.uk)
• We conducted a web-based survey in Europe to identify the perceived pattern of NIV utilisation and the reason for choosing a specific ventilator and interface type in four common clinical scenarios: acute hypercapnic respiratory failure (AHRF), cardiogenic pulmonary oedema (CPE), de novo hypoxic respiratory failure and weaning/post-extubation failure (W/PE). (ersjournals.com)
• In this randomised controlled trial, patients received HFNC or standard oxygen therapy post-extubation. (springer.com)
• In the 24-h post-extubation, there was no difference in mean PaO 2 /FiO 2 ratio (HFNC 227.9, control 253.3, p = 0.08), or RR (HFNC 17.2, control 16.7, p = 0.17). (springer.com)
• However, low dyspnoea levels were observed in each group at 8 h post-extubation, median (IQR) scores were 0 (0-1) for control and 1 (0-3) for HFNC ( p = 0.008). (springer.com)
• Oxygen nebulizer therapy increases humidity to the airway, especially post-extubation. (clinicaltrials.gov)
• This should be looked at both as a routine treatment post- extubation and as specific treatment for post- extubation upper airway obstruction. (cochrane.org)
• The vasoconstrictive properties of epinephrine, and its proven efficacy in the treatment of croup in infants, has led to the routine use of inhaled nebulized epinephrine immediately post- extubation in some neonatal units. (cochrane.org)
• It is also recommended for neonates with post- extubation tracheal obstruction and stridor in neonatal and respiratory textbooks and reviews. (cochrane.org)
• Patient removed from ventilation and discharged 5 days post-extubation in good condition. (wikipedia.org)

Intubation21

• 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%, P = .023, 0.33 [0.016-0.85]) within 96 hours were significantly lower in the high- compared with the low NCPAP group. (nih.gov)
• Cook's comprehensive product offerings also cover intubation , airway exchange, and emergency airway access . (cookmedical.eu)
• Although there has been a strong emphasis on prediction and intubation of the difficult airway, safe extubation of the patient with a potentially difficult airway has not received the same attention. (edu.au)
• Intensive care mortality and morbidity among patients having extubation failure due to airway problems are less than among those requiring re-intubation due to respiratory failure. (eurasianjpulmonol.com)
• Dr. Sessler said the clinical risk factors that were identified in observational studies include female sex, duration of intubation of more than six days, larger-diameter endotracheal tube, traumatic intubation and previous unplanned extubation. (anesthesiaexperts.com)
• (1,2) Tracheal intubation is often performed in an emergency due to the aggravation of respiratory problems, such as apnea, obstruction of the endotracheal tube (ETT), and accidental (AE) and/or unplanned (UE) extubation. (scielo.br)
• Generic guidelines exist for the intubation of different patient groups, as do resources to facilitate airway rescue and transition to the 'can't intubate can't oxygenate' (CICO) scenario. (mja.com.au)
• Intubation, extubation, as well as endoscopy (rigid and flexible) can create APG. (aafprs.org)
• Brian injured patients that remained intubation solely because of a depressed level of consciousness were randomized into immediate extubation or delayed extubation until their level of consciousness improved.All patients met standard ventilatory, and airway criteria for extubation. (clinicaltrials.gov)
• showed that an unplanned extubation prolongs time of intubation thereby increasing the patient's exposure to hazards of airway intervention and mechanical ventilation [ 2 ]. (hindawi.com)
• Treatment almost always involves the immediate establishment of an artificial airway: inserting a breathing tube into the throat (intubation) or making a tiny opening toward the base of the neck and putting a breathing tube into the trachea (tracheostomy). (encyclopedia.com)
• Incidence of laryngeal edema following extubation is reported to be 4.2% with only 1% of patients requiring re-intubation for acute respiratory failure ( 1 ). (ispub.com)
• Airway: Multiple conditions associated with strabismus put this population at risk of difficult intubation. (oncologynurseadvisor.com)
• This will be the number of days from intubation to the extubation date. (clinicaltrials.gov)
• 15. Intubation: Perform Including Laryngeal Mask Airway, AP. (egeneralmedical.com)
• Our study suggests that extubation should not be delayed in extremely premature infants due to fears of need for re-intubation. (iospress.com)
• 10 ] Difficult extubation with deflated cuffs have occurred as a result of folds in the deflated cuff below vocal cords [ 11-13 ] or swollen or tense vocal cords that resulted from traumatic intubation with an excessively large tube. (asahq.org)
• In the same vein, intubation does not guarantee extubation. (kevinmd.com)
• In a randomized, controlled study we have shown that a single dose of surfactant (Curosurf, Chiesi Farmateutici, Parma, Italy) given by short-lasting intubation reduces the need for mechanical ventilation and improves oxygenation in infants with moderate to severe respiratory distress syndrome (RDS) treated with early nasal continuous positive airway pressure (nasal CPAP). (aappublications.org)
• Bronchoscopy excluded congenital lower airway lesions or post-intubation injury. (cmaj.ca)
• In these patients, PAP ventilation can prevent the need for tracheal intubation, or allow earlier extubation. (wikipedia.org)

