Laryngeal Competence after Tracheal Extubation

Burgess, G. E.; Cooper, John R.; Marino, Robert J.; Peuler, Martin J.; Warriner, Robert A.

doi:10.1097/00000542-197907000-00016

Cited by 81 publications

(30 citation statements)

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“…[15,16] Postoperative pulmonary complication incidence of our study was 18.7%, which revealed that male gender, smoking history, coexistence of COPD, and psychiatric complication occurrence were the factors associated with higher risk for post-thoracotomy pulmonary complication incidence; all in accordance with the current literature.…”

Section: Discussionsupporting

confidence: 90%

What is the optimal postoperative oral feeding timing protocol for thoracotomy patients? Prospective randomized clinical trial on postoperative complications

Evman¹,

Akoğlu²,

Yıldızeli³

et al. 2017

Turk Gogus Kalp Dama

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Section: Discussionsupporting

confidence: 90%

What is the optimal postoperative oral feeding timing protocol for thoracotomy patients? Prospective randomized clinical trial on postoperative complications

Evman¹,

Akoğlu²,

Yıldızeli³

et al. 2017

Turk Gogus Kalp Dama

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“…However, residual effects of sedoanalgesia may reduce or suppress the cough reflex, and periglottic sensation may be abnormal for up to 8 h following extubation. 15 Burgess and colleagues 16 reported pulmonary aspiration in 8 of 24 patients who swallowed a solution immediately after extubation. Surprisingly, none of them coughed during the test.…”

Section: Discussionmentioning

confidence: 99%

Effect of Applying Positive Pressure With or Without Endotracheal Suctioning During Extubation: A Laboratory Study

et al. 2014

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BACKGROUND: During invasive mechanical ventilation, secretions accumulate in the subglottic space; consequently, there is a risk of aspiration of these secretions into the airway during cuff deflation and extubation. To minimize this risk, 2 extubation methods are used. The first consists of introducing a suction catheter into the endotracheal tube (ETT) and the trachea. After initiating suctioning, the cuff is deflated and the ETT is removed together with the suction catheter. The second technique involves applying positive pressure to the ETT using a resuscitation bag. Once the manual breath is delivered, the ETT cuff is deflated and the ETT is removed without suction. The aim of this laboratory study is to determine the existence and magnitude of differences in leak volume during cuff deflation and extubation using various combinations of positive pressure with or without endotracheal suctioning.

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“…Cardiovascular complications include tachycardia, hypotensive and hypertensive episodes [7][8][9][10], which may be significant in patients with pre-existing ischaemic heart disease [11,12], pre-eclampsia [13] and in those undergoing neurological procedures [14]. Respiratory complications include local trauma, coughing, desaturation, breath-holding, masseter-spasm, laryngospasm, airway obstruction and aspiration [7,[15][16][17][18]]. …”

Section: Discussionmentioning

confidence: 99%

Airway management before, during and after extubation: a survey of practice in the United Kingdom and Ireland

Rassam¹,

Sandby-Thomas²,

Vaughan³

et al. 2005

Anaesthesia

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SummaryComplications at extubation remain an important risk factor in anaesthesia. A postal survey was conducted on extubation practice amongst consultant anaesthetists in the United Kingdom and Ireland. The use of short acting drugs encourages anaesthetists to extubate the trachea at lighter levels of anaesthesia. The results show that oxygen (100%) is not routinely administered either before extubation or en route to the recovery area. A trend towards a head up or sitting position at extubation is emerging. However, further research into the use of these positions is required. Airway related complications at extubation are relatively frequent but are usually dealt with by simple basic measures. The role of drugs such as propofol in decreasing the incidence of these complications needs further evaluation. Some of these results give concern for patient safety and for training. The importance of teaching and adherence to continued oxygenation until complete recovery is strongly emphasised. Nerve stimulators should be used continually as standard monitoring throughout the anaesthetic period when muscle-relaxing drugs are part of the anaesthetic technique. It has been shown that there are more adverse incidents associated with extubation than intubation and these are occurring not only during extubation itself, but also during the time spent in the recovery room [1][2][3][4][5]. The increased incidence of complications has been correlated with the pre-operative physical status, depth of anaesthesia at extubation, increasing age and gender with a male preponderance [2,6]. These complications remain consistent regardless of the type of operation [1].The problems associated with extubation may be broadly categorised into cardiovascular and respiratory complications. Cardiovascular complications include tachycardia, hypotensive and hypertensive episodes [7][8][9][10], which may be significant in patients with pre-existing ischaemic heart disease [11,12], pre-eclampsia [13] and in those undergoing neurological procedures [14]. Respiratory complications include local trauma, coughing, desaturation, breath-holding, masseter-spasm, laryngospasm, airway obstruction and aspiration [7,[15][16][17][18]].An on-line journal search revealed a lack of recent investigations or statistical data in these areas. This survey was performed with this in mind. The main aims of the survey were twofold. The first was to ascertain extubation practices with regard to the type of surgery, timing, position and techniques. The second was to estimate the incidence of problems associated with extubation and how these were treated. MethodsA postal survey was conducted in May 2004. A total of 845 Consultant Anaesthetists were randomly selected from the membership database of the Association of Anaesthetists of Great Britain and Ireland (AAGBI). These anaesthetists were sent the questionnaire, which they were asked to complete and return anonymously in the stamped, addressed envelope provided. The questionnaire (Fig. 1) was a structured document with...

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Laryngeal Competence after Tracheal Extubation

Cited by 81 publications

References 0 publications

What is the optimal postoperative oral feeding timing protocol for thoracotomy patients? Prospective randomized clinical trial on postoperative complications

What is the optimal postoperative oral feeding timing protocol for thoracotomy patients? Prospective randomized clinical trial on postoperative complications

Effect of Applying Positive Pressure With or Without Endotracheal Suctioning During Extubation: A Laboratory Study

Airway management before, during and after extubation: a survey of practice in the United Kingdom and Ireland

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