Ventilation before Paralysis

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Ventilation before Paralysis

To the Editor: I read with great interest the article by Ikeda et al.1 and the accompanying editorial.2 Surprisingly, the editorial did not refer to the recently published findings of a prospectively assessed algorithm for difficult airway management involving 12,225 facemask ventilations (FMV).3 Patients with indications for awake fiberoptic intubation were excluded. In contrary to traditional...

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Noninvasive ventilation or paradigm paralysis?

Current respiratory management paradigms recommend tracheotomy for ventilator-dependent patients. The review by SHNEERSON and SIMONDS [1] published in the European Respiratory Journal on the current use of noninvasive ventilation (NIV) in neuromuscular disorders does little to dispel this paradigm. The authors note that "nasal and face masks are usually the first choice" for NIV interfaces, and...

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Pretended paralysis requiring artificial ventilation.

A 19 year old nurse with a 12 hour history of shaking and weakness of the right hand presented to the accident and emergency department one morning. Flaccid paralysis of the right arm and hand was found. There was no sensory abnormality, but the reflexes were thought to be generally depressed. A history oftwo neurological episodes was obtained: she reported that at the age of 7 she had had a ri...

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Difficult mask ventilation and muscle paralysis.

To the Editor: We read with great interest the study by Ikeda et al.1 and the accompanying editorial.2 It is now increasingly recognized that muscle relaxants are beneficial in overcoming difficult mask ventilation in adults.2–4 However, both current papers are lacking a sufficient discussion of the reasons why muscle relaxation improves difficult mask ventilation. This can primarily be deduced...

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Background: Bungarus caeruleus (common krait) bite during monsoon season is common in northwest India. Respiratory failure is responsible for high mortality in the victims. In this study we report our experience with manual ventilation using bag valve mask (BVM) in patients with neuroparalysis due to common krait bite.  Methods:This prospective study was conducted between June 2009 and December...

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ژورنال

عنوان ژورنال: Anesthesiology

سال: 2012

ISSN: 0003-3022

DOI: 10.1097/aln.0b013e318266868f