Browsing by Subject "Intubation, Intratracheal"

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    Assessment of neuromuscular and haemodynamic effects of cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia in elderly patients
    (2004) Keleş G.T.; Yentür A.; Çavuş Z.; Sakarya M.
    Background and objective: Neuromuscular block times, quality of muscle relaxation for tracheal tube insertion, and the haemodynamic effects after cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia were compared in elderly patients. Methods: The study was performed in 40 patients over 65 yr of age. Anaesthesia was induced with thiopental, and maintained with sevoflurane in N2O/O2 and remifentanil. Cisatracurium 0.15 mg kg-1 or vecuronium 0.1 mg kg-1 were administered after induction. Intubation was attempted when neuromuscular block was 95%. Onset time, clinical duration of action, recovery index, spontaneous recovery time and tracheal intubation conditions were assessed. Haemodynamic parameters were also monitored. Results: The average ages of the patients were 72.5 ± 5.1 and 73.6 ± 6.3 in the cisatracurium and vecuronium groups, respectively. Onset time was significantly shorter after vecuronium, 158 ± 34s vs. 200 ± 50s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 ± 7.5s vs. 33.7 ± 18.6s (P < 0.05). Clinical duration and spontaneous recovery time were similar in both groups as well as haemodynamic variables. Conclusions: In elderly patients, vecuronium has a faster onset time while cisatracurium has a shorter recovery index under sevoflurane-remifentanil anaesthesia.
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    Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns with Respiratory Distress Syndrome
    (Elsevier (Singapore) Pte Ltd, 2016) Karadag A.; Ozdemir R.; Degirmencioglu H.; Uras N.; Dilmen U.; Bilgili G.; Erdeve O.; Cakir U.; Atasay B.
    Background The aim of this study was to compare the efficacy and adverse effects of various intratracheal beractant administration positions in preterm newborns with respiratory distress syndrome. Methods This study was performed on preterm newborns with respiratory distress syndrome. The inclusion criteria were being between 26 weeks and 32 weeks of gestational age, having a birth weight between 600 g and 1500 g, having received clinical and radiological confirmation for the diagnosis of respiratory distress syndrome (RDS) within 3 hours of life, having been born in one of the centers where the study was carried out, and having fractions of inspired oxygen (FiO2) ≥ 0.40 to maintain oxygen saturation by pulse oximeter at 88-96%. Beractant was administered in four positions to Group I newborns, in two positions to Group II, and in neutral position to Group III. Results Groups I and II consisted of 42 preterm infants in each whereas Group III included 41 preterm infants. No significant differences were detected among the groups with regards to maternal and neonatal risk factors. Groups were also similar in terms of the following complications: patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH), chronic lung disease (CLD), retinopathy of prematurity (ROP), necrotising enterocolitis (NEC), death within the first 3 days of life, death within the first 28 days of life, and rehospitalization within 1 month after discharge. Neither any statistically significant differences among the parameters related with surfactant administration, nor any significant statistical differences among the FiO2 levels and the saturation levels before and after the first surfactant administration among the groups were determined. Conclusion In terms of efficacy and side effects, no important difference was observed between the recommended four position beractant application, the two position administration, and the neutral position. Copyright © 2016, Taiwan Pediatric Association.
