Articles: intubation.
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J Clin Monit Comput · Apr 2021
EditorialThe case for a 3rd generation supraglottic airway device facilitating direct vision placement.
Although 1st and 2nd generation supraglottic airway devices (SADs) have many desirable features, they are nevertheless inserted in a similar 'blind' way as their 1st generation predecessors. Clinicians mostly still rely entirely on subjective indirect assessments to estimate correct placement which supposedly ensures a tight seal. Malpositioning and potential airway compromise occurs in more than half of placements. ⋯ We do not provide technical details of such a '3rd generation' device, but rather present a theoretical analysis of its desirable properties, which are essential to overcome the remaining limitations of current 1st and 2nd generation devices. We also recommend that this further milestone improvement, i.e. ability to place the SAD accurately under direct vision, be eligible for the moniker '3rd generation'. Blind insertion of SADs should become the exception and we anticipate, as in other domains such as central venous cannulation and nerve block insertions, vision-guided placement becoming the gold standard.
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J Clin Monit Comput · Apr 2021
Ultrasound guided tracheal intubation with a styleted tracheal tube in anticipated difficult airway.
Ultrasonography is a simple, reliable, non-invasive technique which helps in real-time assessment of airway anatomy and contributes to safer airway management in various settings like operating rooms, intensive care units and emergency departments. It also helps us to plan the appropriate anesthetic technique especially in difficult airway cases. Here, we discuss the importance of styleted tracheal tube in improving the accuracy of ultrasound guided tracheal intubation in anticipated difficult airway.
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Journal of critical care · Apr 2021
LetterInfluence of respiratory and inflammatory parameters preceding intubation on survival of patients with COVID-19 ARDS- A single centre retrospective analysis.
It remains unclear if intubation and ventilation earlier in the disease course confers a survival advantage in acute respiratory distress syndrome. Our objective was to determine whether patients with COVID-19 who died following mechanical ventilation were more advanced in their disease compared to survivors. ⋯ The rate of fall in SpO2:FiO2 ratio (p = 0.478) and increasing respiratory rate (p = 0.948) prior to IMV were similar between survivors and non-survivors. Our data support a trial of continuous positive airway pressure prior to IMV in patients with moderate-to-severe COVID-19 ARDS.
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Journal of critical care · Apr 2021
Development of a machine learning algorithm to predict intubation among hospitalized patients with COVID-19.
The purpose of this study is to develop a machine learning algorithm to predict future intubation among patients diagnosed or suspected with COVID-19. ⋯ In patients diagnosed or under investigation for COVID-19, machine learning can be used to predict future risk of intubation based on clinical data which are routinely collected and available in clinical setting. Such an approach may facilitate identification of high-risk patients to assist in clinical care.