Articles: intubation.
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Acta Anaesthesiol Scand · Mar 2025
Randomized Controlled Trial Comparative StudyIntubating conditions during rapid sequence induction with either rocuronium or suxamethonium in elderly patients. A randomised study.
During rapid sequence induction, either rocuronium 1.0 mg kg-1 or suxamethonium 1.0 mg kg-1 can be administered to facilitate endotracheal intubation. We hypothezised that rocuronium provided a larger proportion of excellent intubating conditions compared to suxamethonium in elderly patients. ⋯ This reports a superiority trial comparing standardised doses of rocuronium and suxamethonium at 60 s for quality of intubating conditions in the rapid sequence context, and this in an elderly cohort. The findings showed no difference between the drugs concerning intubation outcomes, though the onset or time to peak effect was shorter for suxamethonium, again demonstrated in a cohort 80 years old or older.
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Randomized Controlled Trial
A novel cricoid pressure sensor device enhances the efficacy of oesophageal occlusion during Sellick's manoeuvre: A randomised controlled trial.
The inability to measure the force applied during cricoid pressure is an important limitation in clinical practice. We developed a novel device to measure this force and provide real-time feedback to the operator. ⋯ The use of the novel sensor device achieved a significantly high rate of oesophageal occlusion during application of cricoid pressure.
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Anesthesia and analgesia · Feb 2025
Randomized Controlled Trial Multicenter Study Comparative StudyMcGrath MAC Versus Three-Dimensional Printed Video Laryngoscopes: A Randomized, Manikin-Simulated Noninferiority Controlled Study with Medical Students.
Proficiency in endotracheal intubation (ETI) is essential for medical professionals and its training should start at medical schools; however, large caseload may be required before achieving an acceptable success rate with direct laryngoscopy. Video laryngoscopy has proven to be an easier alternative for intubation with a faster learning curve, but its availability in medical training may be an issue due to its high market prices. We devised a low-cost 3-dimensionally printed video laryngoscope (3DVL) and performed a randomized trial to evaluate if the intubation success rate on the first attempt with this device is noninferior to a standard commercially available video laryngoscope (STVL). ⋯ The 3DVL was inferior in achieving first-attempt intubation when compared with the STVL with a difference in success rate >7.5% margin in simulated scenarios with medical students. Tracheal intubation might require a set of psychomotor skills for which the McGrath MAC device is superior to the low-cost alternative.
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Randomized Controlled Trial Multicenter Study
Early noninvasive ventilation in general wards for acute respiratory failure: an international, multicentre, open-label, randomised trial.
The impact of noninvasive ventilation (NIV) managed outside the intensive care unit in patients with early acute respiratory failure remains unclear. We aimed to determine whether adding early NIV prevents the progression to severe respiratory failure. ⋯ NCT01572337.
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Am. J. Respir. Crit. Care Med. · Feb 2025
Randomized Controlled Trial Multicenter StudyHumidified Noninvasive Ventilation versus High-Flow Therapy to Prevent Reintubation in Patients with Obesity: A Randomized Clinical Trial.
Rationale: The optimal strategy to prevent reintubation in patients with obesity remains uncertain. Objectives: We aimed to determine whether noninvasive ventilation (NIV) with active humidification is superior to a high-flow nasal cannula (HFNC) in preventing reintubation in patients with obesity at intermediate risk. Methods: We conducted a randomized controlled trial in two ICUs in Spain (June 2020-June 2021). ⋯ Conclusions: Among adult critically ill patients with obesity at intermediate risk for extubation failure, the rate of reintubation was not significantly lower with NIV than with HFNC. Nevertheless, there is a risk for underpowered results. Clinical trial registered with www.clinicaltrials.gov (NCT04125342).