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...

We conducted a prospective survey on the incidence of respiratory complications associated with tracheal intubation and extubation in 1005 patients who underwent elective general anaesthesia over a 4-month period. During induction of anaesthesia, respiratory complications occurred in 46 patients (4.6%; 95% confidence limits (CL): 3.3, 5.9%). The common complications were coughing (1.5%) and dif...

BACKGROUND AND PURPOSE Self-extubation is a potentially life-threatening event, but may also provide an opportunity to wean patients who should have been extubated earlier. The purpose of this study was to determine the risk factors for re-intubation after self-extubation. METHODS The medical charts of 69 self-extubated patients treated in Shin Kong Hospital, Taipei, from September 1996 throu...

Surfactant replacement therapy by ‘INSURE’ is a gentle ventilatory approach in preterms with Respiratory Distress Syndrome (RDS) reducing the mortality and is associated with less adverse sequelae than mechanical ventilation. The objective of the present study is to determine the role of surfactant therapy by INSURE in reducing the mortality of preterms with RDS. 59 preterm babies with RDS were...

BACKGROUND The aim of this study was to evaluate the effects of topical ropivacaine anesthesia on hemodynamic responses during intubation and extubation of hypertensive patients. MATERIAL AND METHODS One hundred fifty patients with hypertension ASA II-III were scheduled for noncardiac operations. Patients were divided into 3 groups: a control group receiving 5 ml saline, and 2 groups receivin...

CONTEXT Continuous Positive Airway Pressure (CPAP) is a cost-effective and minimal invasive respiratory support for the newborn. OBJECTIVE To review the evidence related to various aspects of CPAP usage and its applicability for developing countries. EVIDENCE ACQUISITION We conducted a literature search on PubMed, CENTRAL, and Cochrane Database of Systematic Reviews using the terms CPAP OR ...

Structured abstract Background: The efficacy of corticosteroids for reducing the incidence of post-extubation laryngeal edema remains controversial. Objective: To evaluate whether methylprednisolone (MP) started 12 hr prior to planned tracheal extubation, can prevent post-extubation laryngeal edema. Design: Prospective, randomized, blinded, placebocontrolled trial performed in 15 intensive care...

In their prospective multicenter randomized controlled trial, Su et al report that noninvasive mechanical ventilation (NIV) used in all patients after extubation did not reduce re-intubation rate, when compared to standard oxygen therapy.1 Nevertheless, we believe that the concept of “preventive” NIV requires not only early application of NIV but also careful selection of patients who are high ...

We studied the effects of administering exogenous surfactant for the treatment of respiratory distress in premature neonates (born before 37 weeks of gestational age [GA]) and compared the role of different risk factors on the outcome as well as survival rate. All the neonates (242) suffered from moderate to severe respiratory distress, identified by clinical signs, chest X-ray, respiratory dis...

Background: General anesthesia is an essential component of and endotracheal intubation a basic step to secure the airway in patients undergoing any surgical procedure. Airway manipulation causes mucosal inflammation resulting coughing, straining, bucking subsequent distress patient. Aim: To find out whether preemptive use nebulized lignocaine has some role tube tolerance during anesthetic indu...