Articles: intubation.
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Multicenter Study
Association Between Neuromuscular Blocking Agents and Outcomes of Emergency Tracheal Intubation: A Secondary Analysis of Randomized Trials.
To examine the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt and severe complications during tracheal intubation of critically ill adults in an emergency department (ED) or ICU. ⋯ Among critically ill adults undergoing tracheal intubation, the incidences of successful intubation on the first attempt and severe complications were not significantly different between patients who received succinylcholine and patients who received rocuronium.
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Critical care medicine · Jan 2025
Multicenter StudyDiabetes Mellitus Is Not a Risk Factor for Difficult Intubation Among Critically Ill Adults: A Secondary Analysis of Multicenter Trials.
Diabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults. ⋯ Among 2654 critically ill patients undergoing tracheal intubation in an ED or an ICU, diabetes mellitus was not independently associated with the time from induction to intubation, the probability of successful intubation on the first attempt, or the rate of complications during intubation.
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Multicenter Study
A two-person verbal check to confirm tracheal intubation: evaluation of practice changes to prevent unrecognised oesophageal intubation.
Deaths from unrecognised oesophageal intubation continue despite national campaigns emphasising the importance of capnography to confirm tracheal intubation. A two-person verbal intubation check is recommended in consensus guidelines intended to prevent such deaths. This check can be performed by the intubator with their assistant, either as a one-step process (identification of sustained exhaled carbon dioxide) or as a two-step process (adding identification of the tracheal tube passing through the vocal cords during videolaryngoscopy). ⋯ Our results suggest that a two-person verbal intubation check is feasible and acceptable to all members of the intubating team.
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Multicenter Study
Evaluation of the i-gel® Plus supraglottic airway device in elective surgery: a prospective international multicentre study.
The i-gel® Plus is a modified version of the i-gel® supraglottic airway device. It contains a wider drainage port; a longer tip; ramps inside the breathing channel; and an additional port for oxygen delivery. There has been no prospective evaluation of this device in clinical practice. ⋯ The i-gel Plus appears to be an effective supraglottic airway device that is associated with a high insertion success rate and a reasonably low incidence of complications.
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Multicenter Study
Lung parenchymal and pleural findings on computed tomography after out-of-hospital cardiac arrest.
Lung injury and the acute respiratory distress syndrome (ARDS) are common after out-of-hospital cardiac arrest (OHCA), but the imaging characteristics of lung parenchymal and pleural abnormalities in these patients have not been well-characterized. We aimed to describe the incidence of lung parenchymal and pleural findings among patients who had return of spontaneous circulation (ROSC) and who underwent computed tomography (CT) of the chest after OHCA. ⋯ Over three-quarters of patients who survived to the hospital post OHCA and received a chest CT had lung parenchymal or pleural abnormalities, the most common of which were aspiration, pulmonary edema, and consolidation/pneumonia. Future planned research will characterize the clinical impact of these findings and whether early chest CT could identify patients at risk for ARDS or other pulmonary complications.