Aims and Scope
Recent Articles
Physiological Changes in the Pregnancy and Anesthetic Implication during Labor, Delivery, and Postpartum
Leta Melaku
The Open Anesthesia Journal, 2022; 16: e258964582207130.
Electronic Publication Date: September 19, 2022Anaesthesia and Rare Neuromuscular Diseases
Vincenzo Pota, Gerardo Nigro, Giuseppe Limongelli, Clelia Esposito and Maria Caterina Pace
The Open Anesthesia Journal, 2022; 16: e258964582202280.
Electronic Publication Date: March 29, 2022
Editor's Choice
Use of Either Non-invasive Ventilation Immediately Post-extubation or Controlled Mechanical Ventilation for One Hour after Fulfilling Weaning Criteria Decreases Re-intubation of Patients with Post-traumatic ARDS
Mohamed Gaber Ibrahim Mostafa Allam
Introduction:
Re-intubation and re-ventilation after complete weaning of patients with prolonged ventilation are considered a major problem in ICU. The re-intubation in such patients associated with higher mortalities prolongs the duration of ICU stay. The mortality rate in those patients may exceed 40% in some studies.
Aims:
The study aimed to compare and evaluate the effect of use of two new maneuvers with control after fulfilling criteria of weaning from prolonged ventilation, either immediate use of NIV post-extubation and every 12 hours for 24 hours or MV for one hour on both re-intubation and ICU discharge of traumatic ARDS patients who ventilated for one week or more.
Materials and Methods:
It is a prospective double-blind study done on total 300 patients, admitted with respiratory failure ARDS due to severe lung contusion. All of them were selected to be ventilated for > one week. All of them fulfilled the criteria of weaning at the end of the studied period. Patients were randomly allocated in three groups; each group contained 100 patients. Group A was considered the control group. They extubated and followed our routine protocol; patients of group B used our first new maneuver and reconnected to mechanical ventilation before extubation for one hour, while patients of group C used our second new maneuver; patients of this group extubated and immediately connected to NIV with BIPAP mode for 1 hour every 12 hours for 24 hours.
Results:
There was a significant reduction in the number of patients who experienced deterioration in conscious level throughout the study in patients of both groups B and C compared to group A. Also, a significant reduction was seen in the number of patients who experienced deterioration in clinical parameters of respiration, of both groups B and C compared to group A with regard to high respiratory rate, desaturation and development of hyperdynamic circulation (tachycardia and hypertension). Also, a significant reduction was seen in the number of patients who had multiple quadrant parenchymatous infiltration throughout the study in patients of both groups B and C compared to group A. significant reduction in the number of patients marked limitation to FEV1, FVC and MVV in patients of both groups B and C compared to group A.
Conclusion:
Use of either immediate NIV every 12 hours for 24 hours or MV for one hour after fulfillment of weaning criteria reduced reintubation, re-ventilation and post-extubation respiratory failure and decreased the ICU stay in prolonged ventilated patients due to ARDS from severe lung trauma with no significant difference between them.
February 16, 2021
Other Post
- February 14, 2020
Epidural Clonidine as an Adjuvant to Local Anesthetic in Lower Abdominal and Lower Limb Surgeries: A Randomised Controlled Study
April 30, 2019
Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study
October 24, 2019
Effectiveness and Safety of Single Percutaneous Peribulbar Block Using Magnesium Sulphate as an Adjuvant to Local Anesthetics Versus the Standard Peribulbar Block for Strabismus Surgery in Adults
April 30, 2019
Bisoprolol Versus Corticosteroid and Bisoprolol Combination for Prevention of Atrial Fibrillation After On-Pump Coronary Artery Bypass Graft Surgery
July 31, 2018
Clinical Early Warning Scores: New Clinical Tools in Evolution
May 23, 2018
Comparison between Pressure Recording Analytical Method and Fick Method to Measure Cardiac Output in Pediatric Cardiac Surgery
