Ryan M Huebinger, Hutch Stilgenbauer, Jeff L Jarvis, Daniel Ostermayer, Kevin Schulz, Henry E Wang
INTRODUCTION: Endotracheal intubation is an import component of out-of-hospital cardiac arrest (OHCA) resuscitation. In this analysis, we evaluate the association of video laryngoscopy (VL) with first pass success and return of spontaneous circulation (ROSC) using a national OHCA cohort. METHODS: We analyzed 2018 data from ESO Inc. (Austin, TX), a national prehospital electronic health record. We included all adult, non-traumatic cardiac arrests undergoing endotracheal intubation...
February 25, 2021: Resuscitation
Luca Salvatore Menga, Luca Delle Cese, Filippo Bongiovanni, Gianmarco Lombardi, Teresa Michi, Filippo Luciani, Marta Cicetti, Jacopo Timpano, Maria Cristina Ferrante, Melania Cesarano, Gian Marco Anzellotti, Tommaso Rosà, Daniele Natalini, Eloisa S Tanzarella, Salvatore Lucio Cutuli, Gabriele Pintaudi, Gennaro de Pascale, Antonio M Dell'Anna, Giuseppe Bello, Mariano Alberto Pennisi, Salvatore Maurizio Maggiore, Riccardo Maviglia, Domenico Luca Grieco, Massimo Antonelli
BACKGROUND: The efficacy of noninvasive oxygenation strategies (NIOS) in treating COVID-19 disease is unknown. We conducted a prospective observational study to assess the rate of NIOS failure in subjects treated in the ICU for hypoxemic respiratory failure due to COVID-19. METHODS: Patients receiving first-line treatment NIOS for hypoxemic respiratory failure due to COVID-19 in the ICU of a university hospital were included in this study; laboratory data were collected upon arrival, and 28-d outcome was recorded...
March 2, 2021: Respiratory Care
Emily Leede, James Kempema, Chad Wilson, Alejandro J Rios Tovar, Alan Cook, Erin Fox, Justin Regner, Robyn Richmond, Matt Carrick, Carlos V R Brown
BACKGROUND: Several options exist for induction agents during rapid sequence intubation (RSI) in trauma patients, including etomidate, ketamine, and propofol. These drugs have reported variable hemodynamic effects (hypotension with propofol and sympathomimetic effects with ketamine) that could affect trauma resuscitations. The purpose of this study was to compare the hemodynamic effects of these three induction agents during emergency department RSI in adult trauma. We hypothesized that these drugs would display a differing hemodynamic profile during RSI...
March 2, 2021: Journal of Trauma and Acute Care Surgery
Jin Takahashi, Tadahiro Goto, Hiraku Funakoshi, Hiroshi Okamoto, Yusuke Hagiwara, Hiroko Watase, Kohei Hasegawa
BACKGROUND: While the older population accounts for an increasing proportion of emergency department (ED), little is known about intubation-related adverse events in this high-risk population. We sought to determine whether advanced age is associated with a higher risk of intubation-related adverse events in the ED. METHODS: This is an analysis of data from a prospective, 15-centre, observational study-the second Japanese Emergency Airway Network (JEAN-2) study...
March 3, 2021: Emergency Medicine Journal: EMJ
Cassidy Cunningham, Karen Gross, John P Broach, Laurel O'Connor
BACKGROUND: Agitated behaviors are frequently encountered in the prehospital setting and require emergent treatment to prevent harm to patients and prehospital personnel. Chemical sedation with ketamine works faster than traditional pharmacologic agents, though it has a higher incidence of adverse events, including intubation. Outcomes following varying initial doses of prehospital intramuscular (IM) ketamine use have been incompletely described. OBJECTIVE: To determine whether using a lower dose IM ketamine protocol for agitation is associated with more favorable outcomes...
March 8, 2021: Prehospital and Disaster Medicine
Sabrina Correa da Costa Ribeiro
No abstract text is available yet for this article.
2021: Clinics
Hye Jin Kim, Yunho Roh, Soon Young Yun, Wyun Kon Park, Ha Yan Kim, Min Ho Lee, Hyun Joo Kim
When selecting the nasotracheal tube diameter for nasotracheal intubation, atraumatic introduction of the tube through the nasal passage and a safe location of the tube's cuff and tip should be ensured simultaneously. To maintain safety margin for the tube's cuff and tip from the vocal cords and carina (2 cm and 3 cm, respectively), the maximum allowable proximal-cuff-to-tip distance was calculated as 5 cm less than the measured vocal cords-to-carina distance. The primary aim of this study was to find a single predictive preoperative factor of the nostril size and maximum allowable proximal-cuff-to-tip distance of nasotracheal tubes...
