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4. Does Cricoid Pressure Increase the Laryngoscopy Force During Rapid Sequence Induction?--A Randomized Study.

Author

Mittal, Gourav, Jain, Divya, Mahajan, Shalvi, Puri, Goverdhan Dutt, Singh, Jaspreet, and Kumar, Ashok

Subjects
*LARYNGOSCOPY, *TRACHEA intubation, *RESPIRATORY aspiration, *SURGICAL emergencies, *INTUBATION, *HEMODYNAMICS
Abstract

Objective: Cricoid pressure, a manoeuver used to prevent pulmonary aspiration during rapid sequence induction, can result in deterioration of laryngeal view and increased haemodynamic changes. Its effect on laryngoscopy force remains unevaluated. The study aimed to assess the impact of cricoid pressure on laryngoscopy force and intubation characteristics during rapid sequence induction. Methods: Seventy American Society of Anaesthesiologists I/II patients, both sexes, aged 16-65, having non-obstetric emergency surgery were randomly assigned to the cricoid group, which received 30 N cricoid pressure during rapid sequence induction, and the sham group, which received 0 N pressure. Propofol, fentanyl, and succinylcholine were used to produce general anaesthesia. The primary outcome was the peak force of laryngoscopy. Secondary outcomes were the laryngoscopic view, time to execute endotracheal intubation, and intubation success rate. Results: With the application of cricoid pressure, the peak forces of laryngoscopy increased significantly, with a mean difference (95% CI) of 15.5 (13.8-17.2) N. With and without CP, the mean peak forces were 40.758 (4.2) and 25.2 (2.6) N, respectively, P < .001. Without cricoid pressure, the intubation success rate was 100%, compared to 85.7% with cricoid pressure, P = .025. The proportions of CL1/2A/2B patients with and without cricoid pressure were 5/23/7 and 17/15/3, respectively, with P = .005. With cricoid pressure, there was a considerable increase in intubation duration, with a mean difference (95% CI) of 24.4 (2.2-19.9) seconds. Conclusion: Cricoid pressure increases peak forces during laryngoscopy, resulting in worse intubation characteristics. This demonstrates the need of exercising care while performing this manoeuver. [ABSTRACT FROM AUTHOR]

Published
2023
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11. EFFICIENT TECHNIQUE FOR AUTOMATIC EXTRACTION AND IDENTIFICATION OF ELEVATION FROM A REFERENCE IMAGE

Author

Pradhan, Mohan Pratap, Ghose, Mrinal Kanti, Mittal, Gourav, Pradhan, Mohan Pratap, Ghose, Mrinal Kanti, and Mittal, Gourav

Abstract

In Geographic information system (GIS) identification of elevation detail pertaining to a contour in a reference map or topological map plays an important role while creating digital elevation model or digital surface model of a terrain. Traditional technique involving manual identification of elevation demands greater effort and time where in one needs to tediously identify and enter the elevation value. These identified elevations can be later used for creating digital elevation model. In order to reduce the complexity involved in same, effective and efficient automated technique can be devised that identifies the elevation associated with a contour. In addition the automated technique should also ensure correctness and reliability of the elevation details identified. The alignment of elevation details in the feature space adds to the complexity of the problem. Over years several techniques have been proposed based on object oriented technique and pattern detection. Â This proposed work introduces a novel rotation invariant technique for identifying number associated with contours taking into consideration friend pattern chain of the significant pixels representing a digit in a number.

Published
2013

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