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Supraglottic airway in neonatal porcine model.
Pediatr Res
January 2025
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.
Background: Positive pressure ventilation (PPV) in the delivery room is routinely performed using a face mask attached to a ventilation device. In 2023, the Consensus of Science and Treatment Recommendations for neonatal resuscitation stated that a supraglottic airway (SGA) can be used for PPV if resources and training permits. However, there is very limited data on tidal volume (V) delivery using SGAs.
View Article and Find Full Text PDFModification of Ayre's T-Piece From Anesthesia Circuit for Spontaneously Ventilating Tracheostomized Adults.
A A Pract
November 2024
From the Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Transporting spontaneously ventilating adults with tracheostomies from the operating room (OR) or other anesthetizing locations to the intensive care unit (ICU) or other recovery locations presents significant challenges, as traditional T-pieces may not be readily available. This article describes a novel modification to the Ayre's T-piece, designed to address this gap by using readily available equipment. The modification integrates a 3-mL syringe, a size 7.
View Article and Find Full Text PDFWhat CPAP to use in the delivery room? Bench comparison of two methods to provide continuous positive airways pressure in neonates.
BMJ Paediatr Open
November 2024
Department of Anesthesiology, Östersunds sjukhus, Ostersund, Sweden
Background: Continuous positive airway pressure (CPAP) is a recommended first-line therapy for infants with respiratory distress at birth. Resuscitation devices incorporating CPAP delivery can have significantly different imposed resistances affecting airway pressure stability and work of breathing.
Aim: To compare CPAP performance of two resuscitation devices (Neopuff T-piece resuscitator and rPAP) in a neonatal lung model simulating spontaneous breathing effort at birth.
Spontaneous breathing trials should be adapted for each patient according to the critical illness. A new individualised approach: the GLOBAL WEAN study.
Intensive Care Med
December 2024
Intensive Care Unit, Department of Anaesthesiology and Critical Care Medicine B (DAR B), Saint-Eloi Hospital, University Teaching Hospital of Montpellier, Montpellier Cedex 5, France.
Article Synopsis
- The study aimed to determine the most effective spontaneous breathing trial (SBT) methods to evaluate a patient's ability to breathe independently after being extubated, focusing on five critical illnesses.
- In a multicenter randomized crossover design, 100 adult ICU patients underwent three different 15-minute SBTs, measuring their inspiratory efforts using pressure-time-product (PTPmin) before and after extubation.
- Results showed that the unassisted SBTs, specifically PSV0PEEP0 and T-piece trials, were the best at simulating the breathing effort experienced after extubation, with varying effectiveness among different patient categories.
Spontaneous breathing trials: how and for how long?
Curr Opin Crit Care
February 2025
Centre Hospitalier Universitaire de Poitiers, Médecine Intensive Réanimation.
Purpose Of Review: Guidelines recommend systematic performance of a spontaneous breathing trial (SBT) before extubation in ICUs, the objective being to reduce the risk of reintubation. In theory, a more challenging SBT performed with a T-piece may further reduce the risk of reintubation, whereas a less challenging SBT performed with pressure-support ventilation (PSV) may hasten extubation.
Recent Findings: Recent findings show that a more challenging SBT with a T-piece or for a prolonged duration do not help to reduce the risk of reintubation.
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