Articles: intubation.
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For routine anaesthesia in ASA 1 & 2 patients a 6.0-7.0 mm ETT is probably the best balance between ventilation needs and airway trauma.
pearl -
Review Meta Analysis
Impact of nicotine/smoking, alcohol, and illicit substance use on outcomes and complications of burn patients requiring hospital admission: systematic review and meta-analysis.
Burn patients admitted to the hospital with concurrent intoxication are believed to be at an increased risk of poor outcomes and the development of complications, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications between nicotine/smoking, alcohol, and/or substance use in 26,512 burn patients admitted to the hospital to 299,543 burn patients admitted without these characteristics. The PubMed, EMBASE, Cochrane Library, and Web of Science databases were systematically and independently searched. ⋯ Patients using nicotine/smoking were associated with higher rates of intubation and wound/local skin infections. Patients consuming alcohol were associated with more days on a ventilator, had higher rates of intubation, higher rates of inhalation injury, longer ICU LOS, and increased mortality. Patients taking substances were associated with higher %TBSA (percent total body surface area) of burns, longer hospital LOS, higher rates of intubation, higher rates of inhalation injury, longer ICU LOS, and increased wound/local skin infections.
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Otolaryngol Head Neck Surg · Nov 2020
Case ReportsThe Difficult Airway and Aerosol-Generating Procedures in COVID-19: Timeless Principles for Uncertain Times.
The impact of the COVID-19 pandemic on otolaryngology practice is nowhere more evident than in acute airway management. Considerations of preventing SARS-CoV-2 transmission, conserving personal protective equipment, and prioritizing care delivery based on acuity have dictated clinical decision making in the acute phase of the pandemic. With transition to a more chronic state of pandemic, heightened vigilance is necessary to recognize how deferral of care in patients with tenuous airways and COVID-19 infection may lead to acute airway compromise. ⋯ Teams should consider trade-offs among aerosol-generating procedures involving direct laryngoscopy, supraglottic airway use, fiberoptic intubation, and tracheostomy. We share clinical cases that illustrate enduring principles of acute airway management. As algorithms evolve, time-honored approaches for diagnosis and management of acute airway pathology remain essential in ensuring patient safety.