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Books on the topic 'Endotracheal tube'
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1
Fox, Grenville, Nicholas Hoque, and Timothy Watts. Practical procedures. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0020.
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This chapter provides detailed step-by-step descriptions of all the necessary practical procedures in neonatal care. It includes helpful hints and possible complications. Procedures covered include endotracheal intubation, blood sampling, vascular access, CSF sampling, exchange and dilutional transfusion, nasogastric and nasojejunal tube insertion, intercostal chest drain insertion, transurethral catheterization, and suprapubic aspiration of urine.
2
Gore, Cheryl, Junzheng Wu, and C. Dean Kurth. Stridor after Extubation. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0066.
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Postextubation stridor arises from glottic and subglottic edema caused by ischemia of the tracheal mucosa from pressure by the endotracheal tube. Multiple risk factors have been described; preventive measures include appropriate tube sizing, air leak tests, administration of steroids, and smooth airway management techniques, such as atraumatic intubation. When stridor does occur, cool humidified air as well as racemic epinephrine may be used as treatment. The patient is safe for discharge once symptoms have dramatically improved and the window for potential “rebound effect” from racemic epinephrine has passed with no further stridor.
3
Pasala, Sanjiv, Eylem Ocal, and Stephen M. Schexnayder. Procedures. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0004.
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This chapter describes the most common invasive bedside procedures used to facilitate the treatment of critically ill infants and children. These procedures provide invasive monitoring, support organ function, deliver therapies, and aid in diagnostic and therapeutic interventions. The authors include the indications, equipment needed, the required technique, and complications that must be considered for endotracheal intubation, arterial and central venous catheter placement, tube thoracostomy, abdominal paracentesis, pericardiocentesis, and ventriculoperitoneal shunt tap.
5
Fox, Grenville, Nicholas Hoque, and Timothy Watts. Normal values, therapeutic drug levels, and useful formulae. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0021.
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This chapter includes data on normal neonatal blood, urine, and cerebrospinal fluid (CSF) biochemistry values; normal neonatal haematology values; and therapeutic drug levels. Values given use SI units and notes are included to explain any changes expected with gestational and post-natal age, along with notes and references to greater detail in other relevant chapters. The importance of minor variance from locally used normal values is noted, along with local recommendations for therapeutic drug levels. Useful respiratory and biochemical physiological formulae are given, along with some used for routine practical procedures including tube length for endotracheal intubation and umbilical catheter length.
6
Fox, Grenville, Nicholas Hoque, and Timothy Watts. Respiratory support. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0008.
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This chapter includes sections on various modes of both invasive (i.e. via an endotracheal tube) and non-invasive respiratory support in neonates, including conventional ventilation, volume-targeted ventilation, high-frequency oscillatory ventilation (HFOV), extracorporeal membrane oxygenation (ECMO), nasal continuous positive airways pressure (nCPAP), nasal intermittent positive pressure ventilation (nIPPV), and high and low-flow nasal cannula oxygen. There is also a brief section on the care of babies with a tracheostomy as well as management of babies requiring home oxygen. Reference is made to the most recent European Consensus Guidelines. A separate chapter on neonatal respiratory problems (Chapter 7) gives further detail on common lung pathologies requiring respiratory support in neonates.
7
Lee, Richard. Pulse oximetry and capnography in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0073.
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The estimation of arterial oxygen saturation by pulse oximetry and arterial carbon dioxide tension by capnography are vital monitoring techniques in critical care medicine, particularly during intubation, ventilation and transport. Equivalent continuous information is not otherwise available. It is important to understand the principles of measurement and limitations, for safe use and error detection. PETCO2 and oxygen saturation should be regularly checked against PaCO2 and co-oximeter SO2 obtained from the blood gas machine. The PECO2 trace informs endotracheal tube placement, ventilation, and blood flow to the lungs. It is essential their principles of estimation, the information gained and the traps in interpretation are understood.
8
Tinch, Brian, David Martin, and Junzheng Wu. Cystic Fibrosis. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0018.
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Cystic fibrosis is an inherited disorder. The diagnosis should be suspected in an infant who has meconium ileus or infants presenting to the operating room with volvulus. Cystic fibrosis is characterized by frequent mucous plugging in the respiratory tract which may manifest as wheezing and frequent intermittent flare-ups of respiratory decompensation. Optimization of the affected child’s respiratory status prior to elective surgery is mandatory to prevent difficulty with intraoperative ventilation. While the laryngeal mask airway may be used for short procedures, the use of an endotracheal tube facilitates suctioning of the frequently inspissated secretions that accompany cystic fibrosis in order to optimize ventilation.
9
Low, Aaron, and Andrew Pittaway. Neonatal Stridor. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0002.
