Articles: intubation.
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Multicenter Study
Risk factors for extubation failure in patients following a successful spontaneous breathing trial.
To assess the factors associated with reintubation in patients who had successfully passed a spontaneous breathing trial. ⋯ Among routinely measured clinical variables, RSBI, positive fluid balance 24 h prior to extubation, and pneumonia at the initiation of ventilation were the best predictors of extubation failure. However, the combined predictive ability of these variables was weak.
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Critical care medicine · Nov 2006
Randomized Controlled Trial Multicenter StudyReduced burden of bacterial airway colonization with a novel silver-coated endotracheal tube in a randomized multiple-center feasibility study.
To assess the feasibility and safety of the respiratory infection control (RIC) device, a silver-coated endotracheal tube, and its effect on bacterial burden in the airways. ⋯ In this prospectively planned, preliminary analysis, the RIC device was feasible and well tolerated. Larger studies are needed to determine whether delayed colonization, reduced colonization rate, and decreased bacterial burden will decrease the incidence of ventilator-associated pneumonia.
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Pediatric emergency care · Nov 2006
Multicenter StudySurvey of parental willingness to pay and willingness to stay for "painless" intravenous catheter placement.
This study examined how much parents are willing to pay and/or willing to stay to make their child's intravenous (IV) catheter placement painless. ⋯ Parents are willing to spend both time and money to make their child's IV placement painless. This information should be considered when choosing therapies to reduce the pain of IV placement.
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Intensive care medicine · Nov 2006
Multicenter StudyIncreased use of noninvasive ventilation in French intensive care units.
A prospective survey of French intensive care units (ICUs) in 1997 showed moderate and variable use of noninvasive ventilation (NIV). This study examined changes in NIV use in French ICUs after the intervening 5years. ⋯ NIV use has significantly increased in French ICUs during the past 5years, and the success rate has remained unchanged. In patients not previously intubated, NIV is the leading first-line ventilation modality. The proportion of patients successfully treated with NIV increased significantly over the 5-year period (13% vs. 9% of all patients receiving ventilatory support).
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Randomized Controlled Trial Multicenter Study
Premedication for nonemergent neonatal intubations: a randomized, controlled trial comparing atropine and fentanyl to atropine, fentanyl, and mivacurium.
The purpose of this work was to investigate whether using a muscle relaxant would improve intubation conditions in infants, thereby decreasing the incidence and duration of hypoxia and time and number of attempts needed to successfully complete the intubation procedure. ⋯ Premedication with atropine, fentanyl, and mivacurium compared with atropine and fentanyl without a muscle relaxant decreases the time and number of attempts needed to successfully intubate while significantly reducing the incidence of severe desaturation. Premedication including a short-acting muscle relaxant should be considered for all nonemergent intubations in the NICU.