E64 CMAJ, March 1, 2016, 188(4) ©2016 8872147 Canada Inc. or its licensors A psychiatrist was found guilty of sexually abusing his patient and the patient was awarded $550 000 in damages, but a New Brunswick court ruled she’s not entitled to compensation from the Canadian Medical Protective Association (CMPA), which provides liability coverage to physicians. Now the patient is suing the New Bru...

First, it is important to understand that the effects of increasing atmospheric carbon dioxide content are uncertain, and may be as much as an order of magnitude less than is assumed by the computer models. The strength of various feedback effects is also uncertain. But the most important point is that computer models of the state of climate in 100 years’ time are viewed by their creators as sc...

Introduction. Stroke patients often meet respiratory guidelines for extubation, but uncertainty exists if patients will protect their airway due to impaired mental status. Patients with middle cerebral artery (MCA) acute ischemic stroke (AIS) might have specific predictors of successful extubation. Methods. Retrospective cohort of MCA AIS patients requiring intubation. Results. Thirty-seven MCA...

BACKGROUND Post-extubation laryngospasm is a dangerous complication that should be managed promptly. Standard measures were described for its management. We aimed to compare the efficacy of propofol (0.5mg.kg-1) vs. lidocaine (1.5mg.kg-1) for treatment of resistant post-extubation laryngospasm in the obstetric patients, after failure of the standard measures. METHOD This study was conducted o...

BACKGROUND Hemodynamic changes and respiratory tract complications are often followed by tracheal extubation. These events may be dangerous in neurosurgical patients and those with cardiovascular disease or at an old age. OBJECTIVES The aim of this study is to investigate the attenuation of cardiovascular responses and upper airway events resulting from tracheal extubation by low dose propofo...

BACKGROUND Children with obstructive sleep apnea (OSA) have a higher rate of adverse post-extubation respiratory events, such as laryngospasm, upper airway obstruction, apnea, desaturation and/or need for re-intubation. They are overly sensitive to sedatives and narcotics. Although the etiology of OSA is primarily obstruction (mechanical or neuromuscular), a central element may contribute to OS...

Current recommendations for management of obese patients post-extubation are based on clinical experience and expert opinions. It was hypothesised that the application of noninvasive ventilation (NIV) during the first 48 h after extubation in severely obese patients would reduce post-extubation failure and avert the need for reintubation. Following protocol-driven weaning trials, 62 consecutive...

Early and successful extubation prevents several morbidities in preterm newborns. Several secondary non-invasive respiratory modalities exist but with their merits demerits. Given the benefits of nasal high-frequency oscillatory ventilation (nHFOV), we tried to examine whether nHFOV could reduce reintubation rates compared intermittent positive pressure (NIPPV) during post-extubation phase infa...

BACKGROUND Mortality increases when extubations fail. Although predictors of extubation failure have been evaluated, physicians' reasoning to extubate a patient has received minimal attention. We hypothesized that the accuracy and reliability of physicians' extubation decisions are low. METHODS We sent surveys to 55 physicians in the divisions of pulmonary and critical care medicine of 3 teac...