BACKGROUND Patients who have undergone cardiac surgery are generally mechanically ventilated postoperatively. Early postoperative extubation is currently recommended in anesthesia guidelines. No current technology can accurately, non-invasively, measure respiratory competence after extubation. Pulse oximetry has been helpful, but this is a late indicator of respiratory compromise. A novel, non-...

INTRODUCTION Prolonged ventilation and failed extubation are associated with increased harm and cost. The added value of heart and respiratory rate variability (HRV and RRV) during spontaneous breathing trials (SBTs) to predict extubation failure remains unknown. METHODS We enrolled 721 patients in a multicenter (12 sites), prospective, observational study, evaluating clinical estimates of ri...

A trial of the Nellcor Stat Cap, which detects exhaled carbon dioxide, as an aid to determining whether endotracheal tubes are placed in the oesophagus or the trachea, was carried out in the neonatal unit of this hospital. Twenty five neonates, with a mean (range) gestational age of 33 (24-42) weeks and a mean (range) birthweight of 2.17 (0.54-4.1) kg were studied over two months. These babies ...

OBJECTIVE To determine whether postextubation respiratory support via heated, humidified, high-flow nasal cannulae (HHHFNC) results in a greater proportion of infants younger than 32 weeks' gestation being successfully extubated after a period of endotracheal positive pressure ventilation compared with conventional nasal continuous positive airway pressure (NCPAP). STUDY DESIGN We randomly as...

BACKGROUND It remains to be clarified if the application of noninvasive positive pressure ventilation (NPPV) is effective after extubation in patients with hypoxemic respiratory failure who require the sufficient level of positive end-expiratory pressure (PEEP). This study was aimed at examining the effect and the safety of NPPV application following extubation in patients requiring moderate PE...

INTRODUCTION Extubation failure has been associated with poor intensive care unit (ICU) and hospital outcomes in tertiary care medical centers. Given the large proportion of critical care delivered in the community setting, our purpose was to determine the impact of extubation failure on patient outcomes in a community hospital ICU. METHODS A retrospective cohort study was performed using dat...

INTRODUCTION Acute pain is common during the endotracheal extubation period, and is related to complications and adverse outcomes. Patients with delayed extubation after craniotomy are vulnerable to pain and complications of extubation. However, pain control during extubation is still inadequate. Remifentanil, a new opioid with rapid onset and short duration of action, provides adequate analges...

OBJECTIVE The objective of our study was to determine the feasibility of early extubation and to identify the risk factors for delayed extubation in pediatric patients operated for ventricular septal defect closure. METHODS A prospective, observational study was carried out at our Institute. This study involved consecutive 135 patients undergoing ventricular septal defect closure. Patients we...

Stridor is one of the most frequent causes of early extubation failure. The cuff-leak test may help to identify patients at risk to develop post-extubation laryngeal edema. However the discrimination power of the cuff-leak test is highly variable and can be use, at best, to detect patients at risk to develop edema but should not be used to postpone extubation as tracheal extubation can still be...

BACKGROUND Little research has been conducted to validate pain assessment tools in critical care, especially for patients who cannot communicate verbally. OBJECTIVE To validate the Critical-Care Pain Observation Tool. METHODS A total of 105 cardiac surgery patients in the intensive care unit, recruited in a cardiology health center in Quebec, Canada, participated in the study. Following sur...