Search results for "intubation"

Timing, Complications, and Safety of Tracheotomy in Critically Ill Patients With COVID-19

2021

Importance: The current coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented needs for invasive ventilation, with 10% to 15% of intubated patients subsequently requiring tracheotomy. Objective: To assess the complications, safety, and timing of tracheotomy performed for critically ill patients with COVID-19. Design, Setting, and Participants: This prospective cohort study assessed consecutive patients admitted to the intensive care unit (ICU) who had COVID-19 that required tracheotomy. Patients were recruited from March 16 to April 10, 2020, at a tertiary referral center. Exposures: A surgical tracheotomy was performed for all patients following recommended criteria for use…

High flow nasal therapy in perioperative medicine: from operating room to general ward

2018

Abstract Background High flow nasal therapy (HFNT) is a technique in which humidified and heated gas is delivered to the airways through the nose via small nasal prongs at flows that are higher than the rates generally applied during conventional oxygen therapy. The delivered high flow rates combine mixtures of air and oxygen and enable different inspired oxygen fractions ranging from 0.21 to 1. HFNT is increasingly used in critically ill adult patients, especially hypoxemic patients in different clinical settings. Main body Noninvasive ventilation delivers positive pressure (end-expiratory and inspiratory pressures or continuous positive airway pressure) via different external interfaces. …

Ventilación mecánica no invasiva en pre e intraoperatorio y vía aérea difícil

2015

Non-invasive mechanical ventilation is a method of ventilatory assistance aimed at increasing alveolar ventilation, thus achieving, in selected subjects, the avoidance of endotracheal intubation and invasive mechanical ventilation, with the consequent improvement in survival. There has been a systematic review and study of the technical, clinical experiences, and recommendations concerning the application of non-invasive mechanical ventilation in the pre- and intraoperative period. The use of prophylactic non-invasive mechanical ventilation before surgery that involves significant alterations in the ventilatory function may decrease the incidence of postoperative respiratory complications. …

Cocaine or phenylephrine/lignocaine for nasal fibreoptic intubation?

1996

In order to assess if a mixture of phenylephrine/lignocaine is as effective as cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation, 99 patients receiving topical nasal analgesia either with cocaine 10% or a mixture of phenylephrine 1% and lignocaine 4% were studied in a randomized double-blind investigation. After topical analgesia a flexible fibreoptic endoscope was advanced through a nostril. Larynx, glottis and trachea were endoscopically sprayed with lignocaine. Following induction of anaesthesia a nasotracheal tube was inserted fibreoptically. Pain intensity and amount of epistaxis during endoscopy were assessed. Blood pressure, heart rate and ECG-ST seg…

Advanced prehospital airway management techniques

2002

AIRWAY MANAGEMENT IN TRAUMA PATIENTS

1999

Complications related to airway management in traumatized patients are common and, because of the importance and vulnerability of the ventilatory system, can be life threatening within a very short time. 25,39,48 Therefore, airway management is perhaps the most vital component in the treatment of traumatized patients. Patients who have suffered major trauma can present the most complex airway management problems, especially in the prehospital setting. 19 Because the treatment is time-critical, the evaluation of injuries is usually incomplete at the time airway management is undertaken. If the airway is injured, attempts to secure the airway by performing endotracheal intubation or insertion…

Use of Helmet CPAP in COVID-19 – A practical review

2021

Helmet CPAP (H-CPAP) has been recommended in many guidelines as a noninvasive respiratory support during COVID-19 pandemic in many countries around the world. It has the least amount of particle dispersion and air contamination among all noninvasive devices and may mitigate the ICU bed shortage during a COVID surge as well as a decreased need for intubation/mechanical ventilation. It can be attached to many oxygen delivery sources. The MaxVenturi setup is preferred as it allows for natural humidification, low noise burden, and easy transition to HFNC during breaks and it is the recommended transport set-up. The patients can safely be proned with the helmet. It can also be used to wean the p…

Blood CO2 and pH Transients During Apnoea after O2 Breathing in Patients

1990

Endotracheal intubation always is combined with an apnoea the duration of which is dependent on the technique used, the skills of the intubator, and the anatomical situation. The resulting typical potential risks may be (among others) both hypoxaemia and hypercapnia. Therefore the tolerable apnoea time for an intubation procedure is limited in clinical practice to 1 – 2 minutes. It must be noted that the developing hypercapnia is inevitable, whereas hypoxaemia may be avoided even in prolonged apnoea (e.g. >2 min) with “adaequate” preoxygenation [Duda et al., 1988]. Using de-nitrogenation techniques (breathing pure oxygen for 30 to 60 min) “anaesthetized and curarized normal subjects tolerat…

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…

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.