Tracheal12

• Heart rate (HR) and systolic and diastolic blood pressure (SAP, DAP) were measured before, during and after tracheal extubation. (biomedsearch.com)
• The time from tracheal extubation and emergence from anaesthesia were recorded. (biomedsearch.com)
• The time from tracheal extubation and emergence from anaesthesia were similar in both groups. (biomedsearch.com)
• CONCLUSION: These findings suggest that a single-dose bolus injection of dexmedetomidine before tracheal extubation attenuates airway-circulatory reflexes during extubation. (biomedsearch.com)
• 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. (shanahq.com)
• Problems which cause the obstruction of upper airways may not give symptoms until tracheal extubation is performed. (eurasianjpulmonol.com)
• https://www.mja.com.au/journal/2020/consensus-statement-safe-airway-society-principles-airway-management-and-tracheal [Preprint, 1 April 2020]. (mja.com.au)
• Extubation at light levels of anesthesia or sedation can stimulate reflex responses via tracheal and laryngeal irritation. (aijournals.com)
• Authors found that dexmedetomidine 0.5 μg/kg IV, administered before extubation, was more effective in attenuating airway reflex responses to tracheal extubation as compared with fentanyl 1 μg/kg IV. (aijournals.com)
• Since 1973, 16 cases of difficult tracheal extubation have been reported. (asahq.org)
• Use of the Cook airway exchange catheter in 'bridging' the potentially difficult extubation: A case report The unique characteristics of the Cook airway exchange catheter led the author of this case report to use it in the anesthetic management of a morbidly obese patient with significant tracheal deviation secondary to an enlarged thyroid gland. (aana.com)
• After removal of tracheal tube, patients with a history of heart failure received continuous positive airway pressure (CPAP group). (springer.com)

Obstruction12

• 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. (shanahq.com)
• There was no past history of difficulty during feeding or airway obstruction . (bvsalud.org)
• However, following extubation of the endotracheal tube she developed an upper airway obstruction . (bvsalud.org)
• Epiglottitis is an infection of the epiglottis, which can lead to severe airway obstruction. (encyclopedia.com)
• A child may begin complaining of a sore throat and within a few hours be suffering from extremely severe airway obstruction. (encyclopedia.com)
• Diagnosis begins with a high level of suspicion that a quickly progressing illness with fever, sore throat, and airway obstruction is very likely to be epiglottitis. (encyclopedia.com)
• Rhonchi - low-pitched wheezing or snoring sound associated with partial airway obstruction. (prezi.com)
• Study populations should include the group of infants at highest risk for upper airway obstruction from mucosal swelling because of their small glottic and subglottic diameters (i.e. those infants with birth weights less than 1000 grams). (cochrane.org)
• These are the primary anatomical changes that cause chronic upper airway resistance and obstruction, increased inspiratory effort and marked negative pressures on inspiration. (vin.com)
• Treatment is aimed at surgically relieving upper airway obstruction and eliminating exacerbating conditions. (vin.com)
• Nasal obstruction should be suspected if a no. 5 French catheter is not easily passed through the nostrils during airway suctioning or placement of a nasogastric feeding tube. (cmaj.ca)
• Airway compromise from nasal obstruction in neonates and infants. (cmaj.ca)

