The content of the press release has been approved by the presenter. [escardio.org]

Present-generation 3-dimensional ICE probes can be used for volumetric imaging; however, in the present configuration, cross-sectional measurement of annular size is difficult due to the limited field of view of 22°. [imaging.onlinejacc.org]

These five cases are presented below. [ejcts.oxfordjournals.org]

In some models, these differences in the murine nasal cavity can have a significant impact on disease progression and presentation in the lower respiratory tract (LRT) when using intranasal instillation techniques, potentially limiting the… Figures from [semanticscholar.org]

Abstract The passage of a tube into the trachea, whether through the nose or the mouth, is known as intubation, and probably presents more hazards than any other single anaesthetic procedure. [link.springer.com]

• Unconsciousness

  In emergency situations, the patient is often unconscious at the time of this procedure. What kind of tube is used? The tube that is used today is usually a flexible plastic tube. [medicinenet.com]

  An endotracheal tube may be used to maintain a patent airway, to prevent aspiration of material from the digestive tract in the unconscious or paralyzed patient, to permit suctioning of tracheobronchial secretions, or to administer positive-pressure ventilation [medical-dictionary.thefreedictionary.com]

  Whether you are awake (conscious) or not awake (unconscious), you will be given medicine to make it easier to insert the tube. After endotracheal intubation, you will likely be placed on a breathing machine. [ufhealth.org]

  Whether you are awake (conscious) or not awake (unconscious), you will be given medicine to make it easier and more comfortable to insert the tube. You may also get medicine to relax. [medlineplus.gov]

• Hypoxemia

  KEYWORDS: endotracheal intubation; hypoxemia; randomized trial [ncbi.nlm.nih.gov]

  Up to 40% of cases are associated with marked hypoxemia or hypotension. [ccforum.biomedcentral.com]

  First, among the patients in the two groups, there was a high rate of severe hypoxemia (SpO 2 < 90%) prior to airway management (14% in the AO group vs. 17% in the control group) [ 10 ]. [omicsonline.org]

  PHYSIOLOGIC RESPONSES TO INTUBATION The process of intubation may cause hypoxemia, 17 bradycardia, 18 intracranial hypertension, 19 systemic hypertension, 17 and pulmonary hypertension. 20 Hypoxemia seems to be related either to apnea at the time of intubation [pediatrics.aappublications.org]

  This rare syndrome consists of muscular rigidity, extreme hyperpyrexia, hypoxemia, hypercarbia, rhabdomyolysis, autonomic instability, metabolic acidosis, and disseminated intravascular coagulation (DIC). [emedicine.medscape.com]

• Swelling

  As the pseudomembrane gets larger, swelling worsens and lymph nodes become enlarged, giving the neck a “bull-neck” appearance. [brainblogger.com]

  Her tongue is protruding from her mouth with marked swelling to the tongue and lips. The patient is protective of her position and cannot tolerate lying back or being supine. [emdocs.net]

  In these cases, visualization of the laryngeal inlet during laryngoscopy may be impossible, and local trauma caused by the laryngoscope blade or attempts at ETT insertion can lead to increased swelling, rendering mask ventilation difficult or impossible [uptodate.com]

  The most common cause for postoperative hoarseness in patients undergoing procedures that do not involve the head and neck is swelling of the vocal cords. [anesthesiology.pubs.asahq.org]

  These signs and symptoms include but are not limited to sore throat, pain or swelling of the face and neck, chest pain, subcutaneous emphysema, and difficulty swallowing. [surgeryencyclopedia.com]

• Falling

  None of the patients had any adverse effects such as hypotension, bradycardia, respiratory depression and fall in oxygen saturation. [ijaweb.org]

  With severe anemia, cyanosis may not be apparent until the arterial oxygen saturation (Sao 2 ) falls to 60%. [clinicalgate.com]

  Before intubation, gas anesthesia pipes were prone to leak, and surgeons, leaning close to anesthetic gas for hours at a time, would often fall asleep on top of their patients. [brainblogger.com]

  Although attractive, mivacurium falls short in matching succinylcholine in its simplicity, ultrashort onset, and short duration of action. Pancuronium Pancuronium is an aminosteroid NMB. [emedicine.medscape.com]

• Inflammation

  Once in the lungs the meconium can make the baby ill by obstructing the airways and causing inflammation this is called meconium aspiration syndrome. [cochrane.org]

  Classification of intubation injuries: Acute intubation changes: General, Non specific: Inflammation, edema, protrusion of ventricular mucosa Pressure necrosis, loss of mucosa, cartilage and muscle Glottic: Flaps of granulation tissue Granulation tissue [drtbalu.co.in]

