Tracheal extubation and reintubation of the critically ill - challenges coming and going
نویسندگان
چکیده
Tracheal reintubation is a common event in critical care. Elmer and colleagues provide the first comparison of complication rates of initial and subsequent reintubation(s) during the same hospitalization. Their work shows an increased risk of complications associated with reintubation, in particular hypoxemia and hypotension, reminding us to be cautious with patients having minimal reserve and potentially altered airway anatomy. See related research by Elmer et al., http://ccforum.com/content/19/1/12.
منابع مشابه
Occurrence and complications of tracheal reintubation in critically ill adults.
BACKGROUND Timing and preparation for tracheal extubation are as critical as the initial intubation. There are limited data on specific strategies for a planned extubation. The extent to which the difficult airway at reintubation contributes to patient morbidity is unknown. The aim of the present study was to describe the occurrence and complications of failed extubation and associated risk fa...
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Introduction Critically ill mechanically ventilated patients are usually stratified in two levels according to the risk for reintubation. In low-risk patients high flow conditioned oxygen therapy (HFO) may reduce reintubation, whereas in high-risk patients non-invasive mechanical ventilation (NIMV) to prevent reintubation is gaining acceptance. However, data on the efficacy or safety of HFO in ...
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Laryngeal edema is a frequent complication of intubation. It often presents shortly after extubation as post-extubation stridor and results from damage to the mucosa of the larynx. Mucosal damage is caused by pressure and ischemia resulting in an inflammatory response. Laryngeal edema may compromise the airway necessitating reintubation. Several studies show that a positive cuff leak test combi...
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