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    A view on pediatric airway management: a cross sectional survey study
    (Edizioni Minerva Medica, 2022) Saracoglu A.; Saracoglu K.T.; Sorbello M.; Kurdi R.; Greif R.; Abitagaoglu S.; Akin M.; Aksu A.; Aladag E.; Alagoz A.; Alanoglu Z.; Alicikus Tuncel Z.; Altinisik H.B.; Ambrosoli A.L.; Amella S.; Andrašovský A.; Andreotti A.; Arici A.G.; Armstrong J.; Arslan B.; Ávila E.; Aydogmus I.; Ayhan A.; Ayoglu H.; Ayvat P.; Bakis M.; Basaran B.; Baytar C.; Begec Z.; Belete A.; Belludi R.; Bianco M.C.; Bilgin M.U.; Biricik E.; Brueggeney M.K.; Bunjaku D.; Buyukkocak U.; Catineau J.; Cebrián C.G.; Chinnappa S.M.; Cicekci A.; Corte-Ballester J.; Cuéllar Martínez A.B.; Caglar T.; Calisir F.; Cokay Abut Y.; Delen L.A.; Deligoz O.; Demirgan S.; Distefano R.; Dmytriiev D.; Duarte L.; Ece C.; El-Tahan M.; El-Hatib M.; Erdogan Ari D.; Erkalp K.; Erol D.; Erturk E.; Frada R.; Fuchs A.; Garini E.; Gecici M.E.; Giallongo M.; Gomes C.; Gurbuz H.; Has Selmi N.; Hasani A.; Hernandez Cera C.; Hilker T.; Horatanaruang D.; Huitink J.; Karaaslan P.; Karaveli A.; Karisik M.; Kavas A.D.; Kaya A.; Kendigelen P.; Kilinc G.; Koc S.; Dilmen O.; Kozanhan B.; Kupeli I.; Kuyrukluyildiz U.; Lleshi A.; Loizou M.; Luanpholcharoenchai J.; Martinez V.; Matoshi D.; Maurya I.; Meco B.C.; Michalek P.; Milic M.; Mitre I.; Montealegre F.; Nair A.; Nallbani R.; Ng A.; Oc B.; Ok G.; Olguner C.; Ozkan D.; Oksuz G.; Ozcan M.S.; Ozden E.S.; Ozden Omaygenc D.; Ozer Y.; Ozmenoglu Turker H.; Ozmert S.; Rai E.; Rangappa D.; Roca De Togores A.; Salgado H.; Santos P.; Sari S.; Saritas A.; Saygi Emir N.; Sen B.; Shallik N.; Shamim F.; Shirgoska B.; Silay E.; Sinha T.; Srimueang T.; Sudarshan P.; Sugur T.; Sumer I.; Szucs Z.; Sahin T.; Sanal Bas S.; Tan J.; Tawfik L.; Topal S.; Toy E.; Turan Civraz A.Z.; Unal D.; Ural S.G.; Ustalar Ozgen S.Z.; Uysal H.; Yesildal H.; Yilmaz C.; Yuen V.; Yurt E.; Yuzkat N.; Zdravkovic M.; Isohanni M.
    BACKGROUND: This survey aimed to investigate routine practices and approaches of clinicians on pediatric airway in anesthesia and intensive care medicine. METHODS: A 20-question multiple-choice questionnaire with the possibility to provide open text answers was developed and sent. The survey was sent to the members of European Airway Management Society via a web-based platform. Responses were analyzed thematically. Only the answers from one representative of the pediatric service of each hospital was included into the analysis. RESULTS: Among the members, 143 physicians responded the survey, being anesthesiologists (83.2%), intensivists (11.9%), emergency medicine physicians (2.1%), and (2.8%) pain medicine practitioners. Astraight blade was preferred by 115 participants (80.4%) in newborns, whereas in infants 86 (60.1%) indicated a curved blade and 55 (38.5%) a straight blade. Uncuffed tracheal tube were preferred by 115 participants (80.4%) in newborns, whereas 24 (16.8%) used cuffed tubes. Approximately 2/3 of the participants (89, 62.2%) reported not to use routinely a cuff manometer in their clinical practice, whereas 54 participants (37.8%) use it routinely in pediatric patients. Direct laryngoscopy for routine pediatric tracheal intubation was reported by 127 participants (88.8%), while 16 (11.2%) reported using videolaryngoscopes routinely. Interestingly, 39 (27.3%) had never performed neither videolaryngoscopy nor flexible bronchoscopy in children. These results were significantly less in hospitals with a dedicated pediatric anesthesiologist. CONCLUSIONS: This survey on airway management in pediatric anesthesia revealed that the use of cuffed tubes and the routine monitoring of cuff pressure are rare. In addition, the rate of videolaryngoscopy or flexible optical intubation was low for expected difficult intubation. Our survey highlights the need for properly trained pediatric anesthesiologists working in-line with updated scientific evidence. © 2022 Edizioni Minerva Medica. All rights reserved.