OBJECTIVE To review the work of one tertiary paediatric palliative care service in facilitating planned withdrawal of ventilatory support outside the intensive care setting, with the purpose of developing local guidance for practice. METHODS Retrospective 10-year (2003-2012) case note review of intensive care patients whose parents elected to withdraw ventilation in another setting. Demograph...

Several patient populations have been identified as high risk for extubation failure despite successful completion of a spontaneous breathing trial (SBT). Extubation failure and subsequent need for emergent re-intubation have been associated with increased morbidity and mortality. In this review, we discuss ways to optimize the value and performance of the SBT in a subgroup of high-risk patient...

L aryngospasm is a common complication of airway management in anesthetic practice (1). It consists of a prolonged glottic closure reflex mediated by the superior laryngeal nerve. It often occurs with insufficient depth of anesthesia on endotracheal intubation, light anesthesia on tracheal extubation, or a combination of either of the preceding with an airway irritant such as blood, mucus, lary...

We read with great interest the article by Thille et al. [1] and commend the authors on their work. It is accepted that noninvasive ventilation (NIV) used prophylactically reduces post-extubation respiratory failure, but its impact on reintubation remains contentious [2]. Therefore, the current study, which reports reduced rates of reintubation from 28 % to 15 % in high-risk populations with NI...

OBJECTIVE To determine whether nasal continuous positive airway pressure (NCPAP) given with nasal prongs compared with nasal mask reduces the rate of intubation and mechanical ventilation in preterm infants within 72 hours of starting therapy. METHODS Infants <31 weeks' gestation treated with NCPAP were randomly assigned to receive it via either prongs or mask. Randomization was stratified by...

BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) are used routinely to control pain and inflammation after surgery in dogs. Robenacoxib is a cyclooxygenase-2 selective NSAID. HYPOTHESIS/OBJECTIVE Assess the clinical efficacy and safety of an injectable formulation of robenacoxib in dogs undergoing surgery. ANIMALS Three hundred and seventeen client-owned dogs (N = 159 robenacoxib or...

OBJECTIVE To provide a comprehensive, evidence-based review of helium-oxygen gas mixtures (heliox) in the management of pediatric respiratory diseases. DATA SOURCE A thorough, computerized bibliographic search of the preclinical and clinical literature regarding the properties of helium and its application in pediatric respiratory disease states. DATA SYNTHESIS After an overview of the pote...

Extraperitoneal bladder perforation is a known complication of a commonly performed rigid cystoscopy. If unrecognized, this complication can lead to continuous intra-abdominal fluid leakage with consequent organ function impairment and symptoms. This is the first case report in literature of a transurethral bladder perforation causing an acute abdominal compartment syndrome, which was subsequen...