In this clinical trial 100 children less than 4 years old,who had  underwent non-pharyngeal surgeries in Kerman university hospitals were selected randomly and investigated for early airway complications after tracheal extubation.patients were divided into two groups:the first group(n=50) were extubated while they were still anesthetised and the second group(n=50) were extubated after regaining...

Background Extubation is a more challenging medical practice than intubation, and countermeasures against it are similar to those described in the Difficult Intubation Guidelines, but problems cannot be overcome by completely the same methods. We predicted difficult extubation in a pediatric patient with left recurrent laryngeal nerve paralysis and devised an extubation method. Case presentat...

Extubation failure, defined as the need for reinstitution of ventilatory support within 24 to 72 hours of planned endotracheal tube removal, occurs in 2 to 25% of extubated patients. The pathophysiologic causes of extubation failure include an imbalance between respiratory muscle capacity and work of breathing, upper airway obstruction, excess respiratory secretions, inadequate cough, encephalo...

The search for ideal predictors of successful extubation or “liberation” from mechanical ventilation has been a subject of constant investigation for over half a century. Initial investigations were spurred by the need to determine adequate reversal of paralytic agents after general anesthesia, sufficient to allow sustained spontaneous ventilation and permit extubation.1,2 It is notable that th...

The search for ideal predictors of successful extubation or “liberation” from mechanical ventilation has been a subject of constant investigation for over half a century. Initial investigations were spurred by the need to determine adequate reversal of paralytic agents after general anesthesia, sufficient to allow sustained spontaneous ventilation and permit extubation.1,2 It is notable that th...

OBJECTIVE Endotracheal tube air leak pressures are used to predict postextubation upper airway compromise such as stridor, upper airway obstruction, or risk of reintubation. To determine whether the absence of an endotracheal tube air leak (air leak test >/=30 cm H2O) measured during the course of mechanical ventilation predicts extubation failure in infants and children. DESIGN Prospective, ...

OBJECTIVES Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH2O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomo...

OBJECTIVE Neonates mechanic ventilation weaning has become a major clinical challenge, and constitutes a large portion of neonatal intensive care units workload. The spontaneous breathing trial (SBT), performed immediately before extubation, can provide useful information on the patient's spontaneous breathing ability. This study aimed to assess the SBT effectiveness for extubation success pred...

A 1yr old boy weighing 10 kg underwent cleft palate surgery. Post extubation, a swelling was noticed beneath the tongue which progressed gradually and obstructed airway. Small sized endotracheal tube (ETT) used as nasal airway advanced till it relieved obstruction child started maintaining SpO2 >95%. Haemodynamic parameters were stable shifted from OT to PACU where he observed vigilantly for...

OBJECTIVE To determine the effects of tracheostomy on respiratory mechanics and work of breathing (WOB). DESIGN A before-and-after trial of 20 patients undergoing tracheostomy for repeated extubation failure. SETTING Surgical intensive care unit at a university teaching hospital and a level I trauma center. PATIENTS A consecutive sample of 20 patients who met extubation criteria (Pa(O2), ...