scholarly journals A modified bicanalicular intubation procedure to repair canalicular lacerations using silicone tubes

Eye ◽  
2012 ◽  
Vol 26 (12) ◽  
pp. 1542-1547 ◽  
Author(s):  
X Liang ◽  
Y Lin ◽  
Z Wang ◽  
L Lin ◽  
S Zeng ◽  
...  
Keyword(s):  
Intubation Procedure

scholarly journals Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients

2018 ◽  
Vol 46 (4) ◽  
pp. 532-539 ◽  
Author(s):  
Audrey De Jong ◽  
Amélie Rolle ◽  
Nicolas Molinari ◽  
Catherine Paugam-Burtz ◽  
Jean-Michel Constantin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Critically Ill ◽  
Adult Patients ◽  
Intubation Procedure

scholarly journals Noninvasive ventilation vs. high-flow nasal cannula oxygen for preoxygenation before intubation in patients with obesity: a post hoc analysis of a randomized controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maeva Rodriguez ◽  
Stéphanie Ragot ◽  
Rémi Coudroy ◽  
Jean-Pierre Quenot ◽  
Philippe Vignon ◽  
...  
Keyword(s):  
Noninvasive Ventilation ◽  
Controlled Trial ◽  
High Flow ◽  
Severe Hypoxemia ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Post Hoc ◽  
Intubation Procedure

Abstract Background Critically ill patients with obesity may have an increased risk of difficult intubation and subsequent severe hypoxemia. We hypothesized that pre-oxygenation with noninvasive ventilation before intubation as compared with high-flow nasal cannula oxygen may decrease the risk of severe hypoxemia in patients with obesity. Methods Post hoc subgroup analysis of critically ill patients with obesity (body mass index ≥ 30 kg·m−2) from a multicenter randomized controlled trial comparing preoxygenation with noninvasive ventilation and high-flow nasal oxygen before intubation of patients with acute hypoxemic respiratory failure (PaO2/FiO2 < 300 mm Hg). The primary outcome was the occurrence of severe hypoxemia (pulse oximetry < 80%) during the intubation procedure. Results Among the 313 patients included in the original trial, 91 (29%) had obesity with a mean body mass index of 35 ± 5 kg·m−2. Patients with obesity were more likely to experience an episode of severe hypoxemia during intubation procedure than patients without obesity: 34% (31/91) vs. 22% (49/222); difference, 12%; 95% CI 1 to 23%; P = 0.03. Among patients with obesity, 40 received preoxygenation with noninvasive ventilation and 51 with high-flow nasal oxygen. Severe hypoxemia occurred in 15 patients (37%) with noninvasive ventilation and 16 patients (31%) with high-flow nasal oxygen (difference, 6%; 95% CI − 13 to 25%; P = 0.54). The lowest pulse oximetry values during intubation procedure were 87% [interquartile range, 77–93] with noninvasive ventilation and 86% [78–92] with high-flow nasal oxygen (P = 0.98). After multivariable analysis, factors independently associated with severe hypoxemia in patients with obesity were intubation difficulty scale > 5 points and respiratory primary failure as reason for admission. Conclusions Patients with obesity and acute hypoxemic respiratory failure had an increased risk of severe hypoxemia during intubation procedure as compared to patients without obesity. However, preoxygenation with noninvasive ventilation may not reduce this risk compared with high-flow nasal oxygen. Trial registration Clinical trial number: NCT02668458 (http://www.clinicaltrials.gov)

scholarly journals Impact of aerosol enclosure barrier to videolaryngoscopic oro-tracheal intubation: A pilot manikin study

2020 ◽  
pp. 102490792096530
Author(s):  
Hui Chun Fai ◽  
Li Alex ◽  
Wong Chi Keung Gordon
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Healthcare Workers ◽  
Negative Impact ◽  
Cost Effective ◽  
Successful Intubation ◽  
Dental Injury ◽  
Significant Difference ◽  
Negative Effect ◽  
Intubation Procedure

Background: Personal protective equipment used for protection of healthcare workers in the combat against Severe Acute Respiratory Syndrome Coronavirus 2 pandemic is in limited supply worldwide at present – 2020. Use of barrier enclosure during endotracheal intubation can potentially act as a cost-effective adjunct to minimize risks of transmitting the infection to healthcare workers. However, there is concern that the enclosure itself will act as a barrier to the intubation procedure in the emergency settings. Objective: To evaluate the negative effect of barrier enclosure (an aerosol box) on the performance of video-assisted intubation in a manikin Methods: A total of 41 Emergency Department doctors from a local hospital were recruited to perform intubation in a manikin simulating normal and more difficult airways (Cormack-Lehane grades I and IIb) with and without the box. The primary outcome was time of successful intubation. The secondary outcomes were first-attempt success rate, number of successful attempts, need of adjuncts, dental injury and ease of intubation as perceived by the participants. Results: The aerosol box had no significant negative effect on the time of successful intubation (p = 0.630 (Grade I airway) and p = 0.436 (Grade IIb airway)), first-attempt success rate, number of successful attempts, need of adjuncts or dental injury. Participants subjectively reported extra yet minor challenges during intubation in the presence of the box. Conclusion: Within limits of the pilot study, the aerosol box had no statistical significant difference but an increasing trend of prolonged endotracheal intubation interval in the Grade IIb airway and negative impact on first-pass success, and could potentially be used to protect healthcare workers during the aerosol-generating intubation procedure.