  Endotracheal tube-induced sore throat pain and inflammation is coupled to the release of mitochondrial DNA. Mol Pain. 2017;13:1744806917731696. Article CAS PubMed PubMed Central Google Scholar Tang C, Xia Z. [bmcanesthesiol.biomedcentral.com]

• Aspiration

  Once in the lungs the meconium can make the baby ill by obstructing the airways and causing inflammation this is called meconium aspiration syndrome. [cochrane.org]

  In addition, this method is frequently used for aspiration of secretions in patients with atelectasis, pulmonary edema or excess secretions associated with other pulmonary conditions. [nejm.org]

  Cricoid pressure (debatable) Aspiration of stomach contents by NG tube Fasting the patient in preparation Careful bag-mask ventilation to prevent gastric inflation Alternatively: do not bag-mask ventilate (RSI) Pneumothorax and tension pneumothorax Use [derangedphysiology.com]

• Pneumonia

  Intensive care units employ infection control and reduction schemes to reduce pneumonia rates. [ncbi.nlm.nih.gov]

  Support breathing in certain illnesses, such as pneumonia, emphysema, heart failure, collapsed lung or severe trauma. Remove blockages from the airway. Allow the provider to get a better view of the upper airway. [ufhealth.org]

  Aspiration of stomach contents can result in pneumonia and ARDS. Placement of the tube too deep can result in only one lung being ventilated and can result in a pneumothorax as well as inadequate ventilation. [medicinenet.com]

  Mg Hypoxia from de-recruitment of lungs conversion from spontaneous ventilation -> positive pressure ventilation results in de-recruitment when patient apnoeic preoxygenation quick securement of airway increasing PEEP on ventilator Sputum retention + pneumonia [lifeinthefastlane.com]

• Hoarseness

  Previous research by Jones et al. found that 54 of 167 studied patients had hoarseness following short-term intubation. 7 In five of these patients, hoarseness lasted for periods ranging between 9 and 99 days. [anesthesiology.pubs.asahq.org]

  Cases of postoperative hoarseness, vomiting, dysphoria, bucking, and other complications were determined in the two groups. [alliedacademies.org]

  Grade of hoarseness [19]: rating of 0, no hoarseness; level 1, mild hoarseness (complained of hoarseness only when asked); level 2, moderate hoarseness (self-reported hoarseness); level 3, severe hoarseness (change in voice was observed). [bmcanesthesiol.biomedcentral.com]

  The incidence of hoarseness after mediastinoscopy and outcome of video-assisted versus conventional mediastinoscopy in lung cancer staging*. Acta Chirurgica Belgica, Vol. 116, Issue. 1, p. 23. [cambridge.org]

  Aspirating (inhaling) vomit, saliva or other fluids while intubated Pneumonia, if aspiration occurs Sore throat Hoarseness Erosion of soft tissue (with prolonged intubation) The medical team will assess and be aware of these potential risks, and do what [verywell.com]

• Dyspnea

  The trachea is suctioned every hour and as needed, as indicated by patient assessment (dyspnea, gurgling, respirations, activation of ventilator pressure alarms). If so ordered, the trachea is irrigated with normal saline solution. [medical-dictionary.thefreedictionary.com]

• Abnormal Breathing

  Because of the intrathoracic location of a large distensible viscus, bilateral breath sounds may be heard during manual ventilation. 12 For these reasons, whenever abnormal breath sounds are heard, they should not be relied on to confirm endotracheal [clinicalgate.com]

• Vomiting

  Cases of postoperative hoarseness, vomiting, dysphoria, bucking, and other complications were determined in the two groups. [alliedacademies.org]

  Suction: In most resuscitation situations, the patient will either vomit, or at the very least, will have an excess of secretions in their oropharynx. If available, a suction catheter should be included as part of your basic airway equipment. [meds.queensu.ca]

  […] patients with elevated intracranial pressure, heart disease or aneurysm Fentanyl 3 mcg/kg Administer a precalculated dose of an induction agent: Dose Advantages Cautions Etomidate 0.3 mg/kg Good for low blood pressure; okay in hypovolemia Nausea and vomiting [thoracic.org]

  Aspirating (inhaling) vomit, saliva or other fluids while intubated Pneumonia, if aspiration occurs Sore throat Hoarseness Erosion of soft tissue (with prolonged intubation) The medical team will assess and be aware of these potential risks, and do what [verywell.com]

  These challenges range from vomit-flooded airways and ground-level patient positions to ambient lighting and oro-pharyngeal injuries. [ccforum.biomedcentral.com]

• Dysphagia

  Dysphagia followed by tachycardia, tachypnoea and mild temperature are almost always present. [ejcts.oxfordjournals.org]

• Hypotension

  None of the patients had any adverse effects such as hypotension, bradycardia, respiratory depression and fall in oxygen saturation. [ijaweb.org]

