Morbidity related to emergency endotracheal intubation—A substudy of the KETAmine SEDation trial

Jabre, P.; Avenel, Alexandre; Combes, X.; Kulstad, Erik; Mazariegos, Ixchel; Bertrand, Lionel; Lapostolle, Frédéric; Adnet, Frédéric

doi:10.1016/j.resuscitation.2011.01.015

Cited by 67 publications

(56 citation statements)

References 28 publications

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“…3 Emergent intubation is associated with various complications including airway trauma, aspiration, and death. 18,19 However, many studies have suggested that the rate of emergent endotracheal intubation among patients with conscious sedation receiving neuroendovascular therapies is very low. 17,[20][21][22] The findings of this meta-analysis that conscious sedation was actually associated with higher rates of recanalization and no increase in intraprocedural complications should assuage concerns about the perceived disadvantages of conscious sedation for the interventionalist.…”

Section: Discussionmentioning

confidence: 99%

Conscious Sedation versus General Anesthesia during Endovascular Acute Ischemic Stroke Treatment: A Systematic Review and Meta-Analysis

Brinjikji¹,

Murad

Rabinstein³

et al. 2014

AJNR Am J Neuroradiol

237

167

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Section: Discussionmentioning

confidence: 99%

Conscious Sedation versus General Anesthesia during Endovascular Acute Ischemic Stroke Treatment: A Systematic Review and Meta-Analysis

Brinjikji¹,

Murad

Rabinstein³

et al. 2014

AJNR Am J Neuroradiol

237

167

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“…Les plus récentes des études françaises ont rapporté une incidence de l'intubation difficile en préhospitalier de 6 à 11 % [4,5]. Notons que dans le contexte préhospitalier français, l'incidence de l'intubation difficile a diminué après utilisation de l'induction en séquence rapide dans les années 1990 [6,7].…”

Section: Abstract Intubation · Emergency · Anesthesiology · Sedationunclassified

Intubation en urgence

2015

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L'intubation trachéale en urgence est associée à une plus forte incidence de difficultés. Cette difficulté accrue est elle-même associée à une augmentation des complications et de la mortalité. La recherche de critères prédictifs d'une intubation difficile est plus délicate en urgence et moins pertinente. Le recours à des alternatives à l'intubation orotrachéale, l'optimisation de la procédure et l'utilisation de procédures spécifiques limitent la survenue et les conséquen-ces d'une intubation difficile. Le choix d'un matériel, une organisation et un entraînement éprouvés permettent de réduire les conséquences d'un cas d'intubation difficile, pré-vue ou non. Les nouveaux dispositifs de « vidéoscopie » semblent supérieurs aux techniques classiques d'intubation, en particulier en cas d'intubation difficile. Ils devront très certainement trouver leur place dans les prochains algorithmes de prise en charge des intubations difficiles en urgence, voire, plus globalement, des intubations en urgence. Chaque structure potentiellement confrontée à l'intubation en urgence devrait d'ores et déjà s'interroger sur son choix de matériel et sa stratégie.Abstract Tracheal intubation in emergency is associated with a higher incidence of difficulties, resulting in increased incidence of complications and mortality. The search for criteria predicting difficult intubation is more difficult and less relevant. The use of alternatives to tracheal intubation, such as optimization of the procedure, and use of specific procedures limit the onset and consequences of a difficult intubation. The choice of material, a good organization, and a proven training allow reducing the consequences of a case of difficult intubation, scheduled or not. The new "videoscopic" devices seem to be superior to conventional intubation techniques, especially in case of difficult intubation. They will probably have a good position in the next guidelines for difficult intubation in emergency or, more generally, for emergency intubation. Each structure potentially facing emergency intubation should question her choice of material and its strategy.

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“…Use of ketamine or etomidate can reduce the incidence of severe hypotension (compared with thiopental or propofol) [41]. Use of either drug in acutely ill patients limits the incidence of hypotension (systolic blood pressure < 90 mmHg) to approximately 14% [42,43]. As etomidate leads to adrenocortical suppression [42] and may increase mortality in patients with septic shock [44], the use of ketamine in this setting is likely to increase.…”

Section: Induction Of Anaesthesia In the Critically Ill Patientmentioning

confidence: 99%

Airway challenges in critical care

2011

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SummaryAirway management in the intensive care unit is more problematic than during anaesthesia. In general, critically ill patients have less physiological reserve and complications are more common, both during the initial airway intervention (which includes risks associated with induction of anaesthesia), and later once the airway has been secured. Despite these known risks, those managing the airway of a critically ill patient, particularly out of hours, may be relatively inexperienced. Solutions to these challenging airway problems include: recognition of those patients with a potential airway problem; implementation of a plan to deal with their airway; immediate availability of a difficult airway trolley; use of capnography for every airway intervention and continuously in all ventilator‐dependent patients; and appropriate training of all intensive care unit staff including use of simulation.

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Morbidity related to emergency endotracheal intubation—A substudy of the KETAmine SEDation trial

Cited by 67 publications

References 28 publications

Conscious Sedation versus General Anesthesia during Endovascular Acute Ischemic Stroke Treatment: A Systematic Review and Meta-Analysis

Conscious Sedation versus General Anesthesia during Endovascular Acute Ischemic Stroke Treatment: A Systematic Review and Meta-Analysis

Intubation en urgence

Airway challenges in critical care

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