Articles: intubation.
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Randomized Controlled Trial
The impact of a barrier enclosure on time to tracheal intubation: a randomized controlled trial.
Novel devices such as the barrier enclosure were developed in hopes of improving provider safety by limiting SARS-CoV-2 transmission during tracheal intubation. Nevertheless, concerns arose regarding a lack of rigorous efficacy and safety data for these devices. We conducted a randomized controlled trial to evaluate the impact of the barrier enclosure on time to tracheal intubation. ⋯ In healthy surgical patients with normal airway predictors, the use of a barrier enclosure during tracheal intubation did not significantly prolong time to intubation or decrease first-pass intubation success. Nevertheless, there was an increase in difficulty of intubation perceived by the anesthesiologists with use of a barrier enclosure.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 2021
Review Meta AnalysisFace mask versus nasal prong or nasopharyngeal tube for neonatal resuscitation in the delivery room: a systematic review and meta-analysis.
The current neonatal resuscitation guidelines recommend positive pressure ventilation via face mask or nasal prongs at birth. Using a nasal interface may have the potential to improve outcomes for newborn infants. ⋯ In infants born <37 weeks' gestation, in-hospital mortality and morbidity were similar following positive pressure ventilation during initial stabilisation with a nasal prong/tube or a face mask.
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Review Meta Analysis
Effect of dexmedetomidine on hemodynamic responses to tracheal intubation: A meta-analysis with meta-regression and trial sequential analysis.
An uncontrolled adrenergic response during tracheal intubation may lead to life-threatening complications. Dexmedetomidine binds to α2-receptors and may attenuate this response. The primary aim of our meta-analysis is to investigate dexmedetomidine efficacy in attenuating sympathetic response to tracheal intubation, compared with placebo or no dexmedetomidine, in terms of heart rate and blood pressure at intubation. ⋯ Patients receiving premedication with dexmedetomidine for tracheal intubation, compared with no dexmedetomidine, have a lower blood pressure and heart rate, however, the risk of bradycardia and hypotension is relevant and its use during daily practice should be cautiously evaluated for each patient.
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Australas Emerg Care · Sep 2021
Impact of personal protective equipment on prehospital endotracheal intubation performance in simulated manikin.
Tracheal intubation in COVID-19 patients is a potentially high-risk procedure for healthcare professionals. Personal protective equipment (PPE) is recommended to minimize contact with critical patients with COVID-19 infection. This study aimed to primarily examine the effect of PPE use on intubation time and success rate among prehospital healthcare professionals; additionally, we compared intubation times among prehospital health care professionals using PPE with direct laryngoscopy and video laryngoscopy assistance. ⋯ PPE use is associated with increased intubation time and decreased success rate. Video laryngoscopy assistance in cases where PPE use is required facilitates faster endotracheal intubation than does direct laryngoscopy assistance.