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Stridor is a common pediatric and neonatal sign that can sometimes be associated with life-altering or even life-threatening consequences. In the neonatal population, it is often due to use of an endotracheal tube that is too small, laryngomalacia, and subglottic stenosis. Patients often present with co-existing neonatal comorbidities such as patent ductus arteriosus and bronchopulmonary dysplasia. Management of these patients is often complex, requiring exquisite teamwork by otolaryngology surgeons and pediatric anesthesiologists. This chapter reviews the pathophysiology of neonatal stridor as well as its presentation. It describes the surgical approach and challenges to anesthetic management. Crisis situations including code situationse, neonatal resuscitation, and tracheostomy are reviewed.
10
Ng, Ju-Mei. Airway Fire. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0023.
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Airway fires during tracheotomy are rare but potentially fatal events, which are preventable. There are many surgical procedures that place the patient at a higher risk for airway fires, identification of those procedures and the associated risk is the first step towards avoiding this deadly complication. In this chapter the fire triad, of which each of the three components is independently necessary for fire to occur is described. Operating room fire safety measures are reviewed, with emphasis on the management of airway fires. The immediate interventions during an airway fire are discussed, together with the dilemma of which method should be used to secure the airway after the endotracheal tube catches fire.
11
Nizamuddin, Sarah, and Caitlin Aveyard. Airway Foreign Body Aspiration. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0024.
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Aspiration of a foreign body is a potentially life-threatening problem that often necessitates an anesthetic for removal of the foreign body. Foreign body aspiration is most common among children aged 1 to 4 years old and has a wide variety of symptoms ranging from a mild, nagging cough to complete airway obstruction. Definitive diagnosis and treatment of foreign body aspiration involve flexible or rigid bronchoscopy. The urgency of the procedure depends on the type of object aspirated and the location of the foreign body in the airway. The appropriate anesthetic for removal of the foreign body is dependent upon the surgeon’s plan and involves several steps in decision-making: intravenous versus inhalational induction, airway maintenance (endotracheal tube vs. supraglottic airway vs. mask), spontaneous versus controlled ventilation, maintenance of anesthesia (total intravenous anesthesia vs. volatile agents). Good communication with the surgeon or proceduralist is key to a safe and effective anesthetic.
12
Carlucci, Annalisa, and Paolo Navalesi. Weaning failure in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0103.
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Weaning failure has been defined as failure to discontinue mechanical ventilation, as assessed by the spontaneous breathing trial, or need for re-intubation after extubation, so-called extubation failure. Both events represent major clinical and economic burdens, and are associated with high morbidity and mortality. The most important mechanism leading to discontinuation failure is an unfavourable balance between respiratory muscle capacity and the load they must face. Beyond specific diseases leading to loss of muscle force-generating capacity, other factors may impair respiratory muscle function, including prolonged mechanical ventilation, sedation, and ICU-acquired neuromuscular dysfunction, potentially consequent to multiple factors. The load depends on the mechanical properties of the respiratory system. An increased load is consequent to any condition leading to increased resistance, reduced compliance, and/or occurrence of intrinsic positive-end-expiratory pressure. Noteworthy, the load can significantly increase throughout the spontaneous breathing trial. Cardiac, cerebral, and neuropsychiatric disorders are also causes of discontinuation failure. Extubation failure may depend, on the one hand, on a deteriorated force-load balance occurring after removal of the endotracheal tube and, on the other hand, on specific problems. Careful patient evaluation, avoidance and treatment of all the potential determinants of failure are crucial to achieve successful discontinuation and extubation.
13
Rello, Jordi, and Bárbara Borgatta. Pathophysiology of pneumonia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0115.
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Airway colonization, ventilator-associated tracheobronchitis (VAT), and hospital-acquired (HAP) and ventilator-associated pneumonia (VAP) are three manifestations having the presence of micro-organisms in airways in common. Newer definitions have to consider worsening of oxygenation, in addition to purulent respiratory secretions, chest-X rays opacities, and biomarkers of inflammation. Bacteria are the main causes of HAP/VAP. During hospitalization there’s a shift of airway’s colonizing flora from core organisms to enteric and non-fermentative ones. Macro- and micro-aspiration is the most important source of pneumonia. Endotracheal tube secretion leakage is an important source, serving biofilm as a reservoir. Exogenous colonization is infrequent, but it may contribute to cross-infection with resistant species. Prevention of VAP can be achieved by implementing multidisciplinary care bundles focusing on oral/hand hygiene and control of sedation. Pneumonia develops when micro-organisms overwhelm host defences, resulting in a multifocal process. Risk and severity of pneumonia is determined by bacterial burden, organism virulence and host defences. Innate and adaptive immune responses are altered, decreasing clearing of pathogens. Some deficits of the complement pathway in intubated patients are associated with increased risk for VAP and higher mortality. Micro-arrays have demonstrated specific different immunological signatures for VAP and VAT. Early antibiotic therapy is associated with a decrease in early HAP/VAP incidence, but selects for MDR organisms. Attributable mortality is lower than 10%, but HAP/VAP prolongs length of stay, and dramatically increase costs and use of health care resources.
14
Hermans, Greet. Introduction: Chronic Organ Dysfunction Following Critical Illness. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0012.
