Search results for "Intratracheal"

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…

High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis.

2019

Abstract Purpose The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results We included four studies in the primary analysis: one RCT…

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

2017

A patient's willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can jeopardize their spontaneous breathing, topical anesthesia of the airway is a popular technique. The spray-as-you-go technique represents one of the simplest opportunities to anesthetize the airway mucosa. The application of local anesthetic through the working channel of the flexible endoscope is a widespread practice for anesthetists as well as pulmonologists. There is neither need for additional devices nor special training as a pre-requisite to perform this technique. However, a known clinical problem is the coughing and gagging reflex tha…

Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient? Pro

2019

Endoscopic palliative management of esophageal and tracheal rupture

2014

The increasing number of patients requiring intensive care and airway support has led to a growing recognition that significant short- and long-term morbidity may be associated with the use of artificial airways; this is despite significant improvements in the materials used in laryngeal tubes, which aim to decrease the trauma associated with long-term intubation. We present the first case, to our knowledge,of huge, nontraumatic, esophageal perforation, widely communicating with the trachea, and which was treated successfully with double endoscopic stent placement.

The Orogastric Tube Guide® as a novel strategy for gastric tube insertion: a prospective, randomized controlled clinical trial

2020

BACKGROUND Gastric tube insertion, either orally or nasally, is daily practice in anesthesia and intensive care. "Blind" insertion represents the common conventional method and is associated with low first-pass success and frequent complications. This trial aimed to evaluate the novel gastric tube guide as a rigid conduit in regard to insertion success rate, time required and associated complications versus the conventional "blind" insertion method. We hypothesized that the insertion success rate is higher using the Orogastric tube guide. METHODS This trial was approved by ethics committee prior to patient recruitment. In a randomized order, anesthetists performed oral insertion of a gastri…

Franz Kuhn, his contribution to anaesthesia and emergency medicine.

2001

Franz Kuhn (1866-1929), a German surgeon, made a significant practical and scientific contribution towards the development of modern anaesthesia and emergency medicine. He developed modern, scientifically based concepts in close correlation to practical inventions for every day use. All of his studies and developments were patient orientated and led to remarkable improvements in patient safety. Kuhn was a major protagonist of endotracheal intubation, perfected his flexo-metallic endotracheal tubes, worked on different techniques of intubating the trachea, applied positive pressure to the lungs during thoracic surgery and developed anaesthesia machines. In the early 20th century, he wrote se…

The ultra-thin bronchoscope in management of the difficult paediatric airway

1987

The use of an ultra-thin flexible fiberoptic bronchoscope with a single lumen diameter of 2.7 mm at the distal tip to assist intubation of paediatric patients with a difficult airway is reported. Two patients (ages 30 months and 18 months) with mandibular hypoplasia and one patient (three months) with the Pierre-Robin syndrome are reported. In each case two fiberoptic bronchoscopes were used. The first allowed introduction of topical local anaesthetic while the second and smaller one was used for tube placement.

Supraglottic airway devices for surfactant treatment: systematic review and meta-analysis

2019

Objective: To compare surfactant administration via supraglottic airway device (SAD) vs. nasal CPAP alone or INSURE. Study design: A systematic search of PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov was performed. Articles meeting inclusion criteria (RCT, surfactant administration via SAD, laryngeal mask, I-gel) were assessed Results: Five RCTs were eligible. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.57, 95%CI 0.38–0.85) and short-term oxygen requirements (MD −8.00, 95%CI −11.09 to −4.91) compared to nCPAP alone. Surfactant administration via SAD reduced the need for intubation/mechanical v…

Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: Study protocol for a pilot randomized controlled trial, the PROT…

2018

Background Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). Methods PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and under…