Search results for "Endotracheal intubation"
showing 10 items of 21 documents
Alternatives to Endotracheal Intubation for Patients with Neuromuscular Diseases
2005
To evaluate the usefulness of continuous noninvasive mechanical ventilation and mechanical coughing aids to avoid endotracheal intubation and tracheostomy during episodes of acute respiratory failure in patients with neuromuscular disease.We conducted a prospective cohort study at the respiratory medicine ward of a university hospital to study the success rate of the use of continuous noninvasive mechanical ventilation and manually and mechanically (CoughAssist) assisted coughing to avert endotracheal intubation in 24 consecutive episodes of acute respiratory failure for 17 patients with neuromuscular disease. The noninvasive mechanical ventilation and coughing aids were used to reverse dec…
The novel video-assisted intubating laryngeal mask Totaltrack compared to the intubating laryngeal mask Fastrach - a controlled randomized manikin st…
2017
BACKGROUND The novel Totaltrack combines a supraglottic airway device with video laryngoscopic tracheal intubation. The intubation laryngeal mask Fastrach is an established device without visual control of intubation. We hypothesized that supraglottic ventilation success with Totaltrack would be similar to Fastrach, but intubation would be performed faster due to visual control of the procedure. METHODS Fifty-five anaesthesiologists were randomized into one of two study arms: Fastrach Totaltrack. After a standardized introduction, six consecutive attempts of supraglottic ventilation and intubation attempts with each of one of the devices were performed on an airway manikin. The combined pri…
Clinical Use of Oxygen Stores: Pre-oxygenation and Apneic Oxygenation
1992
During states of respiratory arrest the human oxygen stores may be used therapeutically, regardless of the origin, i.e. either prior to the routinely induced apnea for endotracheal intubation or as an emergency measure in any other case of apnea. The present considerations focus on the clinical use of the oxygen stores available, applying.
Sedation and analgesia during noninvasive ventilation (NIV)
2017
The use of noninvasive ventilation (NIV) has increased significantly in patients with acute respiratory failure (ARF) in order to prevent tracheal intubation and its complications. Unfortunately, NIV failure represents a frequent event, with rates that in some cases reach 40%. Mask intolerance, agitation, and delirium may lead to NIV failure, thus requiring endotracheal intubation. NIV failure rates are higher in patients without chronic obstructive pulmonary disease (COPD), and, when used in acute hypoxemic failure, its failure is associated with an increased mortality rate. The practice of sedation during NIV could be a valuable option for patients at risk of intubation. Sedation may decr…
Optimal Pre-Oxygenation: The Nasoral-System
1994
The human body’s intra-and extrapulmonary O2 reserves, i.e. the oxygen stores of the functional residual capacity (FRC) and the blood, will be rapidly depleted during any kind of respiratory arrest (apnea). Application of oxygen prior to iatrogenic apnea (e.g. for endotracheal intubation procedures), therefore, commonly is discussed [e.g. Miller, 1990] as the proposed measure designed to achieve an increase in the human body’s oxygen stores sufficient to avoid hypoxemia. This prophylactic application of oxygen simply has become to be termed “pre-oxygenation”, regardless of the amount of increase in the O2 stores actually achieved. A myriad of different techniques and procedures are practica…
Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analy…
2017
Abstract Purpose To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. Methods We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. Results Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in …
Setting standards and implementing quality improvement in trauma care
1996
Setting standards and implementing quality improvement in trauma care needs consideration of the definitions of standards, guidelines, recommendations and the present quality of trauma care. Essential factors for consideration are the chain of survival and different intervals which may decide on patient outcome: (a) the trauma (occurrence) to trauma recognition interval which has, until now, not been taken into consideration with regard to morbidity and mortality; (b) the scene time is part of the total prehospital time which comprises rescuing the entrapped patient, preparation of the patient for treatment, and transfer to a rescue vehicle. The medical part of the scene time, however, repr…
Infraglottic airway devices and techniques.
2005
Airway management involves far more than just proficiency with tracheal intubation techniques. There are several infraglottic techniques available and the method chosen will depend on the accessibility of equipment, the level of training and expertise, and the patient's specific injury or disease. Endotracheal intubation is most commonly performed by direct laryngoscopy. Several modifications of laryngoscope blades and a variety of adjuncts such as bougies may help to accomplish even a difficult airway. Rigid intubation fibrescopes do improve the view of the larynx, especially in patients with difficult anatomy. They also permit tracheal intubation with less head and cervical spine movement…
Endotracheal intubation using the C-MAC® video laryngoscope or the Macintosh laryngoscope: A prospective, comparative study in the ICU
2012
Introduction Endotracheal intubation in the ICU is a challenging procedure and is frequently associated with life-threatening complications. The aim of this study was to investigate the effect of the C-MAC® video laryngoscope on laryngeal view and intubation success compared with direct laryngoscopy. Methods In a single-center, prospective, comparative before-after study in an anesthetist-lead surgical ICU of a tertiary university hospital, predictors of potentially difficult tracheal intubation, number of intubation attempts, success rate and glottic view were evaluated during a 2-year study period (first year, Macintosh laryngoscopy (ML); second year, C-MAC®). Results A total of 274 criti…
Nasotracheal intubation: look before you leap
2005
Nasotracheal intubation is frequently used for airway management during maxillofacial surgery. Complications such as haemorrhage occur more frequently with this route of intubation than with the orotracheal route. This case report describes a male patient aged 51 yr who developed severe epistaxis after the tube had passed the nares. As an additional complication laryngoscopy and endotracheal intubation failed because of difficult airway (Cormack-Lehane grade 4). Attempts using an intubating laryngeal mask airway and a Bonfils intubating fibrescope did not succeed. The airway was finally managed by cricothyroidotomy. A modified sequence of nasotracheal intubation is proposed to avoid similar…