Nasal14

• A randomized controlled trial of two nasal continuous positive airway pressure levels after extubation in preterm infants. (nih.gov)
• To compare extubation failure rate with two ranges of nasal continuous positive airway pressure (NCPAP) in oxygen dependent preterm infants. (nih.gov)
• AIM To determine whether extubation to nasal continuous airway pressure (NCPAP) results in a greater proportion of infants remaining free of additional ventilatory support for one week after extubation compared with those extubated directly to headbox oxygen. (bmj.com)
• Previous studies using different levels and methods of nasal continuous positive airway pressure (NCPAP) administration have yielded conflicting results with respect to efficacy of this mode of support. (bmj.com)
• In this multicenter, randomized, noninferiority trial, we assigned 303 very preterm infants to receive treatment with either high-flow nasal cannulae (5 to 6 liters per minute) or nasal CPAP (7 cm of water) after extubation. (nih.gov)
• Although the result for the primary outcome was close to the margin of noninferiority, the efficacy of high-flow nasal cannulae was similar to that of CPAP as respiratory support for very preterm infants after extubation. (nih.gov)
• Objectives To assess the efifcacy of nasal bilevel positive airway pressure (nBiPAP) in preventing extuba-tion failure of neonatal respiratory distress syndrome (RDS) in premature infants . (bvsalud.org)
• This study aimed to compare extubation of patients post-cardiac surgery with a BMI ≥30 kg/m 2 onto high-flow nasal cannulae (HFNC) with standard care to determine whether HFNC could assist in minimising post-operative atelectasis and improve respiratory function. (springer.com)
• In this randomised controlled trial, direct extubation onto high-flow nasal cannulae (HFNC) was not found to improve respiratory function after cardiac surgery in patients with a BMI ≥30 kg/m 2 when compared with standard oxygen therapy. (springer.com)
• Zarbock A, Mueller E, Netzer S, Gabriel A, Feindt P, Kindgen-Milles D (2009) Prophylactic nasal continuous positive airway pressure following cardiac surgery protects from postoperative pulmonary complications: a prospective, randomized, controlled trial in 500 patients. (springer.com)
• There is continued debate regarding whether it i s better for an ELBW infant to remain on the ventilator or to extubate to nasal constant positive airway pressure (nCPAP). (iospress.com)
• To determine whether early versus late treatment with porcine surfactant (Curosurf) reduces the requirement of mechanical ventilation in very preterm infants primarily supported by nasal continuous positive airway pressure (nasal CPAP). (aappublications.org)
• Nasal continuous positive airway pressure for respiratory distress in non-tertiary care centres: What is needed and where to from here? (wiley.com)
• Midnasal stenosis can be managed immediately by suctioning airway secretions, humidifying nasal passages with saline nasal drops and using gavage feeding. (cmaj.ca)

Continuous15

• Continuous positive airway pressure was first used in neonates in 1971 for the treatment of respiratory distress syndrome. (bmj.com)
• 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)
• It is common practice to use endotracheal continuous positive airway pressure for various time periods up to 24 hours before attempting extubation in infants who are mechanically ventilated. (aappublications.org)
• One group of 13 study infants were extubated directly from intermittent mandatory ventilation rates of six to ten per minute, and the other 14 control infants were placed on continuous positive airway pressure through endotracheal tubes for six hours prior to an attempt to extubate. (aappublications.org)
• 005). The seven infants who failed the preextubation trial of continuous positive airway pressure were later extubated from low intermittent mandatory ventilation rates without significant pnea or respiratory acidosis. (aappublications.org)
• 01). This study demonstrates that the recommended preextubation trial of continuous positive airway pressure through an endotracheal tube is not only unnecessary but detrimental to very low birth weight infants, in whom more apnea and slight CO 2 retention develop probably because of increased airway resistance through small endotracheal tubes. (aappublications.org)
• Non-invasive face-mask continuous positive airway pressure failed to provide adequate oxygenation. (ispub.com)
• Subsequent chronic lung disease meant David needed to be on continuous positive airway pressure for 14 months with multiple episodes of cyanosis. (justgiving.com)
• Continuous positive airway pressure therapy is recommended for the treatment of preterm newborns with respiratory distress syndrome. (who.int)
• The GDG felt strongly that the technological context of care, including the ability to monitor oxygen saturation and cardiorespiratory status, must be considered prior to instituting any respiratory intervention (supplemental oxygen, continuous positive airway pressure [CPAP] or ventilator support) to critically ill neonates in less-developed medical settings, as these interventions have the potential to lead to more harm than benefit. (who.int)
• In newly born preterm babies with or at risk of respiratory distress syndrome (P), is continuous positive airway pressure (I), compared with routine care (C), effective in preventing adverse newborn outcomes? (who.int)
• Continuous positive airway pressure therapy for newborns with respiratory distress syndrome should be started as soon as the diagnosis is made. (who.int)
• In view of the high proportion of neonatal deaths that are caused by respiratory distress syndrome, the GDG made a strong recommendation despite the low quality of the evidence showing the benefits of early continuous positive airway pressure (CPAP) therapy. (who.int)
• Under what conditions and when should continuous positive airway pressure be provided? (who.int)
• CPAP is an acronym for "continuous positive airway pressure", which was developed by Dr. George Gregory and colleagues in the neonatal intensive care unit at the University of California, San Francisco. (wikipedia.org)

Associated with extubation failure3

• Given the considerable burden associated with extubation failure, it is useful and reasonable for a cuff leak test to rule in high-risk patients to further prepare for a safe extubation," the researchers concluded. (anesthesiaexperts.com)
• The effect of time to reintubation suggests that identification of patients early after extubation and timely reinstitution of ventilatory support has the potential to reduce the increased mortality associated with extubation failure. (nih.gov)
• Only congenital airway anomaly was independently associated with extubation failure. (ovid.com)

