BACKGROUND Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significa...

OBJECTIVE To evaluate the utility of the Cook airway exchange catheter (CAEC) for extubation/reintubation in pediatric patients with a known difficult airway. DESIGN Prospective, nonrandomized. SETTING Pediatric intensive care unit; single academic institution. PATIENTS Twenty intubated children </=18 yrs of age with a known difficult airway requiring extubation. INTERVENTIONS The CAEC ...

INTRODUCTION Critically ill patients can develop acute respiratory failure requiring endotracheal intubation. Swallowing dysfunction after liberation from mechanical ventilation, also known as post-extubation dysphagia, is common and deleterious among patients without neurologic disease. However, the risk factors associated with the development of post-extubation dysphagia and its effect on hos...

BACKGROUND The most common complications after tracheal intubation during general anesthesia are sore throat, hoarseness, and laryngospasm which can cause severe discomfort to patients. Several methods have been suggested to prevent these complications. In this study, the effects of intracuff dexamethasone, lidocaine, and normal saline in reducing post-extubation reactions were compared. METH...

OBJECTIVE To determine whether a collaborative learning strategy-derived clinical practice guideline can reduce the duration of endotracheal intubation following infant heart surgery. DESIGN Prospective and retrospective data collected from the Pediatric Heart Network in the 12 months pre- and post-clinical practice guideline implementation at the four sites participating in the collaborative...

The objective of this study was to assess the impact of fiber-optic laryngoscopy (FOL) on the weaning process from mechanical ventilation in critically ill patients with a positive cuff leak test (CLT) as compared with the current recommended strategy based on corticosteroids.In this prospective observational pilot study conducted over a 1-year period in a 15-bed ICU, CLT was systematically per...

Awake intubation with fiberoptic bronchoscopy (FOB) is a popular technique in patients with difficult intubation criteria. Preservation of spontaneous respiration by nasotracheal intubation with FOB accompanied by sedation was performed in a case assessed as difficult intubation due to a high Mallampati score at preoperative evaluation and the presence of a mass extending to the oral cavity. Fo...

Incorrect endotracheal placement of the tracheal tube can lead to serious complications, such as laryngeal nerve paralysis and accidental extubation [1]. In oral and maxillofacial surgery and dental procedure, the head of the patient was covered in drape, and an anesthesiologist cannot often see tracheal tube. In addition, surgeon (or dentist) may move the head of the patient. Flexion of the ne...

Background and Aim Suppression of deleterious effect of pneumoperitoneum is a very important goal of laparoscopic surgeries. Dexmedetomidine is a highly selective α2adrenoreceptor agonist that causes centrally mediated reduction of sympathetic nervous system activity and lead to sedation and analgesia. The aim of our study was to evaluate the effect of dexmedetomidine on haemodynamic response o...

BACKGROUND A substantial proportion of patients with neuromuscular disease (NMD) who undergo positive pressure ventilation via endotracheal intubation for acute respiratory failure fail to pass spontaneous breathing trials and should be considered at high risk for extubation failure. In our study, we prospectively investigated the efficacy of early application of noninvasive ventilation (NIV) c...