International journal of critical illness and injury science
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Int J Crit Illn Inj Sci · Oct 2013
Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome.
Trauma is an important health concern during pregnancy in developing nations though it is under-reported. ⋯ Injury prevention measures during pregnancy deserve a place in any policy response aimed at reducing feto-maternal morbidity and mortality in developing countries.
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Int J Crit Illn Inj Sci · Oct 2013
Evaluation of tracheal cuff pressure variation in spontaneously breathing patients.
Most of the studies referring cuff tubes' issues were conducted on intubated patients. Not much is known about the cuff pressure performance in chronically tracheostomized patients disconnected from mechanical ventilation. ⋯ The systematic CP measurement in chronically tracheostomized, spontaneously breathing patients showed high variability, which was independent of tube brand, size, type, or time of placement. Consequently, measurements should be made more frequently.
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Int J Crit Illn Inj Sci · Oct 2013
Evaluation of the new supraglottic airway S.A.L.T to aid blind orotracheal intubation: A pilot study.
Supraglottic Airway Laryngopharyngeal Tube (S.A.L.T) is a new airway gadget conceived as an effective device to facilitate blind oro-tracheal intubation. Literature review showed no available clinical study on human subjects. The aim of our study was to evaluate S.A.L.T as an adjunct to blind oro-tracheal intubation. ⋯ S.A.L.T shows limited usefulness as an adjunct for aided blind oro-tracheal intubation.
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Patients with chronic obstructive pulmonary disease and congestive heart failure exacerbations, as well as pneumonia benefit from the use of non-invasive ventilation (NIV), due to increased patient comfort and a reduced incidence of ventilator-associated pneumonia. However, some patients do not tolerate NIV due to anxiety or agitation, and traditionally physicians have withheld sedation from these patients due to concerns of loss of airway protection and respiratory depression. We report our recent experience with a 91-year-old female who received NIV for acute respiratory distress secondary to pneumonia. ⋯ The patient was initially agitated with the NIV, but with the addition of the dexmedetomidine, she tolerated it well. The dexmedetomidine was administered without a loading dose, as a continuous infusion ranging from 0.2 to 0.5 mcg/kg/hr, titrated to a Ramsey score of three. This case illustrates the safe use of dexmedetomidine to facilitate NIV, and improve compliance, which may reduce ICU length of stay.