Articles: intubation.
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Multicenter Study
A Scottish National Prospective Study of airway management skills in new-start SHOs.
There is increasing concern about the ability of junior anaesthetists to manage the airway correctly and alarm that this may lead to adverse events. ⋯ We recommend that facemask anaesthesia is given a high priority in the formative months and that a target number of intubations should be carried out before providing anaesthesia without direct supervision.
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Critical care medicine · Sep 2006
Comment Multicenter StudyClinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study.
To describe the current practice of physicians, to report complications associated with endotracheal intubation (ETI) performed in THE intensive care unit (ICU), and to isolate predictive factors of immediate life-threatening complications. ⋯ ETI in ICU patients is associated with a high rate of immediate and severe life-threatening complications. Independent risk factors of complication occurrence were presence of acute respiratory failure and presence of shock as an indication for ETI. Further studies should aim to better define protocols for intubation in critically ill patients to make this procedure safer.
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Critical care medicine · Aug 2006
Multicenter StudyReduced breathing variability as a predictor of unsuccessful patient separation from mechanical ventilation.
To compare descriptors of the breath-to-breath respiratory variability during a 60-min spontaneous breathing trial in patients successfully and unsuccessfully separated from the ventilator and the endotracheal tube and to assess the usefulness of these predictors in discriminating these two categories of patients. ⋯ In intensive care unit patients undergoing a spontaneous breathing trial, breathing variability is greater in patients successfully separated from the ventilator and the endotracheal tube. Variability indices are sufficient to separate success from failure cases.
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Multicenter Study Comparative Study Clinical Trial
Comparison of direct and video-assisted views of the larynx during routine intubation.
To compare the direct and indirect (video monitor) views of the glottic opening using a new Macintosh blade that is modified to provide a video image of airway structures during laryngoscopy. ⋯ Video-assisted laryngoscopy provides an improved view of the larynx, as compared with direct visualization. This technique may be useful for cases of difficult intubation and reintubation as well as for teaching laryngoscopy and intubation.
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Am. J. Respir. Crit. Care Med. · Jul 2006
Randomized Controlled Trial Multicenter StudyNoninvasive ventilation improves preoxygenation before intubation of hypoxic patients.
Critically ill patients are predisposed to oxyhemoglobin desaturation during intubation. ⋯ For the intubation of hypoxemic patients, preoxygenation using NIV is more effective at reducing arterial oxyhemoglobin desaturation than the usual method.