2021: PloS One
Aidan Sharkey, Liana Zucco, Lindsay Rubenstein, Vincent Baribeau, Feroze Mahmood, Robina Matyal
Health care workers performing aerosolizing procedures on patients with transmissible infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at high-risk for disease acquisition. Current guidelines designed to protect health care workers during aerosolizing procedures prioritize personal protective equipment and enhanced infection control techniques, in particular during procedures such as intubation. To date, little emphasis has been placed on risk mitigation in the setting of bronchoscopy, a procedure that has significant aerosolization potential...
March 9, 2021: A&A Practice
Amy H Attaway, Rachel G Scheraga, Adarsh Bhimraj, Michelle Biehl, Umur Hatipoğlu
Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission...
March 10, 2021: BMJ: British Medical Journal
Pradeep K Bhatia, Sadik Mohammed
Rapid sequence intubation (RSI) is generally done in the patients requiring intubation in the emergency room. These patients are often full stomach and are at the risk of regurgitation and aspiration leading to aspiration pneumonia. The incidence of aspiration pneumonia during RSI is not known as the term "RSI" is poorly defined and the diagnosis of aspiration pneumonia is often clinical and circumstantial. How to cite this article: Bhatia PK, Mohammed S. Aspiration Pneumonia after Rapid Sequence Intubation: A Diagnostic Dilemma! Indian J Crit Care Med 2021;25(2):111-112...
February 2021: Indian Journal of Critical Care Medicine
Rohit Bhowmick
How to cite this article: Bhowmick R. Endotracheal Tube Cuff Pressure Monitor: A Fancy Gadget or Necessary Tool in Intensivist's Armamentarium. Indian J Crit Care Med 2021;25(2):121-122.
February 2021: Indian Journal of Critical Care Medicine
Prashant Nasa, Elie Azoulay, Ashish K Khanna, Ravi Jain, Sachin Gupta, Yash Javeri, Deven Juneja, Pradeep Rangappa, Krishnaswamy Sundararajan, Waleed Alhazzani, Massimo Antonelli, Yaseen M Arabi, Jan Bakker, Laurent J Brochard, Adam M Deane, Bin Du, Sharon Einav, Andrés Esteban, Ognjen Gajic, Samuel M Galvagno, Claude Guérin, Samir Jaber, Gopi C Khilnani, Younsuck Koh, Jean-Baptiste Lascarrou, Flavia R Machado, Manu L N G Malbrain, Jordi Mancebo, Michael T McCurdy, Brendan A McGrath, Sangeeta Mehta, Armand Mekontso-Dessap, Mervyn Mer, Michael Nurok, Pauline K Park, Paolo Pelosi, John V Peter, Jason Phua, David V Pilcher, Lise Piquilloud, Peter Schellongowski, Marcus J Schultz, Manu Shankar-Hari, Suveer Singh, Massimiliano Sorbello, Ravindranath Tiruvoipati, Andrew A Udy, Tobias Welte, Sheila N Myatra
BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice. METHODS: Using a Delphi process, an international panel of 39 experts developed clinical practice statements on the respiratory management of C-ARF in areas where evidence is absent or limited...
March 16, 2021: Critical Care: the Official Journal of the Critical Care Forum
Vinson Wai-Shun Chan, Helen Hoi-Lam Ng, Laiba Rahman, Audrey Tang, Kwan Pui Tang, Alex Mok, Jeremy Pak Ho Liu, Kenny Shiu Cheong Ho, Shannon Melissa Chan, Sunny Wong, Anthony Yuen-Bun Teoh, Albert Chan, Martin Wong, Yuhong Yuan, Jeremy Yuen-Chun Teoh
OBJECTIVES: To assess the risk of coronavirus transmission to healthcare workers performing aerosol-generating procedures and the potential benefits of personal protective equipment during these procedures. DATA SOURCES: MEDLINE, EMBASE, and Cochrane CENTRAL were searched using a combination of related MeSH terms and keywords. STUDY SELECTION: Cohort studies and case controls investigating common anesthetic and critical care aerosol-generating procedures and transmission of severe acute respiratory syndrome coronavirus 1, Middle East respiratory syndrome coronavirus, and severe acute respiratory syndrome coronavirus 2 to healthcare workers were included for quantitative analysis...