Ventilation16

• Failure to make the transition to spontaneous, unassisted ventilation following extubation is relatively common. (bmj.com)
• Difficult airway may be a consequence of patient's anatomy or airway edema developed during the ICU stay and mechanical ventilation. (umassmed.edu)
• With knowledge of the purpose and function of artificial airways, mechanical ventilation, and chest tubes, nurses can readily provide quality and even lifesaving care. (netce.com)
• The following variables were assessed: gender, corrected age, present weight, duration of mechanical ventilation time, and motives/causes of the event on the day of the unplanned extubation event. (scielo.br)
• Fifty-four unplanned extubations occurred, which corresponded to an incidence of 1.0 event/100 days of mechanical ventilation. (scielo.br)
• The duration of mechanical ventilation prior to extubation was 139 +/- 19 h, and the median time to reintubation was 21 h. (nih.gov)
• The clinically diverse cases include practical guidance on the choice of management technique, airway device, its placement, associated medications and mode of ventilation, and cover important advances in equipment and scientific knowledge to keep clinicians up to date on recent developments in the field. (cambridge.org)
• Early and successful extubation can reduce complications such as ventilation acquired pneumonia (VAP). (rch.org.au)
• We measured (Ventilator = EVITA 2 - Dräger°) P0.1, respiratory rate (RR), RR/V T , PaO 2 , PaCO 2 , (i) before extubation, with PS = 6 crnH 2 O, then (ii) in postextubation, during a session of facial mask ventilation of 30 min, with PS = 4 cmH 2 O. We compared the two groups of patients using Mann-Whitney U test for quantitative variables. (beds.ac.uk)
• Fifty-six infants receiving non-invasive ventilation due to unrelieved expiratory dyspnea after the ifrst extubation were selected, and were randomly divided into nBiPAP group (n=27) and nCPAP group (n=29). (bvsalud.org)
• Extubation is performed when the need for mechanical ventilation has resolved. (hindawi.com)
• Airway reflexes, spontaneous ventilation, and cardiovascular function are maintained. (medscape.com)
• The patient may not be able to maintain airway reflexes or spontaneous ventilation, but cardiovascular function is preserved. (medscape.com)
• Develop skills for alternative ventilation strategies using supraglottic airway (SGA) devices, techniques for SGA-endotracheal tube exchange, and surgical techniques for rescue ventilation. (stanford.edu)
• Positive airway pressure (PAP) is a mode of respiratory ventilation used in the treatment of sleep apnea. (wikipedia.org)
• The most common conditions for which PAP ventilation is used in hospital are congestive cardiac failure and acute exacerbation of obstructive airway disease, most notably exacerbations of COPD and asthma. (wikipedia.org)

Emergency Airway Management6

• Here we describe the use of a LMA for emergency airway management in an infant . (bvsalud.org)
• Moreover, reintubation may be needed when personnel available for the procedure have less experience and skill with emergency airway management in contrast to a reintubation that takes place after a planned extubation where appropriate staff is readily available [ 2 , 10 ]. (hindawi.com)
• Does your heart rate increase when you are paged to the emergency department or ICU for emergency airway management? (cambridge.org)
• Every healthcare practitioner involved with emergency airway management will benefit from this book. (cambridge.org)
• Overall, Cases in Emergency Airway Management is a compact yet comprehensive reference for multidisciplinary airway management providers that highlights special considerations associated with a variety of clinical scenarios and presents pragmatic approaches to the most pertinent topics related to emergency airway management. (cambridge.org)
• The Difficult Airway Course: Critical Care™ is an advanced course designed for intensivists and for hospitalists who are responsible for emergency airway management of acute inpatients. (theairwaysite.com)

Failed Airway Management1

• This powerful program, delivered on our new AMEC eLearning platform, covers the most vital lessons in difficult and failed airway management. (theairwaysite.com)

Anesthesia7

• Postoperative extubation failure may arise because of many possible mechanical problems due to the patient, surgery or anesthesia. (eurasianjpulmonol.com)
• Aim of the study: To compare the effects of intravenous Dexmedetomidine and lignocaine on Attenuation of hemodynamic responses and sedation score, Attenuation of airway responses to extubation after intracranial surgeries under general anesthesia. (who.int)
• Become a Stanford H&N Anesthesia and Advanced Airway Management Program (SAAMP) insider and benefit from over 20 years of national and international teaching experience. (stanford.edu)
• This places healthcare workers (HCW) including anesthesia professionals, intensivists, and nurses at a significant risk given the likelihood for a potential interface with droplets, sputum, or bodily fluids while performing routine procedures such as airway management. (apsf.org)
• Literature supports deep neuromuscular blockade providing better operating conditions/view by a surgeon and low airway pressures but, potentially, longer duration to extubation and worse respiratory mechanics at the end of anesthesia versus moderate neuromuscular blockade which shows worse operating conditions/view by a surgeon and worse airway pressures but possibly shorter duration to extubation and better respiratory mechanics at the end of anesthesia. (clinicaltrials.gov)
• In addition, we must use anesthesia circuits, airway interventions, and medication that will be critically important in the coming days. (kevinmd.com)
• The Difficult Airway Course: Anesthesia will help even the most experienced provider perfect the most critical techniques of this dynamic and constantly evolving field. (eventsinamerica.com)

