Search results for "Airway Extubation"

Sequential use of noninvasive ventilation and high flow nasal therapy after early extubation in chest trauma patients recovering from acute hypoxaemi…

2022

Early extubation followed by immediate noninvasive ventilation vs. standard extubation in hypoxemic patients: a randomized clinical trial

2018

Purpose: Noninvasive ventilation (NIV) may facilitate withdrawal of invasive mechanical ventilation (i-MV) and shorten intensive care unit (ICU) length of stay (LOS) in hypercapnic patients, while data are lacking on hypoxemic patients. We aim to determine whether NIV after early extubation reduces the duration of i-MV and ICU LOS in patients recovering from hypoxemic acute respiratory failure. Methods: Highly selected non-hypercapnic hypoxemic patients were randomly assigned to receive NIV after early or standard extubation. Co-primary end points were duration of i-MV and ICU LOS. Secondary end points were treatment failure, severe events (hemorrhagic, septic, cardiac, renal or neurologic …

Extubation in neurocritical care patients: the ENIO international prospective study

2022

Purpose: Neurocritical care patients receive prolonged invasive mechanical ventilation (IMV), but there is poor specific information in this high-risk population about the liberation strategies of invasive mechanical ventilation. Methods: ENIO (NCT03400904) is an international, prospective observational study, in 73 intensive care units (ICUs) in 18 countries from 2018 to 2020. Neurocritical care patients with a Glasgow Coma Score (GCS) ≤ 12, receiving IMV ≥ 24 h, undergoing extubation attempt or tracheostomy were included. The primary endpoint was extubation failure by day 5. An extubation success prediction score was created, with 2/3 of patients randomly allocated to the training cohort …

Association between night-time extubation and clinical outcomes in adult patients

2021

Background: Whether night-time extubation is associated with clinical outcomes is unclear. Objective: The aim of this systematic review and meta-analysis was to evaluate the association between night-time extubation and the reintubation rate, mortality, ICU and in-hospital LOS in adult patients, compared with daytime extubation. Design: A systematic review and meta-analysis. Data sources: PubMed, EMBASE, CINAHL and Web of Science from inception to 2 January 2021 (PROSPERO registration - CRD42020222812). Eligibility criteria: Randomised, quasi and cluster randomised, and nonrandomised studies describing associations between adult patients' outcomes and time of extubation (daytime/night-time)…

Should Reinke edema be considered a contributing factor to post-extubation failure?

2015

We read with interest the recently published review in Critical Care about post-extubation laryngeal edema and stridor by Pluijms et al. [1]. The review considers in detail the risk factors for post-extubation respiratory failure and describes a post-extubation algorithm for its prevention and reduction. We recently published a case report describing the occurrence of post-extubation stridor leading to post-extubation respiratory failure in a woman with a previously undiagnosed Reinke edema (RE) [2]. RE is a progressive laryngeal soft-tissue swelling. The condition typically manifests in female gender as hoarseness and as a gradually deepening voice in patients with a history of smoking, vo…

Analysis and review of the perioperative management of COVID-19 patients in thoracic surgery.

2021

Resumen Debido a la grave situacion de pandemia que vivimos causada por el COVID-19, la Seccion de Anestesia Cardiaca, Vascular y Toracica de la SEDAR pretende dar informacion de los aspectos mas relevantes a considerar en pacientes con sospecha o infeccion confirmada por coronavirus que van a ser sometidos a cirugia toracica. Creemos que es esencial mantener una optima transmision de informacion para llevar a cabo maniobras seguras, tanto para los pacientes como para el personal sanitario. La estrategia de manejo debe basarse en una organizacion exquisita del trabajo, definiendo quien, como y cuando va a realizar cada tarea y procedimiento. Las recomendaciones que se proponen, tras valorar…