Articles: mechanical-ventilation.
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Paediatric anaesthesia · Dec 2021
ReviewVolatile anesthetic agents for life-threatening pediatric asthma: A multicenter retrospective cohort study and narrative review.
Volatile anesthetic agents are described as rescue therapy for children invasively ventilated for critical asthma. Yet, data are currently limited to case series. ⋯ For intubated children for asthma, no differences in mechanical ventilation duration or mortality between those with and without volatile anesthetic exposure were observed. Although volatiles may represent a viable rescue therapy for severe cases of asthma, definitive, and prospective trials are still needed.
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Peak expiratory flow during mechanical insufflation-exsufflation: endotracheal tube versus facemask.
Mechanical insufflation-exsufflation (MI-E) applied through the endotracheal tube (ETT) can effectively eliminate airway secretions in intubated patients. However, the effect of the interface (ETT vs face mask) on expiratory air flow generated by MI-E has not been investigated. This study aimed to investigate the effect of the ETT on peak expiratory flow (PEF) along with other associated factors that could influence PEF generated by MI-E. ⋯ MI-E via ETT generated slower PEF than via face mask, suggesting that a higher-pressure protocol should be prescribed for intubated patients. An insufflation-exsufflation pressure up to +50/-50 cm H2O could be considered to produce a PEF faster than 2.7 L/s, and the applications were safe and feasible for subjects on invasive mechanical ventilation.
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Wien. Klin. Wochenschr. · Dec 2021
Multicenter StudyChanges in characteristics and outcomes of critically ill COVID-19 patients in Tyrol (Austria) over 1 year.
Widely varying mortality rates of critically ill Coronavirus disease 19 (COVID-19) patients in the world highlighted the need for local surveillance of baseline characteristics, treatment strategies and outcome. We compared two periods of the COVID-19 pandemic to identify important differences in characteristics and therapeutic measures and their influence on the outcome of critically ill COVID-19 patients. ⋯ Advanced treatment strategies and learning effects over time resulted in reduced rates of mechanical ventilation and vasopressor use in the second wave associated with shorter ICU length of stay. Despite these improvements, age appears to be a dominant factor for hospital mortality in critically ill COVID-19 patients.
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Observational Study
Practice, Outcomes and Complications of Emergent Endotracheal Intubation By Critical Care Practitioners During the COVID-19 Pandemic.
For patients with COVID-19 who undergo emergency endotracheal intubation, data are limited regarding the practice, outcomes, and complications of this procedure. ⋯ Video laryngoscopy and neuromuscular blockade were used increasingly during the COVID-19 pandemic. Despite a higher rate of first-pass success during the pandemic, the incidence of complications associated with the procedure was higher.