Successful extubation6

• The primary outcome was successful extubation maintained for at least 72 hours. (biomedsearch.com)
• Secondary outcomes included successful extubation maintained for 7 days, total duration of CPAP support, chronic lung disease, and complications of prematurity. (biomedsearch.com)
• Mean gestational age and birth weight were similar in the 2 groups, as were the proportions of infants who achieved successful extubation for 72 hours and for 7 days. (biomedsearch.com)
• or = 14 days, bubble CPAP is associated with a significantly higher rate of successful extubation. (biomedsearch.com)
• 2 5-9 With the exception of successful extubation and chronic lung disease (CLD), 5 7 8 the impact of method of after extubation care on other important neonatal outcomes has not been evaluated. (bmj.com)
• In this review, an efficient strategy for a successful extubation will be explained for patients having high risks for extubation failure and difficult airway problems. (eurasianjpulmonol.com)

Preterm2

• Extubation failure in preterm infants with residual lung disease was lower with NCPAP range of 7-9 compared with 4-6 cmH2O. (nih.gov)
• Conclusions nBiPAP is safe and fea-sible for preventing extubation failure in preterm infants ≤32 weeks with RDS and is more effective than nCPAP. (bvsalud.org)

Reflexes3

• Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation. (biomedsearch.com)
• We investigated whether it also has the ability to attenuate airway and circulatory reflexes during emergence from anaesthesia. (biomedsearch.com)
• A single dose of Dexmedetomidine has been found effective in attenuation of the airway and circulatory reflexes during extubation. (who.int)

Edema8

• Upper airway obstructing conditions like edema, soft tissue collapse and laryngospasm are frequently observed in this group of patients and because of these conditions, it may become hard to ensure airway integrity after extubation. (eurasianjpulmonol.com)
• Which of the following is a reliable method in assessing airway edema? (mhmedical.com)
• E) Although all of these methods have been used to assess airway edema, none of them has been proven to be a reliable method in assessing airway edema. (mhmedical.com)
• Which of the following may be helpful to reduce airway edema? (mhmedical.com)
• E) All of the steps are helpful to reduce airway edema. (mhmedical.com)
• Patients intubated for airway preservation due to airway edema (cervical neck injuries or surgery) as opposed to airway protection. (clinicaltrials.gov)
• Increased airway pressures can lead to an increase in alveolar and perivascular edema, a decline in dynamic lung compliance and hypoxemia. (clinicaltrials.gov)
• A reduction in airway pressures may lead to a decrease in the complications associated with elevated airway pressures including hypoxemia, total static lung compliance, alveolar edema, and long term morbidity. (clinicaltrials.gov)

Complications10

• Traditional awake extubation leads to respiratory complications and hemodynamic response which are detrimental in neurosurgery, ENT surgery and patients with comorbidities. (amrita.edu)
• The primary objective was to compare the respiratory complications and hemodynamic stress response between traditional awake extubation of a endotracheal tube (ETT) and that following exchange extubation of ETT by using a laryngeal mask airway (LMA). (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 Royal College of Anaesthetists 4th National Audit Project highlighted differences in the incidence and consequences of major complications during airway management between the operating room and the critical care environment. (edu.au)
• Outline the types and potential complications of artificial airways. (netce.com)
• (2,3) Patient maintenance using artificial airways is currently a safe practice, but it is not free from complications. (scielo.br)
• This guideline will provide information about the nursing assessment, management and complications of neonatal extubation. (rch.org.au)
• No anesthetic or airway complications were encountered intraoperatively. (asahq.org)
• After were removed the nasogastric tube under fiberoptic visualization, the endotracheal tube was removed safely without difficulty ( Figure 1 (B)). The patient had no airway complications after extubation. (asahq.org)

