Assessment of intubation procedures at reference pediatric and neonatal intensive care units

Bonow, Fernanda P.; Piva, Jefferson Pedro; García, Pedro Celiny Ramos; Eckert, Guilherme Unchalo

doi:10.2223/1238

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…5,7,[11][12][13][14][16][17][18] In relation to the complications after extubation, the main factors considered are traumatic tracheal intubation, accidental extubation, tracheal extubation length of time, tracheal tube's size, tracheal tube traction and friction, and balonet's pressure. 5,6,19,22,25,39,41 The results of this study showed an association between complications after extubation and a bigger number of attempts of intubation (Table 1), but it was not possible to demonstrate the relation between these complications and the length of the mechanical ventilation.…”

Section: Discussionmentioning

confidence: 67%

“…5,6,[35][36][37] Other factors pointed as relevant are the lack of all the material necessary for the procedures, inadequate sedation and analgesia, the lack of pre-oxygenation and ventilation to the patient, traumatic tracheal intubation, and/or various attempts to perform it, incorrect positioning of head and neck, choice of a tracheal tube of improper size, tubes made of improper material. 6,25,35,[37][38][39][40][41] Because this study was conducted in a school hospital, most of the tracheal intubations were performed by resident physicians, who provoked a bigger number of complications, with more attempts of intubation, bradycardia, and hypoxia.…”

Section: Discussionmentioning

confidence: 99%

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Complicações da intubação traqueal em pediatria

Souza¹,

Carvalho²

2009

Rev. Assoc. Med. Bras.

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Objective. Describe the frequency and the types of complications of tracheal intubation and its main causes. MethOds. Cross-sectional study of inpatients in the UTI Pediátrica (Pediatrics Intensive Care Unit) of Santa Casa de Misericórdia, São Paulo, between May/1998 and December/1999, who were submitted to tracheal intubation over 24 hours. The criteria of exclusion included previous intubation, surgeries or traumas in the cervical region or oropharynx. Results. 147 cases were studied, with ages ranging from one month to 15 years and 3 months. In 31.3% tracheal tubes of improper size were used, and 14.3% needed five or more attempts to be intubated. Intubation was more difficult for resident physicians. The bigger number of attempts of tracheal intubation was related to an increase of traumas, hypoxia, bradycardia, and worsening of Downes' score after extubation. 21.8% of accidental extubation were observed. This rate was related to the worsening of Downes' score and the need of reintubation. Resident physicians also caused a bigger number of traumas and bradycardia. cOnclusiOn. Most of the complications can be attributed to the lack of experience and training of the physician who performed the tracheal intubation; thus, it is important, in order to minimize those incidents, to implement training programs and intensify supervision during tracheal intubation.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Complicações da intubação traqueal em pediatria

Souza¹,

Carvalho²

2009

Rev. Assoc. Med. Bras.

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“…Despite the obvious benefits of modern non-depolarizing muscle relaxants (esmeron, cisatracurium besilate) in comparison with their predecessors, their use is not free of side effects and complications. Due to the relatively recent introduction esmeron the practice of pediatric anesthesiology, there is still no sufficient experience of its application and not adequate [2,5]. Some authors suspect influence of prolonged NM-block on septic complications after surgery [7].…”

Section: W Ith the Development Of Anesthetic Management Requirements mentioning

confidence: 99%

Experience with esmeron in day surgery in children

Mirza¹,

Shamil²

2015

Medical news of the North Caucasus

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Medical news of north caucasus 2015. Vоl. 10. iss. 2 137 tween patients with BMI over or less than 50. Despite low number of participants, we suppose that increasing of the study power will be not able to find differences between groups. Basing on this results, we may also suppose that undifferentiated (on the basis of BMI) implementation of the enhanced recovery protocols does not carry risk increase for postoperative complications or complication severity in patients with high or extremely high BMI. However, early humoral mechanisms of action of bariatric surgery limit the study results to the bariatric patients, and the results of enhanced recovery protocols implementation in extremely obese patients in non-bariatric surgery may differ and should be additionally studied.

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“…[12][13][14][15][16][17][18] Premedication can create optimal conditions which increase the ease of intubation through several means, jaw and vocal cord relaxation via muscle relaxants, pharyngeal and laryngeal reflex suppression with sedation, pain reduction with analgesia, and prevention of reflex bradycardia with the use of vagolytics. 10,[19][20][21][22][23] In 2010, an American Academy of Pediatrics (AAP) clinical report 23 refers to a consensus statement from the International Evidence-Based Group for Neonatal Pain concluding that except for emergent situations, premedication should be used for all endotracheal intubations in newborns. 24 In older pediatric patients, rapid sequence induction has become the Keywords ► intubation ► premedication ► neonatologist ► neonatal intensive care…”

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confidence: 99%