  Thiopental 3 - 5 mg/kg Multiple drug interactions; caution if hypovolemic or risk of hypotension Administer a precalculated dose of a paralytic agent Dose Characteristics Cautions Succinylcholine 1 - 1.5 mg/kg Rapid onset, rapid recovery; fasciculation [thoracic.org]

  Systemic hypotension was the most frequent complication following the procedure. Awake bronchoscopic intubation supported with a noninvasive positive pressure delivery systems may be feasible alternative to standard direct laryngoscopy approach. [journals.lww.com]

• Heart Disease

  […] blood pressure, hypovolemia; good in asthma Caution in elevated intracranial pressure or heart disease Propofol 2 - 2.5 mg/kg Rapid onset and recovery Caution if hypovolemic or risk of hypotension Thiopental 3 - 5 mg/kg Multiple drug interactions; caution [thoracic.org]

  This is supposed to have advantages in patients with ischemic heart disease and those with brain injury (e.g. after traumatic brain injury or stroke). [en.wikibooks.org]

  Menda et al. conducted a study on ischaemic heart disease patients undergoing fast-track coronary artery bypass graft comparing dexmedetomidine 1 µg/kg and placebo. [ijaweb.org]

  disease 20 and is presumed to occur with intubation. [pediatrics.aappublications.org]

• Tachycardia

  - Tachycardia - rise in blood pressure - Increase in secretions - Laryngospasm - bronchospasm 19 20.  tube in oesophagous  endobrocheal intubation  trauma to lips tooth  Bleeding  Leak  Trachities  Cough  sore throat  barotrauma to Lungs 20 [de.slideshare.net]

  Dysphagia followed by tachycardia, tachypnoea and mild temperature are almost always present. [ejcts.oxfordjournals.org]

  Byregowda Nagar, Kolar - 563 102, Karnataka India Source of Support: None, Conflict of Interest: None DOI: 10.4103/0019-5049.198404 Background and Aims: Laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing tachycardia [ijaweb.org]

  In a randomized, controlled trial in 90 older infants and children that compared the use of glycopyrrolate and atropine at anesthetic induction, none had bradycardia, but more subjects who received atropine developed sinus tachycardia than those who received [pediatrics.aappublications.org]

• Ulcer

  […] of vocal process Ulcerated troughs and intact median strip Posterior ulceration without intact median strip Subglottis: Bilateral posterolateral midcricoid ulceration Annular inferior cricoid ulceration Chronic long term complications: General: Submucosal [drtbalu.co.in]

  Adverse events included 3 interface-related skin ulcers for each group (ie, 7.6% in the face mask group had nose ulcers and 6.8% in the helmet group had neck ulcers). [jamanetwork.com]

  While the length of intensive care unit stay was significantly reduced with the helmet interface, there were no significant differences in the length of hospitalization or in the rate of skin ulcerations. [dynamed.com]

  Mercury, for example, was administered in the form of a vapor, and was used as a treatment for membranous croup and ulcers of the mouth and throat, as well as for diphtheria. Sometimes, good things come from bad, as in the case of diphtheria. [brainblogger.com]

  She was still ventilated when a peritonitis appeared on the 19th p.o.d. by perforated duodenal ulcer. [ejcts.oxfordjournals.org]

• Skin Ulcer

  While the length of intensive care unit stay was significantly reduced with the helmet interface, there were no significant differences in the length of hospitalization or in the rate of skin ulcerations. [dynamed.com]

  Adverse events included 3 interface-related skin ulcers for each group (ie, 7.6% in the face mask group had nose ulcers and 6.8% in the helmet group had neck ulcers). [jamanetwork.com]

• Confusion

  The lack of a single, reliable test to confirm ETT placement can potentially lead to confusion regarding the location of the tube. [aliem.com]

  These complications are rare but may include: heart attack lung infection stroke temporary mental confusion death Approximately one or two people in every 1,000 may become partially awake while under general anesthesia. [healthline.com]

  This condition should not be confused with that of prolapse of ventricle which is a distinct entity. 3. Subglottic oedema. This condition usually resolves after extubation. Granulation tissue: Can be seen within 48 hours after intubation. [drtbalu.co.in]

  There are obvious exceptions to performing awake intubation, such as patient refusal, young children, and uncooperative patients (due to confusion or learning disabilities). [nysora.com]

• Hypercapnia

  Endotracheal intubation may be achieved by awake direct laryngoscopy in the sick ICU patient whose level of consciousness may be reduced by sepsis, hypercapnia or hypoxemia. [ccforum.biomedcentral.com]

