Objective: This institutional anaesthetic practice evaluation compared patient safety with respect to residual neuromuscular blockade (NMB) at the time of tracheal extubation in patients undergoing high-risk eye surgery.
Methods: Two muscle relaxation regimens were compared: rocuronium administered via intravenous (i.v.) bolus dosing combined with reversal through sugammadex at end of surgery (group R/S; 17 patients); mivacurium administered via continuous i.v. infusion without antagonization (group M; 22 patients). Train-of-four (TOF) monitoring determined the depth of NMB.
Results: The TOF ratio at the time of tracheal extubation was greater in group R/S (median 1.03) than in group M (median 0.62). Time from end of surgery to tracheal extubation was not significantly different. The surgeons were 100% satisfied with the working conditions provided under both relaxation regimens.
Conclusions: Residual postoperative curarization at the time of extubation was frequently observed in group M, whereas there was complete recovery in group R/S. Reversal of NMB by sugammadex provides an additional safety dimension to patient care and should thus be considered especially for those at risk of airway complications or aspiration, in addition to frail patients.
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http://dx.doi.org/10.1177/0300060513489476 | DOI Listing |
Ann Thorac Surg Short Rep
June 2024
Division of Cardiothoracic Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky.
Postoperative positive pressure ventilation (PPV) can contribute to failure of large intrathoracic airway repairs. We report a case of a 67-year-old woman with severe emphysema who presented with an unstable airway and mediastinitis after full-length transmural intrathoracic tracheal intubation injury. After repair, neither extubation nor PPV distal to the repair was feasible.
View Article and Find Full Text PDFBMJ Open
January 2025
Evidence based medicine center, Lanzhou University, Lanzhou, Gansu, China.
Unlabelled: Prophylactic respiratory support for patients after extubation is effective in improving their outcomes and prognosis. However, the optimal post-extubation respiratory support for different populations and disease types of mechanically ventilated patients remains controversial, and there is a lack of detailed, multidisciplinary, evidence-based recommendations for clinical application.
Methods And Analysis: This protocol strictly follows the development process outlined in the WHO Handbook for Guideline Development and Guidelines 2.
Zhonghua Nei Ke Za Zhi
January 2025
Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing100053, China.
To explore the risk factors of delayed extubation after expanded thymectomy in patients with myasthenia gravis. Patients with myasthenia gravis who underwent expanded thymectomy from May 2021 to January 2024 and were admitted to Intensive Care Unit (ICU) after surgery were retrospectively analyzed. Patients were divided in to the delayed extubation and successful extubation according to the length of mechanical ventilation whether exceeding than 48 hours.
View Article and Find Full Text PDFObjective: High-flow nasal cannula (HFNC) is generally considered to have fewer enteral feeding problems than nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation (NIPPV). However, the effects of HFNC on the feeding outcomes in preterm infants are still controversial. The aim of this study was to assess the effect of HFNC on postnatal growth and feeding.
View Article and Find Full Text PDFPLoS One
January 2025
Faculty of Health Sciences, Postgraduation Program in Health Sciences, University of Brasilia, Brasilia, Brazil.
Unplanned extubation (UPE), defined as accidental removal of the endotracheal tube during mechanical ventilation or its replacement due to suspected obstruction or inadequate diameter, is considered the fourth most common adverse event in neonatal intensive care units (NICU). This study aimed to describe a systematic review and meta-analysis protocol that will identify and assess the effect of primary intervention measures designed to prevent UPE in NICU. A search will be carried out in the following databases: PubMed/Medline, EMBASE, Scopus, CINAHL, Cochrane Library, SciELO, and LILACS.
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