Indian Journal of Respiratory Care最新文献_第6页

HME filters: a boon or bane? HME过滤器:是福还是祸?

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Indian Journal of Respiratory Care Pub Date : 2022-12-13 DOI: 10.5005/jp-journals-11010-05208

S. Prasad, Yogesh K. Gaude

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End-of-life issues in the ICU 重症监护室的临终问题

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02102

I. McLellan

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Comparison between gum elastic bougie and malleable stylet as aids to intubation during application of cricoid pressure: a prospective randomised controlled study 一项前瞻性随机对照研究:在应用环软骨压力时，口香糖弹性支架和可塑支架作为插管辅助工具的比较

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02106

Prasad K. N, Jyothsna M, Shenoy U. K

{"title":"Comparison between gum elastic bougie and malleable stylet as aids to intubation during application of cricoid pressure: a prospective randomised controlled study","authors":"Prasad K. N, Jyothsna M, Shenoy U. K","doi":"10.5005/jp-journals-11010-02106","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02106","url":null,"abstract":"Background: Rapid sequence intubation with application of cricoid pressure is widely practiced in all emergency situations to prevent aspiration of gastric contents. Stylet or gum elastic bougie is used as intubation aid for rapidly securing the airway. Aim: To compare gum elastic bougie and malleable stylet as aids for endotracheal intubation during application of cricoid pressure. Results: Endotracheal intubation was successful in the first attempt in all of the 60 patients enrolled in the study. Time taken for laryngoscopy and intubation was clinically similar in both the groups of patients. However, in the stylet group, successful ET intubation was achieved in about 7 sec less when compared to the bougie group (p< 0.05). Ease of intubation as compared using the Visual Analogue Scale (VAS) Score was similar in both groups. Laryngeal view improved in 22 patients of 60 patients (36.66%) after application of cricoid pressure, while it remained the same as before in 22. Overall, the grade remained the same or improved after cricoid pressure in 73.3% of patients. The laryngeal view worsened in 16 patients (27.7%). Conclusion: Gum elastic bougie and stylet are equally effective intubation aids during rapid sequence intubation. Intubation aided by bougie takes more time than that of a stylet, even though it is clinically trivial. Cricoid pressure does not affect the laryngoscopic visualisation of glottis in majority of patients","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42790421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The end of life issues - Part 2 生命终结的问题-第2部分

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02203

I. McLellan

引用次数: 0

Comparison of the safety and effectiveness of dexmedetomidine with a combination of midazolam and fentanyl for sedation during awake fibreoptic nasotracheal intubation 右美托咪定与咪达唑仑和芬太尼联合用于清醒纤维鼻气管插管镇静的安全性和有效性比较

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02211

Tajammul Sayeed, A. Shenoy, U. Goneppanavar

{"title":"Comparison of the safety and effectiveness of dexmedetomidine with a combination of midazolam and fentanyl for sedation during awake fibreoptic nasotracheal intubation","authors":"Tajammul Sayeed, A. Shenoy, U. Goneppanavar","doi":"10.5005/jp-journals-11010-02211","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02211","url":null,"abstract":"Introduction: Several drugs have been used to enhance patient comfort during awake nasal fibreoptic intubation (AFOI) process. Most of these can cause dangerous airway or haemodynamic compromise. This study compared combination of midazolam and fentanyl against dexmedetomidine. Methods: Thirty two adults undergoing AFOI were randomly allocated into group MF (1mg midazolam and 1 µg/kg fentanyl) or group D (dexmedetomidine 1µg/kg over 10 minutes). Following standard airway topicalisation technique, the study drugs were administered and AFOI was performed. Results: The demographic data, patient comfort score, post intubation score, endoscopy and intubation times were comparable. The endoscopy was observed to be easy in all patients except 2 in MF group while intubation was easy in all (group D) versus 12 patients in group MF (P value 0.03). Significant haemodynamic response was observed in group MF while patients were more stable in group D. Postoperatively, 10 and two patients in groups D and MF respectively felt sedation was excellent (P value 0.02) while increased need for sedation was felt by one and three patients in groups D and MF respectively (P value 0.028). AFOI was remembered by six and one patients in groups D and MF respectively (P value 0.003). Two in group D and three in group MF had moderate discomfort. None experienced severe discomfort. The overall satisfaction score was comparable. There were no serious adverse events during the study. Conclusions: Dexmedetomidine provides better intubating conditions and patient satisfaction without adversely affecting the airway or haemodynamic stability during AFOI","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43591921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Anaesthetic management of a huge mediastinal tumour with tracheobronchial compression 巨大纵隔肿瘤伴气管支气管压迫的麻醉治疗

