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Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze the effectiveness of diaphragmatic ultrasound to predict the outcome of extubation in the adult patient in the ICU. Methodology: It is a bibliographic review, and therefore, the information search was carried out in the Wiley, PubMed, Science Direct, and Scopus databases, according to the inclusion criteria. Results: In its main findings it is evident that diaphragmatic ultrasound is a predictive tool for extubation in adult patients, with the variables of diaphragmatic excursion, thickening fraction and/or diaphragmatic thickness. Conclusion: This study contains practical implications that can be taken into account in the control and management of critically ill patients in order to achieve successful extubation goals through ultrasonographic measurements of the diaphragm muscle. [ABSTRACT FROM AUTHOR]

Introduction: one of the main effects of invasive mechanical ventilation is injury to the respiratory muscles, specifically the diaphragm. In which structural and functional alterations can occur that partially or totally modify its function. During mechanical ventilation, a process of disuse atrophy of said muscle occurs. Therefore, the clinical utility of measuring diaphragmatic muscle strength is important to know if the patient has the ability to activate the protective mechanisms of the airway to achieve successful extubation and removal of the mechanical ventilator in the shortest time possible. Objective: describe the measurement of muscle strength as a predictor of extubation in intensive care units. Material and methods: a literature review was carried out, carried out between 2011 and 2022. Results: patients who are subjected to prolonged mechanical ventilation generally develop a diaphragmatic muscle disorder, becoming a problem for the weaning, for it is important know the methods of measuring muscle strength. [ABSTRACT FROM AUTHOR]

Introduction: coughing is a physiological response to protect the airway, it produces aerosols that are identified by imaging reaching a speed of up to 8 meters per second. Extubation produces cough, hypertension, tachycardia, apnea and laryngospasm, there are methods to minimize its occurrence. Due to the COVID-19 pandemic, intravenous lidocaine and superior laryngeal nerve block have been used as cough reflex prophylaxis. The aim was to compare them in cough inhibition. Material and methods: patients aged 18-60 years, elective surgery with balanced general anesthesia, ASA 1-3, with intubation less than 3 hours, were selected. A total of 90 patients were randomized, 45 in each group. A total of 10 patients were eliminated because they presented hemodynamic instability at the end of surgery, and because the intravenous dose of lidocaine was not administered within the established time. Results: there was no statistically significant difference in the number of patients who presented cough in both groups (13 vs 10, p = 0.4684), of these there was a statistically significant difference in the number of decibels in favor of the block group (75.6 vs 67, p < 0.001). Conclusions: block presents less aerolization than intravenous lidocaine in extubation. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería Cuidándote is the property of Colegio Oficial de Enfermeria de Malaga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The word euboxia is a neologism of the Greek eu, good or normal, and the English word box, translated into Spanish as caja, it describes in the medical jargon the obsession we have trying to restore the physiological variables to a normal range; On the other hand, weaning describes a process or protocol for the removal of invasive mechanical ventilation. The euboxia during the course of weaning may delay extubation and beyond achieving reference ranges, it invites reflection and the particularized clinical judgment of the patient to achieve successful extubation. Neurological, respiratory, hemodynamic and metabolic factors must be analyzed during weaning, considering the practice of individualized dysboxia more than euboxia. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Neonatal is the property of Fundacion para la Salud Materno Infantil (FUNDASAMIN) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The identification of the appropriate moment to extubate a patient is of great importance, reintubation is a factor of poor prognosis in patients with mechanical ventilation. OBJECTIVE: To evaluate the association between brain natriuretic peptide (BNP) variability and weaning failure. MATERIAL AND METHOD: An observational, cross-sectional analytical and prospective study was conducted in SSA CDMX hospitals. Patients were included in the extubation protocol to whom serum BNP was determined prior to the spontaneous breathing test and 30 minutes after the start of this, the difference and behavior between both intakes were documented; later its evolution was monitored. RESULTS: We studied 21 patients, mean age was 60 years, the main reason for intubation was neurological deterioration. More failure was found (25%) in those subjects with a decrease in BNP with statistical significance (p = 0.05). The variables BNP1 and BNP2 were associated in a negative way (OR 0.95 and 0.89) to the outcome of failure (p = 0.04 and p = 0.006). CONCLUSIONS: Measurements of BNP variability, during the spontaneous breathing test, specifically in those with a decrease, could be useful in predicting the failure of extubation. [ABSTRACT FROM AUTHOR]

