A difficult extubation!
 An 8 y old male child suffered from Crouzon syndrome, in whom intubation was perceived to be difficult, but extubation expected much more difficult. syndrome is a genetic disorder characterized by the premature fusion of skull bones (craniosynostosis). This early prevents growing normally and affects shape head face.

The purpose of the study was to compare changes in oral health during intubation until 48 hours after extubation in neuroscience intensive care unit (ICU) patients enrolled in a standard or a comprehensive oral care protocol. The effects of manual toothbrushing (standard group, n = 31) were compared with those of tongue scraping, electric toothbrushing, and moisturizing (comprehensive group, n ...

BACKGROUND The primary aim of this randomized study was to describe the feasibility of early administration of surfactant via a thin catheter during spontaneous breathing (Take Care) and compare early mechanical ventilation (MV) requirement with the InSurE (Intubate, Surfactant, Extubate) procedure. METHODS Preterm infants, who were <32 weeks and stabilized with nasal continuous positive airw...

large preterm infants are generally not considered good candidates for surfactant treatment until they have been intubated for progressing respiratory distress. this study has been done to detect the effect of electively providing early single-dose surfactant to large preterm babies with mild to moderate respiratory distress syndrome (rds). a randomized clinical trial was performed on 45 infant...

A crucial step in the transition from mechanical ventilation to extubation is the successful performance of a spontaneous breathing trial (SBT). The American College of Chest Physicians (ACCP) Guidelines recommend removal of the endotracheal tube upon successful completion of a SBT. However, this does not guarantee successful extubation as there remains a risk of re-intubation. Guidelines have ...

BACKGROUND While early extubation after coronary artery bypass grafting (CABG) has been associated with resource savings, its effect on patient outcomes remains unclear. The goal of the present investigation was to evaluate whether early extubation can be performed safely in elderly CABG patients in community practice. METHODS We studied 6,446 CABG patients, aged 65 years and older, treated a...

To the Editor: We read with great interest the article by Tripathi et al1 recently published in RESPIRATORY CARE assessing the impact of a quality-improvement project on the incidence of unplanned extubations. By carrying out this quality-improvement project, they were able to decrease the rate of unplanned extubations from 3.55 to 2.59 per 100 intubation days. The study opens debate regarding ...

BACKGROUND Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients. METHODS One-hundred-forty female, normo...

We have compared changes in vocal function produced after insertion of a laryngeal mask airway (LMA) with those produced by tracheal intubation in 20 patients. Using acoustic waveform analysis, we computed amplitude variability (AV), pitch variability (PV), harmonics-to-noise ratio (HNR) and additive noise level (ANL) before anaesthesia and at 1, 4, and 24 h after tracheal extubation. There wer...

OBJECTIVES/HYPOTHESIS To establish an animal model for post-intubation laryngotracheal injuries resulting in significant laryngotracheal insult without compromising the survival of the animal for a minimum period of 12 weeks post-extubation. To study the extent of injury based on morphometric and histopathological change seen at 12 weeks post-extubation. STUDY DESIGN Randomized block, single-...