Reversing Neuromuscular Blockade

Neuromuscular blocking drugs have for years enabled anesthesiologists beneficially to relax skeletal muscles to improve anesthetic management, increase safety and quality of tracheal intubation, and to provide favorable intraoperative... read more

Reversing Neuromuscular Blockade

Emergency Department Intubation Success With Succinylcholine vs. Rocuronium

In this large observational series, there was no association between paralytic choice and first-pass rapid sequence intubation success or peri-intubation adverse events. There were 2,275 rapid sequence intubations facilitated... read more

Emergency Department Intubation Success With Succinylcholine vs. Rocuronium

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care

Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge... read more

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care

Extubating Ventilated Patients on Vasoactive Infusions is Safe

In a large single centre study, 21% of intubated patients who received infusions of vasoactive infusions while mechanically ventilated were extubated for the first time while still receiving them. Coincident with their earlier... read more

Extubating Ventilated Patients on Vasoactive Infusions is Safe

Hemodynamic Impact of Oxygen Desaturation During Tracheal Intubation Among Critically Ill Children With Cyanotic and Noncyanotic Heart Disease

Oxygen desaturation was more commonly observed during tracheal intubation in children with cyanotic versus noncyanotic heart disease. However, hemodynamic tracheal intubation associated event rates were similar. In both groups,... read more

Hemodynamic Impact of Oxygen Desaturation During Tracheal Intubation Among Critically Ill Children With Cyanotic and Noncyanotic Heart Disease

Does Head of Bed Elevation During Intubation Improve Patient Oriented Outcomes?

To date the study that has shown the biggest benefit to HOB elevation is the 2016 study performed by Khandelwal and colleagues in a teaching hospital system in Seattle, WA. 528 patients managed by anesthesiologists... read more

Does Head of Bed Elevation During Intubation Improve Patient Oriented Outcomes?

Worse outcomes with video laryngoscopy in ICU

When used in intensive care units, video laryngoscopy did not improve the chances of successful intubation on the first try, compared with direct laryngoscopy, and was associated with a significantly higher risk of severe... read more

Emergency Department Hyperoxia Associated with Increased Mortality in Mechanically Ventilated Patients

Emergency Department exposure to hyperoxia is common and associated with increased mortality in mechanically ventilated patients achieving normoxia after admission. This suggests that hyperoxia in the immediate post-intubation... read more

Emergency Department Hyperoxia Associated with Increased Mortality in Mechanically Ventilated Patients

Airway Closure during Surgical Pneumoperitoneum in Obese Patients

In obese patients, complete airway closure is frequent during anesthesia and is worsened by Trendelenburg pneumoperitoneum, which increases airway opening pressure and alveolar pressure: besides preventing alveolar derecruitment,... read more

Airway Closure during Surgical Pneumoperitoneum in Obese Patients

Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults

Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill... read more

Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults

Effect of High-Flow Nasal Oxygen vs Standard Oxygen on 28-Day Mortality in Immunocompromised Patients With ARF

Among critically ill immunocompromised patients with acute respiratory failure (ARF), high-flow oxygen therapy did not significantly decrease day-28 mortality compared with standard oxygen therapy. Of 778 randomized patients... read more

Effect of High-Flow Nasal Oxygen vs Standard Oxygen on 28-Day Mortality in Immunocompromised Patients With ARF

Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine

Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of... read more

Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine

Noninvasive ventilation for avoidance of reintubation in patients with various cough strength

The aim of this study was to assess whether prophylactic noninvasive ventilation (NIV) would benefit patients with various cough strengths.... read more

Noninvasive ventilation for avoidance of reintubation in patients with various cough strength

The Effect of Adhesive Tape vs. Endotracheal Tube Fastener in Critically Ill Adults

The optimal securement method of endotracheal tubes is unknown but should prevent dislodgement while minimizing complications. The use of an endotracheal tube fastener might reduce complications among critically ill adults... read more

The Effect of Adhesive Tape vs. Endotracheal Tube Fastener in Critically Ill Adults

PERFECT Protocol: Volume-based Feeding in Ventilated Adults

Underfeeding in critical illness is common and associated with poor outcomes. Researchers in the UK designed a before-and-after study to evaluate the safety, efficacy and clinical outcomes associated with volume-based feeding... read more

PERFECT Protocol: Volume-based Feeding in Ventilated Adults

Tidal Volume Strategies for those without ARDS

This paper justifies utilizing a higher tidal volume strategy for our patients without primary ARDS/pulmonary disease. This can be very useful. Patient comfort and patient-ventilator synchrony are extremely important. This... read more

Tidal Volume Strategies for those without ARDS

Diagnosis and Management of Acute Exacerbations of COPD – Pharmacology CME

As more and more patients present to the ED with symptoms that suggest an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) –worsening dyspnea, cough and sputum production – emergency clinicians can... read more

Diagnosis and Management of Acute Exacerbations of COPD – Pharmacology CME

Tracheal Intubation Practice and Safety Across International PICUs

There were both similarities and differences in tracheal intubation practice and outcomes across international PICUs. Fewer adverse tracheal intubation–associated events were reported from International versus North American... read more

Tracheal Intubation Practice and Safety Across International PICUs

Airway Management in Microgravity

In the near future, space programs will shift their focus toward long‐duration interplanetary missions, in particular to the Moon and Mars. These exploration missions will be associated with an increased risk of acute medical... read more

Airway Management in Microgravity

Sleep Deprived-Patients in ICU May Fail to Get Off Ventilation

Attempts to wean intubated, critically ill patients off mechanical ventilators were less successful when the patients exhibited atypical sleep or pathological wakefulness, researchers reported. The findings suggest that sleep... read more

Sleep Deprived-Patients in ICU May Fail to Get Off Ventilation

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

Among critically ill adults undergoing tracheal intubation, patients receiving bag-mask ventilation had higher oxygen saturations and a lower incidence of severe hypoxemia than those receiving no ventilation. Among the 401... read more

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults