Articles: intubation.
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The Covid-19 pandemic has required new protocols for endotracheal intubation mandating cumbersome personal protective equipment and modifications to prior intubation procedures. We assessed the success and complications of endotracheal intubation under such protocols. ⋯ New pandemic endotracheal intubation protocols did not result in a decrease in first-pass success, or first-pass success without complications.
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A 65-year-old man presented with shortness of breath, gradually worsening for the previous 2 weeks, associated with dry cough, sore throat, and diarrhea. He denied fever, chills, chest pain, abdominal pain, nausea, or vomiting. He did not have any sick contacts or travel history outside of Michigan. ⋯ Antibiotic therapy with IV meropenem was started. His condition steadily improved; eventually by day 20, he was off vasopressors and was extubated. However, on day 23, he experienced significant hemoptysis that required reintubation and vasopressor support.
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The anatomy of children with severe Pierre Robin sequence can present a challenge for direct laryngoscopy and intubation. Advanced techniques including flexible fiberoptic laryngoscopic intubation have been described but require highly specialized skill and equipment. Rigid video laryngoscopy is more accessible but has not been described in this population. ⋯ 4 Laryngoscope, 131:1647-1651, 2021.
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Randomized Controlled Trial
The effect of reconnection to mechanical ventilation for 1 hour after spontaneous breathing trial on reintubation among patients ventilated for more than 12 hours: A randomized clinical trial.
The resting of the respiratory musculature after undergoing the spontaneous breathing trial (SBT) to prevent extubation failures in critically ill patients needs to be studied further. ⋯ Reconnection to MV after a successful SBT, compared with DE, did not result in a statistically significant reduction in the risk of reintubation in mechanically ventilated patients. Subgroup exploratory findings suggest that the strategy may benefit patients who were ventilated for more than 72 h, which should be confirmed in further studies.