Infants11

• Moreover, in the subset of infants who were ventilated for less than 14 days, the infants on bubble CPAP had a significantly lower extubation failure rate. (biomedsearch.com)
• METHODS A randomised, controlled, clinical trial was conducted at the neonatal intensive care unit of the Royal Women's Hospital, Melbourne, of infants with birthweights between 600 and 1250 g, ventilated via an endotracheal tube for more than 12 hours, requiring less than 50% oxygen, a ventilator rate ⩽ 20/minute, considered by the clinical management team to be ready for extubation. (bmj.com)
• 1 Potential benefits in the care of infants immediately following endotracheal extubation include prevention of atelectasis 2 and improved oxygenation, 3 a decrease in the work of breathing 4 and improved breathing patterns, with a decrease in the frequency and severity of episodes of apnoea. (bmj.com)
• Infants treated with nBiPAP had lower incidence of extubation failure in seven days than infants treated with nCPAP (7.4%vs. 31.0%, P=0.042). (bvsalud.org)
• Extubation Success in Premature Infants With Respiratory Dis. (lww.com)
• Previous investigations have shown that the rate of unplanned extubations in infants and children in the PICU ranges from 0.114 to 4.36 per 100 ventilated days [ 5 , 6 ]. (hindawi.com)
• In this study, 27 very low birth weight infants who were ½ to 28 days old at the time of extubation were randomly divided into two groups. (aappublications.org)
• The use of inhaled nebulized epinephrine after extubation in newborn infants is not supported or refuted by evidence from randomised controlled trials. (cochrane.org)
• Because epinephrine can decrease swelling and its effect has been proven in the treatment of croup in infants, it has been used immediately after extubation to prevent breathing problems. (cochrane.org)
• CONCLUSION: In our cohort of extremely premature infants, the earlier the first extubation attempt the sooner the patient was discharged home and the less likely to develop BPD. (iospress.com)
• The meta-analysis with sequential analysis was designed to evaluate the efficacy and safety of airway administration (inhalation or instillation) of corticosteroids for preventing bronchopulmonary dysplasia (BPD) in premature infants. (biomedcentral.com)

Safe extubation2

• In this article, we will provide a framework for identifying a difficult airway, criteria for safe extubation, as well as review the devices that are available for airway management in the ICU. (umassmed.edu)
• This narrative review focuses on strategies for safe extubation of the trachea for patients with potentially difficult upper airway problems in the intensive care unit. (edu.au)

Incidence4

• CONCLUSIONS NCPAP applied prophylactically after endotracheal extubation reduces the incidence of adverse clinical events that lead to failure of extubation in the seven days after extubation. (bmj.com)
• 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)

Patient's4

• 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)
• Unplanned extubation exposes the patient to morbidity and mortality over and above those associated with the patient's underlying disease [ 6 , 7 ]. (hindawi.com)
• Because the patient's apparent level of distress may not match the actual severity of the situation, and because the disease's progression can be quite surprisingly rapid, it is preferable to go ahead and place the artificial airway, rather than adopting a wait-and-see approach. (encyclopedia.com)
• Assessing the patient's readiness for extubation. (careercast.com)

CPAP1

• A standardized protocol was used for extubation and CPAP. (biomedsearch.com)

Pulmonary3

• Although potentially lifesaving, IPPV is associated with clinically significant morbidity, including chronic lung disease, damage to the upper airway, and systemic and pulmonary infection. (bmj.com)
• Invasive airway rescue -- PART B. Lower Airway -- Section I. Interventional Pulmonary -- Section II. (stanford.edu)
• The main indications for positive airway pressure are congestive heart failure and chronic obstructive pulmonary disease. (wikipedia.org)

Patient16

• Extubation is a particularly vulnerable time for the critically ill patient and, because of the risks involved and the consequences of failure, it warrants specific consideration. (edu.au)
• The findings in the section on Intensive Care and Emergency Medicine reinforce the importance of good airway management in the critical care environment and, in particular, the need for appropriate guidelines to improve patient safety. (edu.au)
• The purpose of this course is to reinforce nurses' knowledge and skills related to the care of patients with artificial airways and/or chest tubes in order to improve outcomes and patient quality of life. (netce.com)
• The primary causes of unplanned extubations included patient agitation, inappropriate handling of patients during the performance of procedures, and inappropriate fixation and positioning of the endotracheal tube. (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)
• Significant institutional preparation is required to optimize staff and patient safety in preparing for the airway management of the COVID-19 patient group. (mja.com.au)
• Changes in management: Airway clinicians in Australia and New Zealand should now already be involved in regular intensive training for the airway management of the COVID-19 patient group. (mja.com.au)
• Identifying the optimal time of extubation in a brain injured population should improve patient outcome. (clinicaltrials.gov)
• More recent data however suggests that delaying extubation in this population increases pneumonias and worsens patient outcomes. (clinicaltrials.gov)
• Would you know how to handle the unexpected arrival of a patient with a gunshot wound to the neck and worsening airway compromise? (cambridge.org)
• Can the patient protect their airway? (fpnotebook.com)
• Emergency caesarean section in a patient with myotonic dystrophy: a case of failed postoperative extubation in a patient with mild disease. (thefreelibrary.com)
• Twelve days after admission patient showed extreme improvement in airway management. (wikipedia.org)
• 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)
• PART A. Upper Airway -- Section I. Evaluation and basic management of the difficult airway patient -- Section II. (stanford.edu)
• Cap off your experience by managing challenging simulation scenarios such as a rapidly expanding neck hematoma, an agitated and uncooperative difficult airway patient, extubation of a difficult-to-intubate patient, and many more. (eventsinamerica.com)

