Abstract | OBJECTIVE: Patients with pulmonary hypertension and right heart failure have a high risk of clinical deterioration and death during or soon after endotracheal intubation. The effects of sedation, hypoxia, hypoventilation, and changes in intrathoracic pressure can lead to severe hemodynamic instability. In search for safer approach to endotracheal intubation in this cohort of patients, we evaluate the safety and feasibility of an alternative intubation technique. DATA SOURCES: Retrospective data analysis. STUDY SELECTION: Two medical ICUs in large university hospitals in the United States. DATA EXTRACTION: DATA SYNTHESIS: All patients were intubated in the first attempt without major complications and eight patients (88%) were alive 24 hours after intubation. Systemic hypotension was the most frequent complication following the procedure. CONCLUSIONS: Awake bronchoscopic intubation supported with a noninvasive positive pressure delivery systems may be feasible alternative to standard direct laryngoscopy approach. Further studies are needed to better assess its safety and applicability.
|
Authors | Jimmy Johannes, David A Berlin, Parimal Patel, Edward J Schenck, Frances Mae West, Rajan Saggar, Igor Z Barjaktarevic |
Journal | Critical care medicine
(Crit Care Med)
Vol. 45
Issue 9
Pg. e980-e984
(Sep 2017)
ISSN: 1530-0293 [Electronic] United States |
PMID | 28682836
(Publication Type: Journal Article, Multicenter Study)
|
Topics |
- Bronchoscopy
(methods)
- Heart Failure
(complications)
- Hospitals, University
- Humans
- Hypertension, Pulmonary
(complications)
- Intensive Care Units
- Intubation, Intratracheal
(methods)
- Respiratory Insufficiency
(complications, therapy)
- Retrospective Studies
- Wakefulness
|