Articles: intubation.
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Review Meta Analysis
Airway devices for awake tracheal intubation in adults: a systematic review and network meta-analysis.
Awake tracheal intubation is commonly performed with flexible bronchoscopes, but the emerging role of alternative airway devices, such as videolaryngoscopes, direct laryngoscopes, and optical stylets, has been recognised. ⋯ Flexible bronchoscopes, optical stylets, and channelled and unchannelled videolaryngoscopes were clinically comparable airway devices in the setting of awake trachela intubation and the time to tracheal intubation was shortest with optical stylets and longest with flexible bronchoscopes.
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Acta Anaesthesiol Scand · Oct 2021
Multicenter StudyPre-hospital emergency anaesthesia in trauma patients treated by anaesthesiologist and nurse anaesthetist staffed critical care teams.
Pre-hospital tracheal intubation in trauma patients has recently been questioned. However, not only the trauma and patient characteristics but also airway provider competence differ between systems making simplified statements difficult. ⋯ Pre-hospital tracheal intubation success and complication rates in trauma patients were comparable with in-hospital rates in a system with very experienced airway providers. Whether the short scene times contributed to a low pre-hospital mortality needs further investigation in future studies.
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Critical care medicine · Oct 2021
Meta AnalysisProne Positioning of Nonintubated Patients With Coronavirus Disease 2019-A Systematic Review and Meta-Analysis.
Several studies have reported prone positioning of nonintubated patients with coronavirus diseases 2019-related hypoxemic respiratory failure. This systematic review and meta-analysis evaluated the impact of prone positioning on oxygenation and clinical outcomes. ⋯ Despite the significant variability in frequency and duration of prone positioning and respiratory supports applied, prone positioning was associated with improvement in oxygenation variables without any reported serious adverse events. The results are limited by a lack of controls and adjustments for confounders. Whether this improvement in oxygenation results in meaningful patient-centered outcomes such as reduced intubation or mortality rates requires testing in well-designed randomized clinical trials.
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Pediatric emergency care · Oct 2021
ReviewEfficacy of Apneic Oxygenation During Pediatric Endotracheal Intubation.
Because of the abundance of complications associated with peri-intubation hypoxia, maintaining adequate oxygen saturation during endotracheal intubation (ETI) is of great concern. In addition to standard preoxygenation techniques, apneic oxygenation (AO), the continuous flow of passive oxygenation, is a potential tool that can be used to eliminate hypoxia during ETI. Although scarcely studied in the pediatric population, AO has proven effective in reducing the incidence of hypoxia in adult patients with minimal side effects. The objective of this study is to evaluate the use of apneic oxygenation in pediatric patients and to determine its efficacy in preventing or delaying oxygen desaturation during the apneic period of ETI. ⋯ The findings in this study confirm that the practice of AO is not only efficacious in increasing the time until initial desaturation but also reduces the overall incidence of hypoxia during laryngoscopy in children.
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Int. J. Clin. Pract. · Oct 2021
Randomized Controlled Trial Clinical TrialNasogastric Tube Insertion in intubated patients with the guide of Wire rope: A Prospective Randomized Controlled Study.
Nasogastric tube (NGT) insertion is sometimes required in intubated patients. NGTs are prone to kink and coil during blind insertion. We hypothesised that wire rope guide-assisted NGT insertion with chin lift can significantly improve the first-attempt success rate over the conventional technique during its insertion in intubated patients. ⋯ The use of rope wire guide for correct positioning of the NGT in intubated patients is less time-consuming with the high first-attempt success rate and lower incidence of procedure-related injuries compared to the conventional method.