March 1, 2021: Critical Care Medicine
Kia Dullemond, Colby Renschler, Jan Trojanowski, Frank Scheuermeyer, Rob Stenstrom, Donald Griesdale, Ruth MacRedmond, Elan Nattrass, Lena Farina, Jeff Yoo
INTRODUCTION: 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. METHODS: We conducted a prospective study of endotracheal intubation in the emergency department, intensive care unit, or ward between September 11, 2018 and June 11, 2020 at two urban hospitals...
January 11, 2021: CJEM
Prakash Adhikari, Sanket Bhattarai, Ashish Gupta, Eiman Ali, Moeez Ali, Mohamed Riad, Jihan A Mostafa
High-flow nasal cannula (HFNC) is an open oxygen delivery system, which provides heated and humidified oxygen at a high flow (up to 60 L/min). This effect can improve mucociliary function, airway clearance, and level of comfort to the patient. It can provide controlled and adequate fraction of inspired oxygen (FiO2 ) between 21% and 100%. Generation of end-expiratory pressure helps in carbon dioxide washout, reduction of anatomical dead space, and recruitment of collapsed alveoli, ultimately improving tissue oxygenation...
February 16, 2021: Curēus
Sergio A Silverio, Hilary Wallace, William Gauntlett, Richard Berwick, Simon Mercer, Ben Morton, Simon N Rogers, John E Sandars, Peter Groom, Jeremy M Brown
The time-critical 'can't intubate, can't oxygenate' [CICO] emergency post-induction of anaesthesia is rare, but one which, should it occur, requires Anaesthetists to perform rapid emergency front of neck access [FONA] to the trachea, restoring oxygenation, and preventing death or brain hypoxia. The UK Difficult Airway Society [DAS] has directed all Anaesthetists to be trained with surgical cricothyroidotomy [SCT] as the primary emergency FONA method, sometimes referred to as 'Cric' as a shorthand. We present a longitudinal analysis using a classical approach to Grounded Theory methodology of ten Specialist Trainee Anaesthetists' data during a 6-month training programme delivered jointly by Anaesthetists and Surgeons...
2021: PloS One
Michael A Frakes, Jeremy B Richards, Michael N Cocchi, Ari Cohen, Jason E Cohen, James Dargin, Franklin D Friedman, Adam S Kaye, Jordan S Rettig, Raghu Seethala, Susan R Wilcox
PURPOSE: Critical care transport is associated with a high rate of adverse events, and the risks and outcomes of transporting critically ill patients during the COVID-19 pandemic have not been previously described. MATERIALS AND METHODS: We performed a retrospective review of transports of subjects with suspected or confirmed COVID-19 from sending hospitals to tertiary care hospitals in Boston. Follow-up data were obtained for patients transported between March 1st and April 20th, 2020...
March 22, 2021: Journal of Intensive Care Medicine
Miguel Ángel Fernández Vaquero, Laura Reviriego-Agudo, María Gómez-Rojo, Pedro Charco-Mora
No abstract text is available yet for this article.
February 19, 2021: Brazilian Journal of Anesthesiology
Guillaume Carteaux, Manuella Pons, François Morin, Samuel Tuffet, Arnaud Lesimple, Bilal Badat, Anne-Fleur Haudebourg, François Perier, Yvon Deplante, Constance Guillaud, Frédéric Schlemmer, Elena Fois, Nicolas Mongardon, Mehdi Khellaf, Karim Jaffal, Camille Deguillard, Philippe Grimbert, Raphaëlle Huguet, Keyvan Razazi, Nicolas de Prost, François Templier, François Beloncle, Alain Mercat, Laurent Brochard, Vincent Audard, Pascal Lim, Jean-Christophe Richard, Dominique Savary, Armand Mekontso Dessap
BACKGROUND: We describe a frugal approach (focusing on needs, performance, and costs) to manage a massive influx of COVID-19 patients with acute hypoxemic respiratory failure (AHRF) using the Boussignac valve protected by a filter ("Filter Frugal CPAP", FF-CPAP) in and out the ICU. METHODS: (1) A bench study measured the impact of two filters with different mechanical properties on CPAP performances, and pressures were also measured in patients. (2) Non-ICU healthcare staff working in COVID-19 intermediate care units were trained with a video tutorial posted on a massive open online course...
March 2, 2021: Annals of Intensive Care
2021-03-25 17:01:22
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