Based on lower rescue anaesthetic requirements, sufficient sedation and parental separation scores in Group 2, intranasal dexmedetomidine 4 µg kg(-1) was more efficient than intranasal dexmedetomidine 3 µg kg(-1). The intranasal route may be an alternative noninvasive route to apply drugs for MRI sedation in paediatric patients. Trial registration ClinicalTrials.gov: NCT02299232.
Background: In Covid-19 pneumonia, high mortality rates reported in intubated patients have raised noninvasive methods of respiratory support. Objective: We aimed to evaluate the impact of HFNC application on intubation requirement, intensive care length of stay, and short-term mortality in patients with COVID-19 pneumonia. Material-method: Patients receiving oxygen by reservoir mask or HFNC therapy in our intensive care units due to COVID-19 pneumonia were included in the study. Group H consisted of patients who received HFNC, and Group K consisted of patients who received conventional oxygen therapy (COT). The number of patients intubated, duration of intensive care stay and short-term mortality were recorded. Results: 43 patients were included. The short-term mortality and the number of patients with intubation need was lower in Group H. There was no significant difference between the Groups in the length of intensive care stay. Conclusion: Administration of HFNC in respiratory failure secondary to COVID-19 pneumonia decreases the need for intubation and mortality.
Background
We evaluated the effect of early awake prone position administration on oxygenation and intubation requirements and short-term mortality in patients with acute respiratory failure due to coronavirus disease 2019 (COVID-19) pneumonia.
Methods
This is an observational-cohort study. Patients receiving mask oxygen therapy in our intensive care units because of acute respiratory failure due to COVID-19 pneumonia were included. The Awake Prone Position (APP) group consisted of patients who were applied awake prone position, whereas non-APP group consisted of patients who were not applied awake prone position. PaCO
2
, PaO
2
, pH, SpO
2
values and PaO
2
/FiO
2
ratios were recorded at the beginning and 24th hour. Demographic data, comorbidities, intubation requirements, ventilator-free days, length of intensive care unit stay and short-term mortality of the patients were recorded.
Results
The data of total 225 patients were examined, and 48 patients who met our study criteria were included. At the 24th hour, the median SpO
2
value of the APP group was 95%, the median PaO
2
value was 82 mmHg, whereas the SpO
2
value of the non-APP group was 90% and the PaO
2
value was 66 mmHg. (
p
= 0.001,
p
= 0.002). There was no statistically significant difference between the groups in length of intensive care unit stay and ventilator-free days, but short-term mortality and intubation requirements was lower in the APP group (
p
= 0.020,
p
= 0.001)
Conclusion
Awake prone position application in patients receiving non-rebreather mask oxygen therapy for respiratory failure due to COVID-19 pneumonia improves oxygenation and decreases the intubation requirements and mortality.
Fentanyl provides better operative conditions and reduces the need for additional propofol doses. These advantages cause a shorter recovery time. Therefore, propofol-fentanyl is superior to the propofol-alfentanil for sedation-analgesia in colonoscopy.
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