Articles: intubation.
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Pediatr Crit Care Me · Apr 2023
Observational StudyUnplanned Extubations Requiring Reintubation in Pediatric Critical Care: An Epidemiological Study.
Unplanned extubations are an infrequent but life-threatening adverse event in pediatric critical care. Due to the rarity of these events, previous studies have been small, limiting the generalizability of findings and the ability to detect associations. Our objectives were to describe unplanned extubations and explore predictors of unplanned extubation requiring reintubation in PICUs. ⋯ Predictors associated with increased risk of reintubation included age and respiratory primary diagnosis. Including clinical factors (e.g., oxygen and ventilatory requirements at the time of unplanned extubation) in the model may increase predictive ability.
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Anesthesia and analgesia · Apr 2023
Pro-Con Debate: Videolaryngoscopy Should Be Standard of Care for Tracheal Intubation.
In this Pro-Con commentary article, we discuss whether videolaryngoscopy (VL) should be the standard of care for tracheal intubation. Dr Aziz makes the case that VL should be the standard of care, while Dr Berkow follows with a challenge of that assertion. In this debate, we explore not only the various benefits of VL, but also its limitations. ⋯ While cost is a barrier to broad implementation of VL, those costs are normalizing. However, it may still be challenging for institutions to secure purchase of VL for every intubating location, as well as back-up airway devices. As airway management care increasingly transitions from DL to VL, providers should be aware of the benefits and risks to this practice change.
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Ulus Travma Acil Cerrahi Derg · Apr 2023
Observational StudyWhich test best predicts difficult endotracheal intubation? A prospective cohort study.
It is critical to identify patients whose intubation will be difficult to ensure that necessary precautions are taken. In this study, we aimed to show the power of almost all tests used to predict difficult endotracheal intubation (DEI), and to determine which test are more accurate for this purpose. ⋯ Despite comparing 22 tests, the results obtained in this study cannot definitively identify any single test that pre-dicts difficult intubation. Nonetheless, our results show that MHD (high sensitivity and negative predictive value) and AOJMT (high specificity and positive predictive value) are the most useful tests to predict difficult intubation.
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Acta clinica Croatica · Apr 2023
Comparative StudyLARYNGEAL MASK AIRWAY VERSUS ENDOTRACHEAL INTUBATION FOR ADENOIDECTOMY IN OUTPATIENT SURGERY - SINGLE CENTER EXPERIENCE.
Adenoidectomy with or without tonsillectomy remains one of the most routinely performed surgical procedures in children. The duration of the procedure is usually less than half an hour and is done in a day surgery setting. Airway management for adenoidectomy can be especially challenging as the airway is shared between the surgeon and the anesthesiologist. ⋯ The need for neuromuscular blockers was also lower in the LMA group (p=0.01). There was no statistically significant difference in the intraoperative dose of opioid analgesia (p=0.09). Flexible LMA is a satisfactory alternative to endotracheal intubation for outpatient pediatric adenoidectomy.