Tag: intubation
PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children
Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more
Post-extubation Dysphagia
Despite having the tools and techniques for tracheal intubation for > 4000 years, and performing oral intubation with positive pressure mechanical ventilation for > 50 years, only recently has attention focused on... read more
High-Flow Nasal Cannula vs. Noninvasive Ventilation
High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Therefore, Hernández et al set out to test if high-flow conditioned... read more
Urgent Intubation without Neuromuscular Blocking Agents and the Risk of Tracheostomy
Neuromuscular blocking agents play a significant role in improving the success rate for urgent intubation, although there is limited evidence about the effect on subsequent outcomes, such as the incidence of tracheostomy.... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Ventilation
This complex randomized, controlled trial failed to demonstrate that early extubation to non-invasive ventilation reduced the total time of mechanical ventilation. I will continue to extubate early and will use non-invasive... read more
Designing a Nurse-Delivered Delirium Bundle: What ICU Staff, Survivors, and Their Families Think?
Generally, the bundle was deemed acceptable and deliverable. However, like any complex intervention, component adaptations will be required depending on resources available to the ICU; in particular, involvement of pharmacists... read more
Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients
Liberating patients from ongoing invasive mechanical ventilation is typically a 3-step process. First, clinicians must recognize that patients may no longer require mechanical ventilation, when the reasons for intubation... read more
Noninvasive Ventilation in Pneumonia-induced Early Stage Mild ARDS
Treatment with noninvasive ventilation (NIV) did not reduce the need for intubation among patients with pneumonia-induced early mild acute respiratory distress syndrome (ARDS), despite the improved PaO2/FIO2 observed with... read more
Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes
Diaphragm atrophy developing during mechanical ventilation strongly impacts clinical outcomes. Targeting an inspiratory effort level similar to that of healthy subjects at rest might accelerate liberation from ventilation.... read more
Early Mobilization Reduces Duration of Mechanical Ventilation and Intensive Care Unit Stay in Patients With ARF
The introduction of early mobilization for patients with mechanical ventilation (MV) in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve... read more
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
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
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
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
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
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
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
