Airway Management and Risk Factors for Prolonged Intubation in Patients with Severe Croup

2021 ◽  
Author(s):  
Tadashi Oi ◽  
Norihiko Tsuboi ◽  
Kaoru Tsuboi ◽  
Satoshi Nakagawa
Keyword(s):  
Risk Factors ◽  
Airway Management ◽  
Upper Airway ◽  
Respiratory Illness ◽  
Internal Diameter ◽  
Factors Affecting ◽  
Prolonged Intubation ◽  
Age Appropriate ◽  
The Difference ◽  
Pediatric Icu

AbstractCroup is a common respiratory illness in children with a substantial variation in the severity of symptoms. Most of the patients present with mild symptoms, but patients with severe croup require intensive care unit (ICU) management. The aim of this study was to investigate the airway management of patients with severe croup who required intubation and determine the risk factors for prolonged intubation. We performed an 18-year retrospective observational cohort study at the pediatric ICU of a tertiary children's hospital in Japan. A total of 16 patients with croup who were intubated for upper airway obstruction were included in the study. Most patients (13of 16, 81%) were intubated with an endotracheal tube (ETT) smaller than their age-appropriate size. The median difference in the internal diameter (ID) between the selected ETT and the age-appropriate size was 1.0 mm (interquartile range: 0.5–1.0). Multivariate analysis performed on factors affecting the cumulative incidence of extubation revealed that the difference in ID between the selected ETT and age-appropriate size (mm) significantly reduced the duration of intubation (hazard ratio: 0.092, p = 0.03). A downsized ETT without a cuff may be recommended for intubation of patients with croup.

scholarly journals FACTORS AFFECTING CREDIT SPREAD IN INDIAN DEBT MARKET

2021 ◽  
Vol 9 (2) ◽  
pp. 333-337
Author(s):  
Praveen Gupta, Et. al.
Keyword(s):  
Risk Factors ◽  
Null Hypothesis ◽  
Credit Spread ◽  
Government Bonds ◽  
Factors Affecting ◽  
Linear Dependency ◽  
Debt Market ◽  
Repo Rate ◽  
The Difference ◽  
The Relationship

This paper shows that how Macro risk factors affect the credit spread in the Indian debt market. Credit spread is the difference between government bonds and corporate bonds of the same maturity. Various factors impact the spread directly and indirectly. The main focus of this paper to determine the relationship between these factors and find out which factors are explaining credit spread. This paper determines the significance linear dependency of credit spread on various factors through regression analysis. These factors are the market risk factors such as Inflation, GDP growth, and liquidity factors like the Repo rate. This paper will show that whether we are accepting the null hypothesis which states that these factors affect the credit spread or reject the hypothesis of no impact of variables on credit spread

scholarly journals Respiratory illness in children with disability: a serious problem?

Breathe ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. e97-e103 ◽  
Author(s):  
Marijke Proesmans
Keyword(s):  
Risk Factors ◽  
Upper Airway ◽  
Respiratory Illness ◽  
List Type ◽  
Complex Interplay ◽  
Respiratory Problems ◽  
Children With Disability ◽  
Complex Patients ◽  
Underlying Causes ◽  
Risk Of Aspiration

Key pointsChildren with neurocognitive impairment often present with chronic or recurrent respiratory problems.The respiratory problems have an important impact on quality of life and life expectancy.The underlying causes are multiple: risk of aspiration, insufficient cough, upper airway obstruction and progressive kyphoscoliosis.There is often a complex interplay between these known risk factors.The diagnostic and therapeutic approach should be multidisciplinary.Educational aimsTo provide data on the prevalence of respiratory problems in children with disability and to increase awareness on this topic.To provide insight into the complex interplay of the underlying causes and risk factors for chronic lung infection and respiratory failure.To give an overview of the diagnostic approaches relevant in this context.To highlight possible therapeutic approaches.To touch on ethical considerations in this group of vulnerable and complex patients.

Risk Factors for Neonatal Acquired Subglottic Stenosis

1986 ◽  
Vol 95 (6) ◽  
pp. 626-630 ◽  
Author(s):  
Steven K. Dankle ◽  
David E. Schuller ◽  
Richard E. McClead
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Neonatal Intensive Care ◽  
Effective Means ◽  
Assisted Ventilation ◽  
Subglottic Stenosis ◽  
Prolonged Intubation

