Articles: intubation.
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Randomized Controlled Trial Multicenter Study Comparative Study
ETCare: a randomized, controlled, masked trial comparing two solutions for upper airway care in the NICU.
Small quantities of normal saline are sometimes instilled into the endotracheal tube of intubated neonates, to assist with the removal of thick secretions and maintain patency of the endotracheal tube. However, saline is detrimental to the innate immune system of the upper airway mucosa, rapidly unfolding and inactivating antimicrobial peptides such as LL-37. We previously reported the preparation and feasibility testing of 'ETCare', a low-sodium, physiologically based solution for airway care, and we now report results of a randomized, masked, controlled, two-centered study testing ETCare vs sterile saline among 60 intubated NICU patients. ⋯ On the basis of this study and our previous 10-patient feasibility trial, we maintain that, for airway care, intubated NICU patients tolerate ETCare as well as saline. Data from this study can be used in estimating the sample sizes needed for a phase III trial. We speculate that such a trial will demonstrate that, compared with saline, ETCare will result in fewer nosocomial infections and less chronic lung disease.
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Anaesth Intensive Care · Aug 2007
Multicenter StudyAirway management equipment in a metropolitan region: an audit.
Difficult airway equipment containers are commonly found in operating rooms, but the availability of airway equipment beyond that environment is unknown. Using the Difficult Airway Society (U. K.) and American Society of Anesthesiologists' guidelines, we conducted an inspection audit of airway equipment at all anaesthetic sites in our region. ⋯ One third of the items with an expiry date were expired. Quality control and implementation of airway guidelines could rectify these deficiencies. Anaesthesia organisations should be encouraged to publish detailed equipment guidelines.
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Emerg Med Australas · Jun 2007
Multicenter StudyPractice makes perfect? Evaluation of cricoid pressure task training for use within the algorithm for rapid sequence induction in critical care.
To assess task training in cricoid pressure application suitable for incorporation into the algorithm for rapid sequence induction in acute care. ⋯ The application of cricoid force by critical care staff can be significantly improved by up to 3 min of practice on a simple task trainer.
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Randomized Controlled Trial Multicenter Study
12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial.
The efficacy of corticosteroids in reducing the incidence of postextubation laryngeal oedema is controversial. We aimed to test our hypothesis that methylprednisolone started 12 h before a planned extubation could prevent postextubation laryngeal oedema. ⋯ Methylprednisolone started 12 h before a planned extubation substantially reduced the incidence of postextubation laryngeal oedema and reintubation. Such pretreatment should be considered in adult patients before a planned extubation that follows a tracheal intubation of more than 36 h.
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Paediatric anaesthesia · Feb 2007
Randomized Controlled Trial Multicenter StudyTracheal intubating conditions and pharmacodynamics following cisatracurium in infants and children undergoing halothane and thiopental-fentanyl anesthesia.
The aims of the present study were to determine the tracheal intubating conditions, onset time, duration of action, and hemodynamic responses following the administration of cisatracurium 0.15 mg x kg(-1) to infants and children. ⋯ Cisatracurium 0.15 mg x kg(-1) produces acceptable intubating conditions at 120 s in the great majority of infants and children. Anesthesia background and age have significant effects on intubating conditions and duration of action of cisatracurium.