N Engl J Med 2014;370:e4. DOI: 10.1056/NEJMvcm1300964 Copyright © 2014 Massachusetts Medical Society. Overview Endotracheal extubation refers to the removal of an endotracheal tube from the trachea. This procedure is commonly performed in operating rooms, postanesthesia care units, and intensive care units. This review focuses on extubation of the trachea after general anesthesia and short-term...

OBJECTIVE Endotracheal tube air leak pressures are used to predict postextubation upper airway compromise such as stridor, upper airway obstruction, or risk of reintubation. To determine whether the absence of an endotracheal tube air leak (air leak test >/=30 cm H2O) measured during the course of mechanical ventilation predicts extubation failure in infants and children. DESIGN Prospective, ...

CEN, CFRN, CPEN, and Tom Pietrantonio, BSRT, RRT-RCP, reply: In a study published in Respiratory Care, Shimizu et al3 concluded that the conventional adhesive tape methods had greater extubation force than the 2 endotracheal tube holders and that extubation force varies considerably depending on the width, length, and type of adhesive tape used. Mohammed and Hassan4 studied endotracheal tube sl...

Insufficient cough strength has a major role in extubation and decannulation outcomes. Cough capacity can be easily evaluated by measuring flows during coughing. Values vary depending on whether cough flows are measured through the mouth or through a tracheostomy or endotracheal tube. It is important to standardize these measurements and start using them routinely in the extubation and decannul...

Background: General anesthesia is an essential component of and endotracheal intubation a basic step to secure the airway in patients undergoing any surgical procedure. Airway manipulation causes mucosal inflammation resulting coughing, straining, bucking subsequent distress patient. Aim: To find out whether preemptive use nebulized lignocaine has some role tube tolerance during anesthetic indu...

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, ...

1. Davila VR, Schwab C, Papadimos TJ, Casabianca AB. A difficult extubation: Endotracheal tube ensnarement by a Kirschner wire. Int J Crit Illn Inj Sci 2015;5:128-9. 2. Dryden GE. Circulatory collapse after pneumonectomy (an unusual complication from the use of a Carlens catheter): Case report. Anesth Analg 1977;56:451-2. 3. Suresh YV, Mehandale SG, Vijesh KS. Difficult extubation – A case repo...

BACKGROUND Identifying patients at high risk of post-extubation acute respiratory failure requiring respiratory or mechanical cough assistance remains challenging. Here, our primary aim was to evaluate the accuracy of easily collected parameters obtained before or just after extubation in predicting the risk of post-extubation acute respiratory failure requiring, at best, noninvasive mechanical...

Background: The unplanned departure of endotracheal tube is one of the main complications for endotracheal intubation. In addition to endotracheal extubation, its movement can also lead to damage to the oral cavity. Stabilizing endotracheal tube is the most important factor that can prevent unplanned departure of endotracheal tube as well as its movement. The current study was done with the aim...