Articles: intubation.
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Best Pract Res Clin Anaesthesiol · Jul 2021
ReviewMechanical ventilation in neurocritical care setting: A clinical approach.
Neuropatients often require invasive mechanical ventilation (MV). Ideal ventilator settings and respiratory targets in neuro patients are unclear. Current knowledge suggests maintaining protective tidal volumes of 6-8 ml/kg of predicted body weight in neuropatients. ⋯ Additionally, the weaning process from MV is particularly challenging in these patients who cannot control the brain respiratory patterns and protect airways from aspiration. Indeed, extubation failure in neuropatients is very high, while tracheostomy is needed in one-third of the patients. The aim of this manuscript is to review and describe the current management of invasive MV, weaning, and tracheostomy for the main four subpopulations of neuro patients: traumatic brain injury, acute ischemic stroke, subarachnoid hemorrhage, and intracerebral hemorrhage.
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Ulus Travma Acil Cer · Jul 2021
Randomized Controlled TrialComparison of the C-MAC D-Blade videolaryngoscope and direct laryngoscope in pediatric patients: Randomized controlled trial.
Endotracheal intubation is a key skill for clinicians and may be challenging in some patients due to various reasons. Nowadays, various kinds of videolaryngoscopes are available and usually used as a rescue device when direct laryngoscopy failed. Pediatric airway has some differences when compared with adults and may be challenging. This study aims to compare and evaluate C Mac D-Blade and commonly used Macintosh laryngoscope in pediatric patients. ⋯ C Mac D-Blade videolaryngoscope shortened intubation time about twice when compared to Macintosh blade C Mac D-Blade videolaryngoscope, Videolaryngoscopes may be a good alternative for routine intubation, education and a rescue device for difficult intubation.
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J Vasc Surg Venous Lymphat Disord · Jul 2021
Multicenter Study Observational StudyVenous thrombosis, thromboembolism, biomarkers of inflammation, and coagulation in coronavirus disease 2019.
Coronavirus disease 2019 (COVID-19) is associated with abnormal inflammatory and coagulation markers, potentially mediating thrombotic events. Our objective was to investigate the incidence, time course, laboratory features, and in-hospital outcomes of COVID-19 patients with suspected venous thromboembolism (VTE). ⋯ Male sex, elevated CRP, and elevated platelet count at admission were associated with VTE on univariable analysis. However, only male sex remained significant on multivariable analysis. Older age, active malignancy, disseminated intravascular coagulation, and elevated D-dimer at admission were independently associated with death for patients hospitalized with COVID-19.
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Observational Study
The association of rocuronium dosing and first-attempt intubation success in adult emergency department patients.
The recommended rocuronium dose for rapid sequence intubation is 1.0 mg/kg; however, the optimal dose for emergency airway management is not clear. We assessed the relationship between rocuronium dose and first-attempt success among emergency department (ED) patients undergoing rapid sequence intubation. ⋯ Rocuronium dosed ≥1.4 mg/kg was associated with higher first attempt success when using direct laryngoscopy and among patients with pre-intubation hypotension with no increase in adverse events. We recommend further prospective evaluation of the dosing of rocuronium prior to offering definitive clinical guidance.