4 results on '"Nadkarni, Vinay"'
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2. First-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial.
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Garcia-Marcinkiewicz, Annery G, Kovatsis, Pete G, Hunyady, Agnes I, Olomu, Patrick N, Zhang, Bingqing, Sathyamoorthy, Madhankumar, Gonzalez, Adolfo, Kanmanthreddy, Siri, Gálvez, Jorge A, Franz, Amber M, Peyton, James, Park, Raymond, Kiss, Edgar E, Sommerfield, David, Griffis, Heather, Nishisaki, Akira, von Ungern-Sternberg, Britta S, Nadkarni, Vinay M, McGowan, Francis X Jr, and Fiadjoe, John E
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ESOPHAGUS , *RESEARCH , *AIRWAY (Anatomy) , *CHILDREN'S hospitals , *RESEARCH methodology , *MEDICAL cooperation , *EVALUATION research , *RANDOMIZED controlled trials , *COMPARATIVE studies , *LARYNGOSCOPY , *STATISTICAL sampling , *TRACHEA intubation , *VIDEO recording - Abstract
Background: Orotracheal intubation of infants using direct laryngoscopy can be challenging. We aimed to investigate whether video laryngoscopy with a standard blade done by anaesthesia clinicians improves the first-attempt success rate of orotracheal intubation and reduces the risk of complications when compared with direct laryngoscopy. We hypothesised that the first-attempt success rate would be higher with video laryngoscopy than with direct laryngoscopy.Methods: In this multicentre, parallel group, randomised controlled trial, we recruited infants without difficult airways abnormalities requiring orotracheal intubation in operating theatres at four quaternary children's hospitals in the USA and one in Australia. We randomly assigned patients (1:1) to video laryngoscopy or direct laryngoscopy using random permuted blocks of size 2, 4, and 6, and stratified by site and clinician role. Guardians were masked to group assignment. The primary outcome was the proportion of infants with a successful first attempt at orotracheal intubation. Analysis (modified intention-to-treat [mITT] and per-protocol) used a generalised estimating equation model to account for clustering of patients treated by the same clinician and institution, and adjusted for gestational age, American Society of Anesthesiologists physical status, weight, clinician role, and institution. The trial is registered at ClinicalTrials.gov, NCT03396432.Findings: Between June 4, 2018, and Aug 19, 2019, 564 infants were randomly assigned: 282 (50%) to video laryngoscopy and 282 (50%) to direct laryngoscopy. The mean age of infants was 5·5 months (SD 3·3). 274 infants in the video laryngoscopy group and 278 infants in the direct laryngoscopy group were included in the mITT analysis. In the video laryngoscopy group, 254 (93%) infants were successfully intubated on the first attempt compared with 244 (88%) in the direct laryngoscopy group (adjusted absolute risk difference 5·5% [95% CI 0·7 to 10·3]; p=0·024). Severe complications occurred in four (2%) infants in the video laryngoscopy group compared with 15 (5%) in the direct laryngoscopy group (-3·7% [-6·5 to -0·9]; p=0·0087). Fewer oesophageal intubations occurred in the video laryngoscopy group (n=1 [<1%]) compared with in the direct laryngoscopy group (n=7 [3%]; -2·3 [-4·3 to -0·3]; p=0·028).Interpretation: Among anaesthetised infants, using video laryngoscopy with a standard blade improves the first-attempt success rate and reduces complications.Funding: Anaesthesia Patient Safety Foundation, Society for Airway Management, and Karl Storz Endoscopy. [ABSTRACT FROM AUTHOR]- Published
- 2020
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3. Ian Jacobs - Resuscitation leader, educator and researcher.
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Parr, Michael, Morley, Peter, Considine, Julie, Walker, Tony, Nolan, Jerry P., Perkins, Gavin D., and Nadkarni, Vinay M.
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HISTORY of medical research , *HISTORY of medical education , *RESUSCITATION , *HISTORY , *LEADERSHIP - Published
- 2015
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4. Sustained Aeration of Infant Lungs (SAIL) trial: study protocol for a randomized controlled trial.
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Foglia EE, Owen LS, Thio M, Ratcliffe SJ, Lista G, Te Pas A, Hummler H, Nadkarni V, Ades A, Posencheg M, Keszler M, Davis P, and Kirpalani H
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- Australia, Bronchopulmonary Dysplasia etiology, Canada, Clinical Protocols, Europe, Gestational Age, Humans, Infant, Extremely Premature, Infant, Newborn, Prospective Studies, Research Design, Respiratory Distress Syndrome, Newborn diagnosis, Respiratory Distress Syndrome, Newborn mortality, Respiratory Distress Syndrome, Newborn physiopathology, Risk Factors, Time Factors, Treatment Outcome, United States, Intermittent Positive-Pressure Ventilation adverse effects, Intermittent Positive-Pressure Ventilation mortality, Lung physiopathology, Positive-Pressure Respiration adverse effects, Positive-Pressure Respiration mortality, Respiratory Distress Syndrome, Newborn therapy
- Abstract
Background: Extremely preterm infants require assistance recruiting the lung to establish a functional residual capacity after birth. Sustained inflation (SI) combined with positive end expiratory pressure (PEEP) may be a superior method of aerating the lung compared with intermittent positive pressure ventilation (IPPV) with PEEP in extremely preterm infants. The Sustained Aeration of Infant Lungs (SAIL) trial was designed to study this question., Methods/design: This multisite prospective randomized controlled unblinded trial will recruit 600 infants of 23 to 26 weeks gestational age who require respiratory support at birth. Infants in both arms will be treated with PEEP 5 to 7 cm H2O throughout the resuscitation. The study intervention consists of performing an initial SI (20 cm H20 for 15 seconds) followed by a second SI (25 cm H2O for 15 seconds), and then PEEP with or without IPPV, as needed. The control group will be treated with initial IPPV with PEEP. The primary outcome is the combined endpoint of bronchopulmonary dysplasia or death at 36 weeks post-menstrual age., Trial Registration: www.clinicaltrials.gov , Trial identifier NCT02139800 , Registered 13 May 2014.
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- 2015
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