  Indications for endotracheal tube (ETT) placement include: severe hypoxaemia requiring PEEP; hypercapnia with acidosis; inability to protect the airway; to control ventilation in the presence of raised intracranial (or intraocular) pressure; to facilitate [en.wikibooks.org]

  Airway obstruction is common at the accident scene in patients with severe TBI [ 10, 11 ], and resulting hypoxaemia and hypercapnia are known to trigger secondary injuries that adversely affect outcome [ 12, 13 ]. [journals.plos.org]

This is a surgical emergency and prompt recognition and initiation of treatment is essential to a favorable outcome. There are very few case reports of medical treatment [4]. Medical treatment has been applied only after early diagnosis. [ejcts.oxfordjournals.org]

Some of these opinions may contain information about treatment or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. [webmd.com]

Nevertheless, successful conservative treatment in a large tracheal tear has been reported. 11, 12 Mullan et al have suggested that the length of intact trachea > 3 cm above the carina is the important predictor of successful conservative treatment. 12 [rc.rcjournal.com]

In addition, urolithiasis was also associated with a high risk of intensive care unit treatment, shock, and arrhythmias after AMI. Medical treatments for urolithiasis may decrease the risk of MI, except the use of NSAIDs. [dovepress.com]

Knowledge of associated clinical variables may improve the estimation of early prognosis and guide management in these patients. [neurology.org]

Outlook (Prognosis) The outlook will depend on the reason the procedure needed to be done. References Driver BE, Reardon RF. Tracheal intubation. In: Roberts JR, Custalow CB, Thomsen TW, eds. [mountsinai.org]

After discussion with the patient's relatives about the risk of surgical repair and the prognosis of neurological condition, conservative treatment was considered. [rc.rcjournal.com]

However misreading of this complication sometimes leads to delaying the diagnosis, then to worsening the prognosis. Subsequent infection spreads into the mediastinum and responsibility of the physician is engaged. [ejcts.oxfordjournals.org]

This result shows why it is vital to analyze data by the intention-to-treat principle; in this case, an erroneous conclusion could be reached if the data were analyzed by treatment received, because the success of intubation is not independent of prognosis [jamanetwork.com]

Martyn JA, Richtsfeld M (2006) Succinylcholine-induced hyperkalemia in acquired pathologic states: etiologic factors and molecular mechanisms. Anesthesiology 104: 158–169 PubMed CrossRef Google Scholar 21. [link.springer.com]

We considered subgroups defined both by the etiology of the illness or injury that was apparent to out-of-hospital providers and by the etiology of the illness or injury based on retrospective review of the final medical record. [jamanetwork.com]

[…] hypertension. 20 Hypoxemia seems to be related either to apnea at the time of intubation or possible airway obstruction associated with positioning. 17 Bradycardia is presumed to be vagal in origin, because the very rapid onset is suggestive of a reflexive etiology [pediatrics.aappublications.org]

†Adjusted for: age, gender, bystander CPR, initial cardiac rhythm, duration of resuscitation, location of arrest, status of Emergency Life-Saving Technicians, epinephrine use and etiology. [westjem.com]

Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283: 2008–12. pmid:10789670 View Article PubMed/NCBI Google Scholar 27. [journals.plos.org]

Epidemiology of pediatric prehospital care. Ann Emerg Med. 1987;16:284-292. Google Scholar 30. United States Department of Transportation. Emergency Medical Technician: Basic, National Standard Curriculum. [jamanetwork.com]

Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation. 2009;119:1484–91. for the Resuscitation Outcomes Consortium. [ccforum.biomedcentral.com]

Malekianzadeh 1, Gholamreza Noori 2, Abolfazl Mohammadbeigi 3 1 Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran 2 Department of surgery, Arak University of Medical Sciences, Arak, Iran 3 Department of Epidemiology [medgasres.com]

Pre-intubation nebulised salbutamol or adrenaline Hypoxia Pre-oxygenation Continuous pulse oximetry Aspiration Cricoid pressure (debatable) Aspiration of stomach contents by NG tube Fasting the patient in preparation Careful bag-mask ventilation to prevent [derangedphysiology.com]

There are no randomized trials of intravenous fluid administration to prevent PIH in critically ill adults. The investigators propose a randomized trial of fluid loading to prevent PIH in critically ill adults. [clinicaltrials.gov]

[…] of vagal response (especially children younger than age 5 often have bradycardic response to laryngoscopy) Atropine 0.02 mg/kg Prevention of worsening intracranial pressure or bronchospasm Lidocaine 1.5 mg/kg Prevention of hypertensive response in patients [thoracic.org]

Barfield, MD – Centers for Disease Control and Prevention Ann L. Jefferies, MD – Canadian Paediatric Society Sarah Kilpatrick, MD – American College of Obstetrics and Gynecology Tonse N.K. [pediatrics.aappublications.org]