Neonates5

• In a multicenter cohort of neonates recovering from cardiac surgery, we sought to describe the epidemiology of extubation failure and its variability across centers, identify risk factors, and determine its impact on outcomes. (ovid.com)
• Neonates who failed extubation had a greater median postoperative length of stay (33 vs 23 days, P (ovid.com)
• This multicenter study showed that 11% of neonates recovering from cardiac surgery fail initial postoperative extubation. (ovid.com)
• The primary objective was to assess whether nebulized epinephrine administered immediately after extubation in neonates weaned from IPPV decreases the need for subsequent additional respiratory support. (cochrane.org)
• Neonates have to breathe through their nose because the entire length of their tongue abuts against the hard and soft palates, and because the high position of their epiglottis (at the level of the third and fourth cervical vertebrae compared with the fifth and sixth vertebrae in adults) causes increased resistance of the oral airway. (cmaj.ca)

Stridor1

• Stridor is a harsh sound produced usually at or near the larynx by the vibration of upper airway structure, and is predominantly inspiratory. (authorstream.com)

Failure18

• Factors contributing to failure include upper airway instability, alveolar atelectasis, and poor respiratory drive. (bmj.com)
• Extubation failure due to airway problems is rare in critically ill patients. (eurasianjpulmonol.com)
• To examine the impact of etiology of extubation failure and time to reintubation on hospital outcome, we performed a post hoc analysis of prospectively gathered data on 74 MICU patients (47 men, 27 women), 64 +/- 2 yr of age who required reintubation within 72 h of extubation. (nih.gov)
• With multiple logistic regression, both cause for extubation failure and time to reintubation were independently associated with hospital mortality. (nih.gov)
• In conclusion, etiology of extubation failure and time to reintubation are independent predictors of outcome in reintubated MICU patients. (nih.gov)
• Careful consideration must be made for patients who have had previous failed attempts at extubation, and the reasons for the failure. (rch.org.au)
• Area Under the Receiver Operator Characteristics Curve for the Prediction of Extubation Failure. (archbronconeumol.org)
• Correlations Between Variables Related to Extubation Failure. (archbronconeumol.org)
• Binomial Logistic Regression for Variables Related to Extubation Failure in Univariate Analysis. (archbronconeumol.org)
• Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT). (archbronconeumol.org)
• INTRODUCTION: Extubation failure (EF) refers to the inability to maintain spontaneous breathing after removal of endotracheal tube. (minervamedica.it)
• Lombardi FS, Cotoia A, Petta R, Schultz M, Cinnella G, Horn J. Prediction of extubation failure in Intensive Care Unit: systematic review of parameters investigated. (minervamedica.it)
• Extubation failure was defined as reintubation less than 72 hours after the first planned extubation. (ovid.com)
• We observed a 4-fold variation in extubation failure rates across hospitals, suggesting a role for collaborative quality improvement to optimize outcomes. (ovid.com)
• Extubation Failure in Brain-injured Patients: Risk Factors and Development of a Prediction Score in a Preliminary Prospective Cohort Study. (tripdatabase.com)
• Extubation failure was defined as the need for ventilatory support during intensive care unit stay. (tripdatabase.com)
• Extubation failure within 48 h was also analyzed. (tripdatabase.com)
• Neurologic outcomes were recorded at 6 months.Extubation failure occurred in 43 (31%) patients with 31 (24%) within 48 h. (tripdatabase.com)

Causes of unplanned extubation1

• After determining the rate and causes of unplanned extubation, a program was developed consisting of education and a formalized endotracheal tube taping policy. (hindawi.com)

Management of the Difficult Airway1

• Management of the difficult airway is an important, but as yet poorly-studied, component of intensive care management. (edu.au)

Oxygen2

• A #1 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. (bvsalud.org)
• Following extubation, he developed respiratory distress and oxygen desaturation. (ispub.com)

Cardiac2

• In this study, prophylactic extubation onto HFNC post-cardiac surgery in patients with a BMI ≥30 kg/m 2 did not lead to improvements in respiratory function. (springer.com)
• respond to airway crises and basic/advanced cardiac life support. (payscale.com)

Exchange catheter1

• Keywords: Cook airway exchange catheter, difficult extubation. (aana.com)