Endotracheal intubation has proven to be a relatively safe and effective means of securing the airway in neonates. Some concern remains, however, regarding airway management in critically ill infants who require assisted ventilation for extended periods. Among the various risk factors associated with the complication of acquired subglottic stenosis in neonates, the one most frequently cited has been “prolonged” intubation, although opinion varies regarding the definition of this term. Various recommendations exist that attempt to establish the limits of “safe” periods of intubation for infants. Some feel that tracheotomy is indicated when airway support is required beyond those limits. In an attempt to define important risk factors involved in the development of neonatal subglottic stenosis, a retrospective analysis of infants admitted to the Neonatal Intensive Care Unit of Columbus Children's Hospital who required intubation during a 3-year period from 1977 to 1980 was undertaken. Of 343 infants who survived hospitalization, five patients were identified as having acquired subglottic stenosis. The average duration of intubation for these five patients was 56.2 days. The incidence of subglottic stenosis for infants whose duration of intubation ranged from 3 to 50 days was 0.4% (1/245). Infants with birth weights less than 1,500 g appeared more susceptible to the development of intubation-related laryngeal injury. The conclusion of this study is that endotracheal intubation is an appropriate means of long-term airway management in neonates hospitalized in a pediatric intensive care unit, providing other known risk factors are minimized.

scholarly journals Retrospective Analysis of Pediatric Tracheostomy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Akdag ◽  
Zeynep Baysal ◽  
Ayfer Gozu Pirinccioglu ◽  
Aylin Gul ◽  
Fazıl Emre Ozkurt ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Patient Population ◽  
Chart Review ◽  
Genetic Diseases ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Upper Airway Obstruction ◽  
Prolonged Intubation ◽  
Significant Difference ◽  
The Difference

Purpose. This paper reviews analyses for tracheostomy within our patient population over the last 6 years. Methods. We conducted a retrospective chart review of consecutive patients undergoing tracheostomy at the tertiary Dicle University Medical hospital, Turkey, from January 2006 to December 2012. Patient age, sex, emergency, planned tracheostomy, indications, complications, and decannulation time were all assessed. Results. Fifty-six (34 male, 22 female) adult Pediatric patients undergoing tracheostomy between 2006 and 2013 were investigated. The most common indication for tracheostomy was upper airway obstruction (66.7%), followed by prolonged intubation (33.3%). Mean decannulation times after tracheostomy ranged between 1 and 131 days, the difference being statistically significant (P=0.040). There was no significant difference in terms of mean age (9.8±6.0; P=0.26). There was also no statistical difference between emergency and planned tracheotomies (P=0.606). Conclusion. In our patient population, there was a significant decline in the number of tracheotomies performed for prolonged intubation and an increasing number of patient tracheostomy for upper airway obstruction. According to the literature, permanent decannulation rates were slightly higher with an increase in genetic diseases such as neuromuscular disease.

scholarly journals Should Subtotal Thyroidectomy Be Abandoned in Multinodular Goiter Patients From Endemic Regions Requiring Surgery?

2015 ◽  
Vol 100 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Tayfun Yoldas ◽  
Ozer Makay ◽  
Gokhan Icoz ◽  
Timur Kose ◽  
Gulten Gezer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Thyroid Disease ◽  
Multinodular Goiter ◽  
Subtotal Thyroidectomy ◽  
Factors Affecting ◽  
Risk Factors For Recurrence ◽  
The Difference ◽  
Transient Hypoparathyroidism ◽  
Benign Thyroid

Abstract The most convenient surgical procedure for benign thyroid diseases is still controversial. The aim of this study is to determine the recurrence rate and risk factors for recurrence after different thyroidectomy procedures in multinodular goiter patients. Patients were separated into two groups according to the detection of a recurrent nodule or not after thyroidectomy. Of the 748 patients, 216 (29%) had recurrence, while 532 had no recurrent nodule. The difference between surgical procedures described as subtotal (ST), near total (NT) and total thyroidectomy (TT) was statistically significant. Transient hypoparathyroidism was significantly higher in NT and TT, when compared to ST patients (P < 0.05). Young age, bilateral multinodular goiter and insufficient surgery are risk factors affecting recurrence for benign nodular thyroid disease. Currently, subtotal procedures should be discontinued and total or near total procedures should be preferred. Meanwhile, the probability of a higher risk of hypoparathyroidism should be kept in mind.

Apolipoprotein(a), Fibrinopeptide A and Carotid Atherosclerosis in Middle-Aged Men

1994 ◽  
Vol 72 (04) ◽  
pp. 563-566 ◽  
Author(s):  
Tuomo Rankinen ◽  
Sari Väisänen ◽  
Michele Mercuri ◽  
Rainer Rauramaa
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Bifurcation ◽  
Carotid Intima Media Thickness ◽  
Fibrinopeptide A ◽  
Carotid Imt ◽  
Apolipoprotein A ◽  
The Difference

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

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