scholarly journals Comparison of hypoxemia, intubation procedure, and complications for non-invasive ventilation against high-flow nasal cannula oxygen therapy for patients with acute hypoxemic respiratory failure: a non-randomized retrospective analysis for effectiveness and safety (NIVaHIC-aHRF)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chao Zhang ◽  
Min Ou
Keyword(s):  
Respiratory Failure ◽  
Oxygen Therapy ◽  
High Flow ◽  
Severe Hypoxia ◽  
Invasive Ventilation ◽  
Severe Hypoxemia ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen ◽  
Intubation Procedure

Abstract Background Optimization of preoxygenation procedure can help to secure the method of intubation by reducing the risks of severe hypoxemia and other problems. There is confusion for efficacy of non-invasive ventilation compared to high-flow oxygen therapy regarding occurrence of severe hypoxemia during the intubation procedure. The purpose of the study was to compare the difference between noninvasive ventilation and high flow oxygen therapy to prevent desaturation during laryngoscopy. Methods Patients underwent high-flow nasal cannula oxygen therapy (HCO cohort, n = 161) or non-invasive ventilation procedure (NIV cohort, n = 154) for oxygenation and ventilation due to acute hypoxemic respiratory failure in the intensive care unit. Data before preoxygenation, preoxygenation, intubation, laryngoscopy, and complications of patients due to tracheal intubation were retrospectively collected and analyzed. Results There was no difference between both cohorts for the demographical and clinical conditions of the patients before preoxygenation (p > 0.05 for all parameters), numbers of patients with severe hypoxia during the intubation procedure (35 vs. 45, p = 0.303), the time duration of laryngoscopy (p = 0.847), number of laryngoscopies attempts (p = 0.804), and immediate and late complications during the intubation procedure. The values of pulse oximetry were reported higher for patients of NIV cohort than those of HCO cohort during preoxygenation. Fewer numbers of patients were reported with severe hypoxia among patients of the NIV cohort than those of the HCO cohort (24 vs., 40, p = 0.042) who have moderate-to-severe hypoxemia (partial pressure of arterial oxygen to fraction of inspired oxygen ratio ≤ 200 mmHg) before preoxygenation. The most common complications were hypertension, pulmonary aspiration, and increased 30-day mortality. Conclusions When compared, there was no difference between non-invasive ventilation technique and high-flow oxygen therapy to minimize severe hypoxia prior to laryngoscopy and endotracheal intubation in patients with acute respiratory failure.

scholarly journals Laryngeal Radiation Fibrosis: A Case of Failed Awake Flexible Fibreoptic Intubation

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Johannes M. Huitink ◽  
Lambert Zijp
Keyword(s):  
Airway Management ◽  
Gold Standard ◽  
Fibreoptic Intubation ◽  
Clinical Symptoms ◽  
Severe Case ◽  
Intubation Technique ◽  
Radiation Fibrosis ◽  
Radiation Induced ◽  
Induced Changes ◽  
Intubation Procedure

Awake fibreoptic intubation is accepted as the gold standard for intubation of patients with an anticipated difficult airway. Radiation fibrosis may cause difficulties during the intubation procedure. We present an unusual severe case of radiation induced changes to the larynx, with limited clinical symptoms, that caused failure of the fibreoptic intubation technique. A review of the known literature on radiation fibrosis and airway management is presented.

scholarly journals Laryngeal perforation during a standard intubation procedure in a pig

2012 ◽  
Vol 46 (3) ◽  
pp. 261-263 ◽  
Author(s):  
R Steinbacher ◽  
S von Ritgen ◽  
Y P S Moens
Keyword(s):  
Case Report ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Animal Research ◽  
Present Case Report ◽  
Laryngeal Anatomy ◽  
Intubation Procedure

Pigs are frequently anaesthetized in animal research settings. Due to the unique laryngeal anatomy, endotracheal intubation is demanding in pigs. Several complications associated with endotracheal intubation have been reported in pigs, but laryngeal perforation following difficult intubation has not been documented so far. The present case report describes laryngeal perforation in a three-month-old pig following difficult intubation.

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