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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.
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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 epinep
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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.
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4

Sakezles, Christopher Thomas. Hybrid endotracheal tubes. 1998.

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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 f
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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 mad
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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, a
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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 tu
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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 a
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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,
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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 bod
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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 func
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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 impo
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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.
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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 ac
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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
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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
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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 tr
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