Department of Anesthesiology1

• The Stanford Advanced Airway Management Program (SAAMP) of the Department of Anesthesiology offers comprehensive, multidisciplinary airway training to a national and international audience. (stanford.edu)

Reintubation3

• Intended for staged extubation and subsequent reintubation. (cookmedical.eu)
• Patients requiring reintubation after failed extubation have a poor prognosis, with hospital mortality exceeding 30 to 40%, though the reason remains unclear. (nih.gov)
• It is more common to require reintubation after an unplanned extubation than after a planned extubation [ 8 ]. (hindawi.com)

Ventilatory4

• Success was defined by no requirement for additional ventilatory support over the week following extubation. (bmj.com)
• A Prospective Trial of Elective Extubation in Brain Injured Patients Meeting Extubation Criteria for Ventilatory Support. (clinicaltrials.gov)
• Patients that meet standard airway and ventilatory criteria for extubation but have a Glasgow coma score of less than or equal to 8 are immediately extubated. (clinicaltrials.gov)
• During the weaning process, NTproBNP plasma levels, CCE, and standard hemodynamic and ventilatory data were collected 30 minutes before extubation (T1), 2 hours (T2) and 12 hours later (T3). (springer.com)

Lower airway4

• As well as upper airway problems, this text also encompasses the management of less commonly discussed lower airway challenges. (cambridge.org)
• Master techniques in upper and lower airway management. (stanford.edu)
• Congenital abnormalities of the lower airway -- Section VII. (stanford.edu)
• Lower airway emergencies. (stanford.edu)

Critically2

• The principles for airway management should be the same for all patients with COVID-19 (asymptomatic, mild or critically unwell). (mja.com.au)
• Taught by a world-class faculty of airway experts, The Difficult Airway Course: Critical Care™ focuses exclusively on the airway challenges posed by critically ill inpatients. (theairwaysite.com)

Neck5

• I would like to share with you the "Extubation Algorithm" that I have developed for major neck and upper airway surgery. (shanahq.com)
• Obesity, obstructive sleep apnea syndrome, major head and neck surgery, upper airway surgery and cervical column operations are hazardous conditions affecting extubation success. (eurasianjpulmonol.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)
• Bivona® Pediatric Adjustable Neck Flange Hyperflex™ tracheostomy tube is intended to provide a secure airway for patients with unusual anatomy. (smiths-medical.com)

Intensive4

• Managing the airway in the intensive care unit (ICU) is complicated by a wide array of physiologic factors. (umassmed.edu)
• For this reason, it is necessary to identify the postoperative patients who are expected to have difficult extubation processes and to transfer them to intensive care unit for a careful and planned extubation process. (eurasianjpulmonol.com)
• We teach all aspects of advanced airway management in the operating room, emergency department, intensive care unit, and in adult and pediatric patients. (stanford.edu)
• The course, which is ideally suited for the anesthesiologists, critical care, emergency medicine, and ENT physician, provides participants with the essential evidence-based knowledge and technical skills to manage anticipated and unanticipated difficult airway in the operating room, emergency department, and intensive care unit, as well as in diverse clinical settings. (stanford.edu)

Artificial1

• Managing artificial airways. (careercast.com)

Earlier extubation1

• We tested the hypothesis that earlier extubation attempts would decrease length of hospital stay and BPD. (iospress.com)

Cough1

• probability of success providing the presence of at least two operating airway functions.A simplified clinical pragmatic score assessing cough, deglutition, gag reflex , and neurologic status was developed in a preliminary prospective cohort of brain-injured patients and was internally validated (bootstrapping). (tripdatabase.com)

Outcomes1

• Respiratory and hemodynamic outcomes following exchange extubation with laryngeal mask airway as compared to traditional awake extubation. (amrita.edu)

Emergencies2

• This guide to critical airway emergencies will prepare you to safely manage these high-pressure situations. (cambridge.org)
• Although both conditions may present as upper airway emergencies, they are quite separate disease entities. (vin.com)

Surgical3

• This course is designed for nurses working in critical care and general and specialty medical-surgical units in which patients require assistance maintaining a patent airway and respiration. (netce.com)
• Because of concerns about airway management, surgical intervention should be avoided as much as possible and undertaken only in tertiary care settings. (nih.gov)
• Difficult extubation secondary to the surgical procedure often was caused by fixation of endotracheal or pilot tube to bony facial structures via Kirschner wires [ 2-4 ] or screws. (asahq.org)

Respiratory distress1

• After weaning to room air and extubation, her respiratory distress recurred over the next few hours. (cmaj.ca)

Stimulation of airway1

• Tightness is caused by stimulation of airway receptors with bronchoconstriction. (cancer.gov)