Background: Airway management in critically ill obese patients is potentially associated with a higher risk of adverse events due to a constellation of physiological and anatomical challenges. Data from international prospective studies on peri-intubation adverse events in obese critically ill patients are lacking.
Methods: INTUBE (International Observational Study to Understand the Impact and Best Practices of Airway Management In Critically Ill Patients) was an international multicentre prospective cohort study enrolling critically ill adult patients undergoing in-hospital tracheal intubation in 197 sites from 29 countries worldwide from October 1, 2018, to July 31, 2019.
Tracheal extubation is an integral part of airway management. Even though available data indicated that the incidence of complications immediately after tracheal extubation may be higher than during tracheal intubation, it is significantly underexplored in the scientific literature in comparison with tracheal intubation. Failure to re-secure the airway during or immediately after tracheal extubation may have fatal consequences.
View Article and Find Full Text PDFIntroduction: Conscious sedation is widely used in medicine but may cause impairment of psychomotor and cognitive function that affect some aspects of a patient's life, such as car driving. This systematic review aims to summarize available evidence (direct or indirect) on driving ability after conscious sedation.
Evidence Acquisition: A comprehensive search was conducted including MEDLINE/PubMed, EMBASE, SCOPUS, clinicaltrials.
Extubation represents an essential component of airway management. While being a common procedure in anesthesiology and critical care medicine, it is accompanied by a significant risk of morbidity and mortality. Safe extubation requires considerable skills, risk stratification and advanced planning.
View Article and Find Full Text PDFAim: To evaluate the effectiveness of utilizing the integrated pulmonary index for capnography implementation during sedation administered by nurses.
Design: Cluster-randomized trial.
Methods: Participants were enrolled from the interventional radiology department at an academic hospital in Canada.
Health Informatics J
May 2024
Before a medical procedure requiring anesthesia, patients are required to not eat or drink non-clear fluids for 6 h and not drink clear fluids for 2 h. Fasting durations in standard practice far exceed these minimum thresholds due to uncertainties in procedure start time. The aim of this retrospective, observational study was to compare fasting durations arising from standard practice with different approaches for calculating the timepoint at which patients are instructed to stop eating and drinking.
View Article and Find Full Text PDFAm J Respir Crit Care Med
June 2024
Introduction: The ageing population has led to an increasing proportion of surgical patients with greater frailty and comorbidity. Complications and mortality within 30 days of a surgical procedure are often used to evaluate success in the perioperative period however these measures can potentially underestimate a substantial level of morbidity associated with surgery. Personal wearable technologies are now readily available and can offer detailed information on activity intensity, sedentary behaviour and sleeping patterns.
View Article and Find Full Text PDFJ Clin Monit Comput
February 2024
The purpose of this study was to evaluate the feasibility and accuracy of remote Video Plethysmography (VPPG) for contactless measurements of blood pressure (BP) and heart rate (HR) in adult surgical patients in a hospital setting. An iPad Pro was used to record a 1.5-minute facial video of the participant's face and VPPG was used to extract vital signs measurements.
View Article and Find Full Text PDFJ Clin Monit Comput
February 2024
The accurate recording of respiratory rate (RR) without contact is important for patient care. The current methods for RR measurement such as capnography, pneumography, and plethysmography require patient contact, are cumbersome, or not accurate for widespread clinical use. Video Plethysmography (VPPG) is a novel automated technology that measures RR using a facial video without contact.
View Article and Find Full Text PDFIndividuals with SARS-CoV-2 infection can develop symptoms that persist well beyond the acute phase of COVID-19 or emerge after the acute phase, lasting for weeks or months after the initial acute illness. The post-acute sequelae of COVID-19, which include physical, cognitive, and mental health impairments, are known collectively as long COVID or post-COVID-19 condition. The substantial burden of this multisystem condition is felt at individual, health-care system, and socioeconomic levels, on an unprecedented scale.
View Article and Find Full Text PDFBackground: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated.
Methods: This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents.
J Clin Monit Comput
October 2023
Capnography monitors trigger high priority 'no breath' alarms when CO measurements do not exceed a given threshold over a specified time-period. False alarms occur when the underlying breathing pattern is stable, but the alarm is triggered when the CO value reduces even slightly below the threshold. True 'no breath' events can be falsely classified as breathing if waveform artifact causes an aberrant spike in CO values above the threshold.
View Article and Find Full Text PDFPLoS One
January 2023
Importance: Selenium contributes to antioxidative, anti-inflammatory, and immunomodulatory pathways, which may improve outcomes in patients at high risk of organ dysfunctions after cardiac surgery.
Objective: To assess the ability of high-dose intravenous sodium selenite treatment to reduce postoperative organ dysfunction and mortality in cardiac surgery patients.
Design, Setting, And Participants: This multicenter, randomized, double-blind, placebo-controlled trial took place at 23 sites in Germany and Canada from January 2015 to January 2021.
Background: The high-fidelity ORSIM (Airway Simulation Ltd) and the low-fidelity wooden-block fiber-optic task trainers allow users to familiarize themselves with the psychomotor skills required to manipulate the fiber-optic scope.
Methods: This single-center study aimed to compare residents' performance of fiber-optic intubation after 2 different types of task training. Twenty-four residents with experience of <8 fiber-optic intubations were randomized to either the ORSIM or a wooden-block task trainer.
Int J Colorectal Dis
September 2022
Purpose: Squamous cell carcinoma of the anus (SCCA) suffers a constant increase each year in the last decades. Recent studies suggested the possibility of local excision (LE) as an option for early-stage SCAC patients. This systematic review aims to summarize the available evidence on the comparison of LE vs.
View Article and Find Full Text PDFAm J Respir Crit Care Med
August 2022
Cardiovascular instability/collapse is a common peri-intubation event in patients who are critically ill. To identify potentially modifiable variables associated with peri-intubation cardiovascular instability/collapse (i.e.
View Article and Find Full Text PDFAim: To determine if smart alarm-guided treatment of respiratory depression using the Integrated Pulmonary Index is an effective way to implement capnography during nurse-administered sedation.
Design: Parallel cluster-randomized trial.
Methods: Nurses will be randomized to use capnography with or without the Integrated Pulmonary Index enabled.
Background: In the era of enhanced recovery after surgery, there is significant discussion regarding the impact of intraoperative anesthetic management on short-term outcomes following liver transplantation (LT), with no clear consensus in the literature.
Objectives: To identify whether or not intraoperative anesthetic management affects short-term outcomes after liver transplantation.
Data Sources: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.