Tag: intubation
An Index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy
In patients with pneumonia with acute respiratory failure treated with high-flow nasal cannula (HFNC), ROX is an index that can help identify those patients with low and those with high risk for intubation. This was a... read more
COVID-19 Awake Proning – All Hype?
In this prospective meta-analysis of observational studies of patients with acute hypoxemic respiratory failure due to COVID-19, APP did not result in lower intubation or mortality rates, despite reported improvements in... read more
Pharyngeal abscess: a rare complication of repeated nasopharyngeal swabs
A 73-year-old end-stage renal disease patient who had undergone craniopharyngioma resection 30 years previously was admitted to hospital after a fall. He developed hospital-acquired laboratory-confirmed SARS-CoV-2 that required... read more
Current airway management practices after a failed intubation attempt
The majority of second intubation attempts were undertaken by emergency consultants and registrars. A change from a non-consultant intubator to a consultant intubator of any specialty for the second attempt and intubation... read more
Prone Positioning Non-intubated COVID-19 Patients with Severe Hypoxemia Was Safe
In a small sample, prone positioning non-intubated COVID-19 patients with severe hypoxemia was safe; however, many patients did not tolerate prolonged durations. Although patients had improved oxygenation and respiratory... read more
Bacterial Superinfection Pneumonia in COVID-19 Respiratory Failure
Severe community-acquired pneumonia secondary to SARS-CoV-2 is a leading cause of death. Current guidelines recommend patients with SARS-CoV-2 pneumonia receive empirical antibiotic therapy for suspected bacterial superinfection,... read more
COVID-19 Pneumonia: Typical or Atypical Form of ARDS?
Evidence-based guidelines can never help a doctor resolve whether a patient is best managed by inserting an endotracheal tube or avoiding its use. That decision is based on clinical judgment, gestalt, and tacit knowledge.... read more
Pre-hospital critical care management of severe hypoxemia in victims of COVID-19
Patients with Covid-19 and severe hypoxemia may pose a considerable challenge for the pre-hospital emergency medical services. Intubation may be associated with a high risk of complications in these patients and should be... read more
Circuits Between Infected Macrophages and T Cells in COVID-19 Pneumonia
Some patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) develop severe pneumonia and the acute respiratory distress syndrome (ARDS). Distinct clinical features in these patients have led... read more
Apnoeic Oxygenation for Emergency Anaesthesia of Pre-hospital Trauma Patients
Apnoeic oxygenation did not influence peri-intubation oxygen saturations, but it did reduce the frequency and duration of hypoxia in the post-intubation period. Given that apnoeic oxygenation is a simple low-cost intervention... read more
The Ventilator Book
If you need something that teaches you both the concepts of mechanical ventilation and how to manage patients with respiratory failure, this is the book for you. The Ventilator Book is written to be read in the ICU or Emergency... read more
Endotracheal intubation to reduce aspiration events in acutely comatose patients
Whether intubation results in a reduction in the incidence of aspiration events and whether these are more frequent in patients with low GCS scores are not yet established. The paucity of evidence on this topic makes clinical... read more
Experience Caring for a Severe COVID-19 Patient With ARDS in the ICU
The author's experience caring for a patient with COVID-19 whose condition deteriorated rapidly into a critical illness in the negative pressure room of the ICU is described in this article. The onset of severe acute... read more
Sick Meningitis, POCUS for Pneumoperitoneum, and Treatment of CHS
Today on the emDocs cast with Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER) we cover three posts: the sick meningitis patient, ultrasound for pneumoperitoneum, and treatment of cannabiniod hyperemesis syndrome. Part... read more
Epidemiology of Invasive Pulmonary Aspergillosis Among COVID-19 Intubated Patients
We found a high incidence of CAPA among critically ill COVID-19 patients and that its occurrence seems to change the natural history of disease. A total of 108 patients were enrolled. Prospective, multicentre study... read more
All Intensivists Are Not Created Equal
I’d like to preface this story by saying that the majority of the intensivists I have worked with have been exceptional, caring, and professional. We had all established a good camaraderie, and we had mutual respect for... read more
Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy
To the best of our knowledge, this is the first multicenter study that prospectively evaluated the benefits and the role of HFNO combined with awake prone positioning in the prevention of intubation in an adjusted large cohort... read more
Early Arterial Embolization and Mortality in Mechanically Ventilated Patients With Hemoptysis
The objective of this study was to clarify whether early intervention by arterial embolization reduced mortality in mechanically ventilated patients with hemoptysis. The results show that early intervention by arterial... read more
Use and Outcomes of Nasotracheal Intubation Among Patients Requiring Mechanical Ventilation Across U.S. PICUs
Nasotracheal intubation is used in a minority of U.S. PICUs and mainly among young cardiac patients. Nasotracheal intubation is associated with a lower rate of unplanned extubations in this patient population. Future... read more
Obesity and the Risk of Intubation or Death in Patients with COVID-19
Among consecutive patients hospitalized with coronavirus disease 2019, obesity was an independent risk factor for intubation or death. A total of 305 patients were included in this study. We stratified patients by body... read more
Awake Prone Positioning for COVID-19 Hypoxemic Respiratory Failure
Infection with SARS-CoV-2 can result in Coronavirus Disease–19 (COVID-19). While the majority of patients are asymptomatic or have mild disease, approximately 14% develop more severe disease including hypoxemic respiratory... read more
Prone Positioning in Non-intubated Patients with COVID-19
As the COVID-19 pandemic has put severe stress and strain on the capacity of hospitals around the world, concerted efforts have been made to evaluate therapeutics aimed at preventing the need for mechanical ventilation. The... read more
