The Value of Not Intubating Comatose Patients With Acute Poisoning

Noninvasive Airway Management of Comatose Patients With Acute Poisoning

“…3 Furthermore, assigning a GCS score involves some subjective judgment, which may lead to interobserver variability. 4 The percentage agreement for GCS scoring among physicians was not reported in this study, 1 which could lead to potential misclassification of patients in this study.…”

“…An accompanying editorial lauded the study as a practice-changing trial providing rigorous evidence. 2 Although we have recommended against indiscriminate intubation of patients based on a low Glasgow Coma Scale (GCS) score, 3,4 we are concerned about the ability of this study 1 to provide conclusive evidence allowing a paradigm shift in clinical practice.…”

“…Fourth, our major concern about this study is the consideration of intubation as an independent factor. As outlined by the Editorial that accompanied this study, while avoiding intubation can protect comatose patients from complications, it may also prevent them from ICU admission and, therefore, from close monitoring for markers of deterioration. This is a key point, especially considering daily emergency department overcrowding.…”

“…3 Therefore, metformin exposure during fetal and neonatal periods could result in a reduction in testicular size, Sertoli cell numbers, and sperm count, and may result in hypospadias and subinfertility. 4 Based on available data, use of metformin during pregnancy is still controversial, 5 and further data are required to identify the long-term effects of metformin on fetal testicular cells and determine infertility rates among male infants who were exposed to metformin during pregnancy. Therefore, in the MOMPOD study, long-term monitoring of fertility in male infants is highly recommended for the possible effects of fetal exposure to metformin.…”