Tracheal extubation in both the critical care and anesthesia setting is not only an important milestone for patient recovery, but also a procedure that carries a considerable risk of complication or failure. Mechanical ventilation is associated with significant complications that are time-dependent in nature, with a longer duration of intubation resulting in a higher incidence of complications,...

Introduction Pro: Every Mechanically Ventilated Patient Should Be Monitored With Capnography From Intubation to Extubation Endotracheal Intubation Preventing Mishaps Operating Room Setting Physiology of the Arterial-Versus-End-Tidal CO2 Difference Carbon Dioxide Elimination Management of Positive End-Expiratory Pressure Alveolar V̇E Minimizing the Duration of Mechanical Ventilation Acute Respira...

N Engl J Med 2014;370:e4. DOI: 10.1056/NEJMvcm1300964 Copyright © 2014 Massachusetts Medical Society. Overview Endotracheal extubation refers to the removal of an endotracheal tube from the trachea. This procedure is commonly performed in operating rooms, postanesthesia care units, and intensive care units. This review focuses on extubation of the trachea after general anesthesia and short-term...

Background INtubate-SURfactant-Extubate (INSURE) method is one of the effective methods in treatment of infants with respiratory distress syndrome (RDS). This study was performed to predict risk factors for the failure of  INSURE method in treatment of RDS in preterm infants. Materials and Methods: In this cross-sectional study, 192 infants who born between July 2011 and April 2016 at women and...

Airway management relates to the period of tracheal intubation, maintenance of endotracheal tube in situ, and finally extubation. Problems related to difficult extubation still pose significant challenge for both anesthesiologists and intensivists. This article reviews current approach to extubation strategy following difficult intubation. Guidelines and algorithm may be helpful in order to ens...

BACKGROUND This was an evaluation of intra-individual variation of the cuff-leak test (ΔCLT) immediately post-intubation and pre-extubation, as a predictor of post-extubation stridor. METHODS Prospective, clinical investigation in the ICU of a non-university hospital. CLTs were performed immediately after intubation (T0) and before extubation (T1) to evaluate the differences in cuff leak (ΔCL...

As evidenced by the recent trials, a large proportion of infants can be adequately managed with CPAP, with comparable rates of BPD to those achieved in mechanically ventilated infants.2,3 These trials also made clear that a significant proportion of infants initially started on CPAP eventually require mechanical ventilation, which was more evident among infants of lower gestational age. In the ...

Newfactan is a domestically developed, bovine lung-derived, semi-synthetic surfactant. The aim of this study was to compare the clinical efficacy of Newfactan with that of Surfacten in the treatment of respiratory distress syndrome (RDS). Newfactan or Surfacten was randomly allocated to 492 newborn infants who were diagnosed as RDS and required surfactant instillation in four participating hosp...