In this issue of Indian Pediatrics, Sinha, et al.(1) have reported the results of a single center randomized controlled trial evaluating aerosolized L-epinephrine vs budesonide for the treatment of post-extubation stridor. While the benefits of intravenous corticosteroids on postextubation stridor are still unclear(2), the authors propose inhaled steroids may provide similar action to intraveno...

Introduction Extubation failure in critically ill patients has associated morbidity, but it cannot be safely predicted or avoided. Preventive NIMV has proved beneficial only in hypercapnic patients. We hypothesized that High-flow oxygen therapy may reduce postextubation respiratory failure due to gas humidification, avoidance of lung collapse by moderate PEEP, and work of breathing reduction by...

Patients: Ninety-seven consecutive patients with similar baseline characteristics requiring >48 hours of mechanical ventilation and considered at risk of developing postextubation respiratory failure (i.e., patients who had hypercapnia, congestive heart failure, ineffective cough and excessive tracheobronchial secretions, more than one failure of a weaning trial, more than one comorbid conditio...

Respiratory complications after tracheal extubation are associated with significant morbidity and mortality, suggesting that process improvements in this clinical area are needed. The decreased rate of respiratory adverse events occurring during tracheal intubation since the implementation of guidelines for difficult airway management supports the value of education and guidelines in advancing ...

Endoscopic sinus surgery performed on a healthy young male could have resulted in a fatal outcome when a surgically placed nasal pack became dislodged upon extubation and unknowingly was aspirated. Unlike the "missing" nasal packs or posterior pharyngeal packs placed intraoperatively, this particular pack was to remain in place 12 to 24 hours postoperatively, status postseptoplasty. At the conc...

BACKGROUND One small study suggests that gargling with licorice before induction of anesthesia reduces the risk of postoperative sore throat. Double-lumen tubes are large and thus especially likely to provoke sore throats. We therefore tested the hypothesis that preoperative gargling with licorice solution prevents postoperative sore throat and postextubation coughing in patients intubated with...

RET 2.0 DESCRIPTION/DEFINITION The decision to discontinue mechanical ventilation involves weighing the risks of prolonged mechanical ventilation against the possibility of extubation failure.1,2 This guideline will focus on the predictors that aid the decision to extubate, the procedure referred to as extubation, and the immediate postextubation interventions that may avoid potential reintubat...