Sedatives, analgesics, and antipsychotics in tracheostomised intensive care unit patients – Is less more?

Sedation and anaesthesia are used universally to facilitate mechanical ventilation – with larger cumulative doses being used in those with prolonged ventilation. Transitioning from an endotracheal to a tracheostomy tube enables the depth of sedation to be reduced. Early use of speaking valves with tracheostomised patients has become routine in some intensive care units (ICUs). T he return of verbal communication has been observed to improve ease of patient care and increase patient and family engagement, with a perceived reduction in patient agitation.
Source: Australian Critical Care - Category: Nursing Authors: Tags: Research paper Source Type: research

Related Links:

Publication date: Available online 30 September 2019Source: Trends in Anaesthesia and Critical CareAuthor(s): Imen Zouche, Sahar Elleuch, Sondes Briki, Rahma derbelAbstractIn the maxillofacial trauma associated with base of skull fracture, nasotracheal intubation is contraindicated. Surgical repair may require intermaxillary fixation which contraindicate orotracheal intubation. The submental intubation is an interesting alternative to tracheotomy.This type of intubation was used in maxillofacial surgery operating unit in 17 patients with mandibular fracture who require an intermaxillary fixation associated with a skull bas...
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research
Abstract Failure to manage bleeding in the airway is an important cause of airway-related death. The purpose of this narrative review is to identify techniques and strategies that can be employed when severe bleeding in the upper airway may render traditional airway management (e.g., facemask ventilation, intubation via direct/video laryngoscopy, flexible bronchoscopy) impossible because of impeded vision. An extensive literature search was conducted of bibliographic databases, guidelines, and textbooks using search terms related to airway management and bleeding. We identified techniques that establish a def...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Abstract In recent years, it has become increasingly apparent that the laryngotracheal stenosis (LTS) cohort comprises distinct etiological subgroups; however, treatment of the disease remains heterogeneous with limited research to date assessing predictors of treatment outcome. We aim to assess clinical and surgical predictors of endoscopic treatment outcome for LTS, as well as to further characterize the disease population. A retrospective chart review of adult patients with LTS presenting over a 16-year period was conducted. Seventy-five patients were identified and subdivided into 4 etiologic subgroups: iatrog...
Source: Ear, Nose and Throat Journal - Category: ENT & OMF Authors: Tags: Ear Nose Throat J Source Type: research
Kapil D Soni, Thanigai Arasu, Richa Aggarwal, Vanlal DarlongJournal of Anaesthesiology Clinical Pharmacology 2019 35(3):412-413
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Authors: Mahfouz M. AbdulKader,*, Mohammad RM, Mohammed KS, Murugan L Abstract Anesthetic management of cases of post-tracheostomy stenosis is challenging for most of the anesthesiologists. We are describing a case of severe post-tracheostomy stenosis and its management using Hunsaker Mon-Jet laser resistant tube. PMID: 31435468 [PubMed]
Source: Oman Medical Journal - Category: Middle East Health Tags: Oman Med J Source Type: research
The current study investigates the effect of bronchoscopy-guided percutaneous dilatational tracheostomy (PDT) on the evolution of respiratory acidosis depending on endotracheal tube (ET) sizes. In addition, th...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Background: Percutaneous tracheostomy, almost associated with cough reflex and hemodynamic fluctuations, is a common procedure for traumatic brain injury (TBI) patients, especially those in neurosurgery intensive care units (NICUs). However, there are currently a lack of effective preventive measures to reduce the risk of secondary brain injury. The aim of this study was to compare the effect of dexmedetomidine (DEX) vs sufentanil during percutaneous tracheostomy in TBI patients. Methods: The 196 TBI patients who underwent percutaneous tracheostomy were randomized divided into 3 groups: group D1 (n = 62, DEX infusion ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
We describe the case of a 7 year old case of Harberland syndrome with special focus on the difficulties faced by us in mask ventilation, as well as intubation and the need for elective ventilation and planned extubation. We also discuss the precautions to be taken while undertaking such a case like preparations for emergency tracheostomy and possibility of re-intubation after extubation. A meticulous preoperative workup along with neurological and airway examination along with preparation for elective ventilation and tracheostomy is a prerequisite for the successful management of this case.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Authors: Mishra N, Singh S PMID: 31257817 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
Conclusions: The incidence of POPC was 12.1% following infratentorial tumor surgery. The predictors for the occurrence of POPCs were postoperative blood transfusion, LCN palsy, prolonged ICU stay, and tracheostomy.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
More News: Anesthesia | Anesthesiology | Australia Health | Intensive Care | Nursing | Tracheostomy