Articles: intubation.
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Some patients with acute heart failure (AHF) who are treated initially with noninvasive ventilation (NIV) will require endotracheal intubation, which indicates NIV failure. The incidence and prognosis of NIV failure in patients with AHF are not well characterized. ⋯ Intubation after initial NIV treatment was required in 1.5% of subjects hospitalized with AHF and treated with NIV, and was associated with high in-hospital mortality. These findings can guide future prospective interventional trials and quality improvement ventures.
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Respiratory medicine · Oct 2020
COVID-19 patients in a tertiary US hospital: Assessment of clinical course and predictors of the disease severity.
Patients with severe COVID-19 can develop ventilator-dependent acute hypoxic respiratory failure (VDAHRF), which is associated with a higher mortality rate. We evaluated the clinical course of hospitalized COVID-19 patients and compared them with the patients who received invasive mechanical ventilation. Characteristics of intubated patients who were successfully weaned from the ventilator were compared with the patients who failed to be extubated or died in the hospital. ⋯ Patients who required invasive mechanical ventilation were more likely to have older age, male gender, coronary artery disease, diabetes, and obesity. The patients who were successfully weaned from the ventilator were more likely to be younger in age, and none of them had heart failure or CAD.
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Multicenter Study
Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study.
Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs' intubation performance in pediatric ICUs. The purpose of this study was to describe the current landscape of intubations performed by RTs in pediatric ICUs. ⋯ RTs infrequently intubate in pediatric ICUs, with success rates similar to other providers but higher adverse event rates. RTs were more likely to use video laryngoscopy than other providers. RTs' intubation participation, success, and adverse event rates varied greatly across pediatric ICUs.
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The aim of this study was to determine the effect of an aerosol box on tracheal intubation difficulty. Eighteen experienced anesthetists intubated the trachea of a manikin with a normal airway 6 times using a direct laryngoscope, a McGRATH™ MAC videolaryngoscope, or an airway scope AWS-S200NK videolaryngoscope with or without an aerosol box. ⋯ When using any of the laryngoscopes, there were no statistically significant differences in the Cormack-Lehane grade and peak force to maxillary incisors with and without the aerosol box. In summary, the effect of an aerosol box on tracheal intubation difficulty is not clinically relevant when an experienced anesthetist intubates the trachea in a normal airway condition.
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Multicenter Study Observational Study
Tracheal intubation in traumatic brain injury: a multicentre prospective observational study.
We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. ⋯ NCT02210221.