A 67-year-old woman underwent right radical neck dissection for cervical lymph node metastasis from maxillary gingival carcinoma. Two months later, metastasis in the left superior internal jugular lymph nodes were discovered, and left radical neck dissection was performed. Postoperatively, airway obstruction occurred despite performing extubation after confirming that the patient had fully reco...

subcutaneous emphysema is a rare complication of postoperative nausea and vomiting and can lead to airway compromise. we describe a case of delayed, severe subcutaneous emphysema after postoperative vomiting which fortunately did not lead to airway compromise and eliminated with conservative management. rough and difficult laryngoscopy and intubation, presence of clots and bloody discharge afte...

INTRODUCTION Availability of objective criteria for predicting successful extubation could avoid unnecessary prolongation of mechanical ventilation and/or inadvertent premature extubation, but the predictors of successful extubation in children are unclear. This study was performed to detect and validate respiratory function predictors of successful extubation in children admitted to the pediat...

External distraction using a rigid external distractor (RED) frame (RED frame II, KLS-Martin, Jacksonville, USA) is frequently used for maxillary distraction and reconstruction.[1-3] Airway management with the RED frame could be a greater risk of failed intubation/extubation. It could significantly interfere with ventilation with a face mask or intubation by direct laryngoscopy. However, anaest...

BACKGROUND The ideal timing for extubation of patients with myasthenic crisis (MC) and the factors that influence extubation outcome are not well established. OBJECTIVES To assess the risk of extubation failure in MC and to identify predictors of extubation failure. DESIGN We reviewed consecutive episodes of MC treated with endotracheal intubation from January 1, 1987, through December 31, ...

Safely returning intubated, mechanically ventilated patients to independent breathing requires 3 steps.1,2 First, clinicians must recognize when respiratory failure has resolved or improved enough to allow a spontaneous breathing trial (SBT). Second, a 30–120 min SBT should be used to test the patient’s ability to breathe without the ventilator.3 Third, if the SBT is successful, the physician m...

A 73-yr-old male with atrial fibrillation presented for pulmonary vein mapping and isolation. Following uneventful tracheal intubation, femoral vein catheters and a 7-Fr right internal jugular vein (IJV) catheter were placed with ultrasound guidance. After the seven-hour procedure, a large right neck hematoma was apparent. Ultrasound examination showed no compromise of the IJV or carotid artery...

Extubation failure is an outcome of increasing importance but nearly all studies have been conducted in academic settings. The article by Seymour and colleagues demonstrates that extubation failure is an outcome to be avoided in the community hospital setting as well. Patients failing extubation experience longer lengths of stay, experience higher intensive care unit mortality, and incur greate...

An important cause of pulmonary oedema is Negative Pressure Pulmonary Oedema (NPPE) which characteristically develops soon after extubation from an endo-tracheal intubation. In this case report we identified a case of previously healthy man who was intubated for General Anaesthesia for extraction of impacted molar tooth. Soon after extubation he developed severe respiratory distress. Immediate ...