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02212

A. Shenoy, Shyamsunder Kamath

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Utility of arterial to end-tidal carbon dioxide difference [P(a – ET)CO2] as a weaning index 动脉与潮汐末二氧化碳差异[P（a–ET）CO2]作为断奶指数的效用

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02110

Prathibha Todur, S. Johnson, A. Shenoy

{"title":"Utility of arterial to end-tidal carbon dioxide difference [P(a – ET)CO2] as a weaning index","authors":"Prathibha Todur, S. Johnson, A. Shenoy","doi":"10.5005/jp-journals-11010-02110","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02110","url":null,"abstract":"Introduction: Quantification of physiological dead space (VDphys) provides important insight into the efficiency of ventilation and its relation to pulmonary perfusion. Arterial to end-tidal carbon dioxide difference [P(a-ET)CO2] may provide a valuable surrogate measure of VDphys and may be useful as an index of weaning success. Aim: To evaluate the utility of [P(a-ET)CO2] as a weaning index. Methods: This prospective study enrolled 52 invasively mechanically ventilated adult patients treated in Medical Intensive Care Unit (MICU) between December 2010 and December 2011. The end-tidal carbon dioxide concentration was measured using a side stream capnograph at each attempt at decreasing ventilatory support and when they were ready to be weaned. A receiver operating characteristic (ROC) curve was constructed for weaning success, progressive weaning and extubation success. A cut-off point was obtained from these curves from which the sensitivity, specificity, positive and negative predictive values were obtained. Results: The ability of [P(a-ET)CO2] as a predictor of progressive reduction in ventilator support (n = 118), predictor of weaning from mechanical ventilation (n = 40) and for extubation success (n = 39) was evaluated. The area under the curve (AUC) for progressive weaning, spontaneous breathing trial and extubation success were 0.852, 0.905 and 0.702 and a threshold of 10.5 mm Hg, 9.4 mm Hg and 9.5 mm Hg respectively were obtained. Conclusion: P(a-ET)CO2 of ≤ 10 mm Hg may be used as an index of weaning during progressive weaning from mechanical ventilation, spontaneous breathing trial and to predict success of extubation.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47870318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Challenges in critical care medicine in India 印度重症医学面临的挑战

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02101

J. V. Divatia

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Practical approach to sleep disordered breathing 治疗睡眠呼吸障碍的实用方法

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02205

Anup Bansal, A. S. Ponnish, N. Ramakrishnan

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Comparison of Laryngeal tube suction II (LTS II) and Proseal laryngeal mask airway (PLMA) for controlled ventilation in anaesthetised and paralysed adult patients 喉导管抽吸II（TTS-II）和Prosecal喉罩气道（PLMA）在麻醉和瘫痪成年患者控制通气中的比较

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Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02105

N. Jasmine, A. Shenoy, Daniel Thomas Anjilivelil

{"title":"Comparison of Laryngeal tube suction II (LTS II) and Proseal laryngeal mask airway (PLMA) for controlled ventilation in anaesthetised and paralysed adult patients","authors":"N. Jasmine, A. Shenoy, Daniel Thomas Anjilivelil","doi":"10.5005/jp-journals-11010-02105","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02105","url":null,"abstract":"Background: LTS II and PLMA are supraglottic devices that may be used for ventilation in patients with normal as well as difficult airways at risk of aspiration. Aim: Comparison of LTS II with PLMA during controlled ventilation in paralysed patients with respect to time to successful insertion, success rate of insertion, attempts at repositioning, airway leak pressure, ease of ventilation and Ryle’s tube insertion, fibreoptic laryngeal view and complications. Methods: Thirty patients were studied using a prospective, randomised cross-over design. Ethical committee clearance and informed consent were obtained from all patients. Anaesthesia was induced with propofol and fentanyl and neuromuscular blockade achieved with vecuronium. Patients were divided into two groups: Group LTS and Group PLMA. In each group, the first airway device was inserted, various parameters observed and then removed. The second airway device was then inserted and the same parameters noted. Anaesthesia was continued with the second device in position. Results: Success with insertion at first attempt and time to insertion were comparable with both devices [LTS II 27/30 (17.5 s) and PLMA 29/30 (15.5 s) respectively]. PLMA required repositioning in fewer patients and provided better fibreoptic view than LTS II. Ryle’s tube insertion failed in four patients with PLMA but in none with LTS II. No significant difference was found in the airway seal pressure [mean, PLMA (27 cm H2 O) and LTS II (26.4 cm H2 O)], ease of ventilation or overall complications. Conclusion: Insertion and ventilation are comparable with PLMA and LTS II. Ryle’s tube insertion is easier with LTS II but requires more repositioning attempts and does not provide a good view of the larynx","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48867160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0