Despite a thorough weaning assessment, including a spontaneous breathing trial (SBT), liberation from mechanical ventilation via endotracheal extubation is associated with re-intubation rates of up to 24%.1 Re-intubation, in turn, is associated with an increased risk of mortality, intensive care unit (ICU) stay, need for transfer to longterm care facility,2 and nosocomial pneumonia.3 Avoiding r...

OBJECTIVE To evaluate the performance of an extubation readiness test based on a spontaneous breathing trial using pressure support. DESIGN Retrospective chart review. SETTING Pediatric intensive care unit. PATIENTS All infants and children admitted to the pediatric intensive care unit requiring intubation from July 2007 to December 2008 were eligible for this study. INTERVENTIONS Routi...

BACKGROUND Midlatency auditory evoked potentials (MLAEP) are a promising tool for monitoring suppression of sensory processing during anaesthesia and might help to avoid awareness. MLAEP in children are different to those in adults and the exact changes during general anaesthesia are unknown. METHODS In 49 children of age between 2 and 12 yr, MLAEP were recorded before anaesthesia, during tra...

Methods A historical cohort study was conducted in a mixed intensive care unit with 40 beds at a University Centre. Patients analyzed were those admitted between 2010 and 2014, over the age of 16 years, with invasive mechanical ventilation for more than 24 hours and who overcome a spontaneous breath testing (SBT). Predictive variables: age, gender, days of intubation, length of intravenous seda...

BACKGROUND The effectiveness of noninvasive ventilation (NIV) after extubation in preventing post-extubation respiratory failure is still controversial. METHODS We conducted a prospective, multicenter randomized controlled study involving patients on mechanical ventilation for > 48 hours who tolerated a 2-hour spontaneous breathing trial and were subsequently extubated. The patients were ran...

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...

Tracheobronchomalacia (TBM) is characterized by weakness of cartilaginous supporting structures of tracheal and bronchial walls, resulting in central airway obstruction. It is a rare condition that can occur after prolonged intubation. Here, we report a 26-year-old, alcoholic male who had TBM, mild subglottic, and severe tracheal stenosis following 2 weeks of intubation. Subglottic and tracheal...

Sedation is generally required during endotracheal intubation and mechanical ventilation in infants and children. While there are many options for the provision of sedation, the most commonly used agents such as midazolam and fentanyl demonstrate a context-sensitive half-life, which may result in a prolonged effect when these agents are discontinued following a continuous infusion. We present a...

Blind nasal intubation has been one of the favoured methods of intubating the trachea in patients with restricted mouth opening and thus a difficult laryngoscopy and oro-tracheal intubation. Here, we describe airway management of patient who presented with traumatic ankylosis of the right temporomandibular joint and reduced mouth opening that was planned for elective release of the ankylosis an...