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Chapter 12 introduces various issues surrounding organ dysfunction following critical illness and ICU hospitalizations. It covers possible complications that can arise from various organ system failures or problems during ICU stays, including difficult ventilator weaning and tracheostomy, local complications from endotracheal tubes (ETTs), surviving acute kidney injury (AKI), and decreased functional capacity and decreased QoL.
15
Eyre, Lorna, and Simon Whiteley. In-hospital transfer of the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0004.
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While focus has traditionally been on the planning, logistics, and outcome of inter-hospital transfers of the critically-ill patient, attention is turning to in-hospital transfers. Numerically, more in-hospital transfers occur and there is growing evidence that these are associated with a high incidence of adverse events, and increased morbidity and mortality. Appropriate planning, communication, and preparation are essential. Patients should be resuscitated and stabilized (optimized) prior to transfer, to prevent deterioration or instability during transfer. Endotracheal tubes and vascular access devices should be secure. The minimum recommended standards of monitoring should be applied. All drugs and equipment likely to be required during the transfer should be checked and available. Critically-ill patients should be accompanied by personnel with the appropriate knowledge skills and experience to carry out the transfer safely and to deal with any complications or incidents that arise.
16
Billioux, Alexander. Infections in the Transplant Patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0056.
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Recipients of donor-derived tissues and organs are at particularly high risk of infection because of their unique combination of risk factors. Chronic illness results in more exposure to health care contexts in which pathogens—especially drug-resistant species—might be acquired. The transplant surgery itself compromises anatomical barriers to infection via indwelling venous and urinary catheters, endotracheal tubes, and surgical wounds. Donor-derived tissues and organs may harbor infectious pathogens undetected during rapid pre-transplant evaluations. The immunosuppression necessary to prevent rejection of donor tissues increases the risk of infection. In addition, each type of transplanted organ bears unique infectious risks. Many pathogens seen in post-transplant patients have unique clinical presentations. Infections in the transplant patient can vary depending on time from transplantation, the type of organ transplanted, and the primary manifestation of the infection.
17
Sinkin, Robert A., and Christian A. Chisholm, eds. PCEP Specialized Newborn Care (Book IV). 3rd ed. American Academy of Pediatrics, 2016. http://dx.doi.org/10.1542/9781610020596.
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Developed by a distinguished editorial board, the Perinatal Continuing Education Program (PCEP) is a comprehensive, self-paced education program in four volumes. This popular resource features step-by-step skill instruction, and practice-focused exercises covering maternal and fetal evaluaton and immediate newborn care. The PCEP workbooks feature leading-edge procedures and techniques, and are filled with clear explanations, step-by-step skill instruction, and practice-focused exercises. Book IV includes 6 units dealing with complex neonatal therapies, such as assisted ventilation, as well as a unit on continuing care for at-risk babies and those with special problems following intensive care. Contents include: Unit 1: Direct Blood Pressure Measurement Skills Units: Transducer Blood Pressure Monitoring Unit 2: Exchange, Reduction, and Direct Transfusions Part 1: Respiratory Distress Skills Unit: Exchange Transfusions Unit 3: Continuous Positive Airway Pressure Skills Unit: Delivery of Continuous Positive Airway Pressure Unit 4: Assisted Ventilation With Mechanical Ventilators Skills Unit: Endotracheal Tubes Unit 5: Surfactant Therapy Skills Unit: Surfactant Administration Unit 6: Continuing Care for At-Risk Babies
18
Kattwinkel, John, Robert J. Boyle, Christian A. Chisholm, and Susan B. Clarke, eds. PCEP Specialized Newborn Care (Book IV). 2nd ed. American Academy of Pediatrics, 2012. http://dx.doi.org/10.1542/9781581107128.
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New 2nd edition features step-by-step skill instruction, and practice-focused exercises. Developed by a distinguished editorial board, the Perinatal Continuing Education Program (PCEP) is a comprehensive, self-paced education program in four volumes. The PCEP workbooks have been significantly revised and brought up-to-date with leading-edge procedures and techniques. The revised volumes are filled with clear explanations, step-by-step skill instruction, and practice-focused exercises. They offer time- saving, low-cost solutions for self-paced learning or as adjuncts to instructor-led skills training. New 2nd edition features 6 units dealing with complex neonatal therapies, such as assisted ventilation, as well as a unit regarding Continuing Care for at-risk babies and those with special problems, following intensive care. Contents include: Unit 1: Direct Blood Pressure Measurement Skill Unit: Transducer Blood Pressure Monitoring Unit 2: Exchange, Reduction, and Direct Transfusions Skill Unit: Exchange Tranfusions Unit 3: Continuous Positive Airway Pressure Skill Unit: Delivery of Continuous Positive Airway Pressure Unit 4: Assisted Ventilation With Mechanical Ventilators Skill Unit: Endotracheal Tubes Unit 5: Surfactant Therapy Skill Unit: Surfactant Administration Unit 6: Continuing Care for At-Risk Babies Subsection: Babies With Special Problems Pretest Answer Key Index