BACKGROUND: The percentage of failed extubation reported in the literature in medical intensive care units (ICU) is 10-20%. OBJECTIVE: To know the percentage of failed extubation in the trauma intensive care unit. MATERIAL AND METHOD: An observational study was conducted, without intervention, transversal and prospective, in the period from March 1st, 2017 to February 28, 2018. The inclusion criteria were: patients who entered to the trauma ICU, who used mechanical ventilation for more than 24 hours and that were extubated; both genders were accepted, who were entitled to the health Institute, coming from the emergency room or operating room. RESULTS: A hundred patients met the inclusion criteria, the percentage of failed extubation was 24%, the prevalence risk factors for failed extubation were not receiving a ventilation withdrawal protocol (p = 0.001), more than 7 days of mechanical ventilation (p = 0.01) and hypokalemia (p = 0.02). CONCLUSION: The percentage of failed extubation found in this ICU was 24%. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Mechanical ventilation (MV) is the basis of supportive treatment of acute respiratory failure. However, the perpetuation of ventilatory support beyond what is necessary can mean a greater chance of nosocomial infection, respiratory muscle atrophy and increased hospital stay and costs. Thus, the fan-off maneuver, conducted by testing spontaneous ventilation (TSV) must be designed appropriately and early in the evolution of a patient connected to VM. However, the failure of extubation also has a significant morbidity and mortality, and there are currently no suitable parameters to predict its success or failure. The CROP index in prospective cohort study found that a score of 13 mL/breath/min predicted successful weaning with positive and negative predictive values of 71% and 70%, respectively, in a population with a success rate of weaning of about 60%, which dates from 1991, without since then having any more studies, or reports of this index in the Mexican population taken. Objective: To assess the effectiveness of the CROP index as a prognostic indicator for removal of mechanical ventilatory support. Material and method: An observational, comparative, longitudinal and prolective cohort. A sample was determined of patients (men and women) under mechanical ventilatory support, in protocol withdrawal of ventilation. Initial measurements were taken to calculate CROP index, index Tobin and MIP, with a subsequent measurement at 48 hours to determine the success or failure of the extubation process. Univariate statistics were used to determine the association of the CROP index greater than 13 and the successful extubation as dichotomous qualitative variables using the χ² test. This association was also evaluated by the value of the relative risk (Hazard ratio, RR). Results: Sixty-five patients were included in the recall protocol of invasive mechanical ventilation, of whom 55.3% were women. Association with the CROP index > 13 and successful extubation was determined by finding a χ²=23.4, with a p value <0.001. This association was also evaluated by the value of the finding that the relative risk CROP index > 13 has an RR = 3.01 for successful extubation, with a confidence interval of 95% from 1.59 to 5.67. Conclusions: The CROP index above 13 (as recommended by the weaning protocol) was statistically significantly associated with successful extubation, proving to be superior even to other predictors of successful extubation. [ABSTRACT FROM AUTHOR]

Background: Atelectasis is a decrease of lung volume caused by airway obstruction or pressure on the external part of the lung. It is common after surgery and extubation. The purpose of this investigation was to determine factors related with alectasis following extubation in preterm neonates with a weight under 1250 g who were referred to a neonatal intensive care unit. Methods: The study was conducted in neonates admitted to a neonatal intensive care unit requiring mechanically assisted ventilation. Preterm neonates born at 28 to 36 weeks' gestation and with 0 to 28 days' extrauterine life, with mechanically assisted ventilation for at least 24 hours, and that when undergoing planned extubation had a weight under 1250 g were included. Two comparative groups were formed: group A, with alectasis after extubation; group B, without alectasis after extubation. Results: As factors associated with alectasis after extubation, reintubation in two or more occasions and cycling higher than 20 per minute, which were statistically relevant, were identified. Conclusions: In addition to previous general measures to prevent alectasis, extubation with ventilation not higher tan 20 cycles per minute should be programmed and reintubation should be avoided as much as possible. [ABSTRACT FROM AUTHOR]

The main objective these anesthetic technique is give the tools at the neurosurgery, to performance the neurological surgery with security in order to preserve at most the function and the preserve the patient integrity or not increase the damage that the lesion had caused. To do it, the anesthesiologist should have a special training and is compulsory meeting a high performance neuroscience team. [ABSTRACT FROM AUTHOR]

Introduction. The use of the mechanical ventilation in critically ill patients who enter the Pediatric Intensive Care Unit gets to be indispensable until in a 90% of the cases. Nevertheless, the use of this technique is not innocuous, reason why its retirement of early way is high-priority to avoid complications. To date there are few studies that demonstrate to the best method and moment to make a successful early extubation in children, having to extrapolate to this population protocols for adult patients. Insolvent. Objective. To compare the effectiveness of a protocol for early extubation, against the habitual form of extubation on the basis of the number of insolvent extubations and total time of mechanical ventilation. Material and methods. Longitudinal, prospective, comparative and randomized study. Of each patient one registered time of ventilation and sedation. In the studied group a previous test of respiratory sufficiency was applied to the extubation, and in the group control the extubation on the basis of criteria and experiences of the physicians at the PICU was carried out, establishing like time of pursuit 48 hours postextubation. Results. 106 patients entered the study, of who 52 (22 women and 30 men) belonged to the Group Protocol, with an age average of 3.82 ± 3,6 years, and 54 (29 women and 25 men) belonged to the Conventional Group, with a rank of age of 4.9 ± 4.2 years, being the diagnosis most frequent the one of Cardiothoracic Surgery in both groups. The time of Mechanical Ventilation for the group protocol (Zt = 2.68 p < 0.05) was of 70.8 ± 56.6 hours vs. 106 ± 82 hours of the conventional group and I do not appear any extubation insolvent in any of the groups. Conclusions. The time of mechanical ventilation was smaller in the group Protocol, in addition to appearing extubations in no of both groups. [ABSTRACT FROM AUTHOR]

Copyright of Revista Umbral Científico is the property of Universidad Manuela Beltran and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The extubation along with the intubation is one of the critical moments of the general anesthesia development. Currently, there aren't any algorithms or sequences of procedures design for extubation, that is why establishing previously an action strategy, having monitoring, appropriate material for the difficult airway management and experienced personnel all adapted to the specific circumstances of the patient is due. A 61 year old patient is presented with difficult airway (Mallampati IV and Cormack IV) lung cancer diagnosed and recommend for a right lower lobectomy. The early extubation was done because of the potential benefits in the thoracic surgery. The strategic plan for this particular case is exposed. [ABSTRACT FROM AUTHOR]