FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4387248654> ?p ?o ?g. }

• W4387248654 endingPage "A1983" @default.
• W4387248654 startingPage "A1983" @default.
• W4387248654 abstract "SESSION TITLE: Critical Iatrogenic Complications SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/09/2023 02:10 pm - 02:55 pm INTRODUCTION: Endotracheal intubation (ETI) is a life-saving procedure, performed emergently more than 600,000 times annually in the US. ETI has several complications, including acute traumatic airway injury, as well as inflammation and scarring from prolonged pressure of the endotracheal tube (ETT) on airway tissues. Mechanical ventilation can cause nosocomial injury to the patient, through injurious set parameters, or through patient ventilator asynchrony resulting in damaging tidal volumes or regional overdistension. We present a case in which airway injury from ETI lead to injurious patient-ventilator asynchrony. CASE PRESENTATION: A 44 year old female was intubated following cardiac arrest. She had a history of tracheal stenosis and necrosis resulting from multiple ETIs, in the setting of multiple drug overdoses. She had desaturation episodes, and the following ventilator wave form was observed (Figure 1). The patient's respiratory effort did not match her measured respiratory rate, her expiratory tidal volumes (Vt) were much less than inspiratory Vt, and peak inspiratory pressures rose in a step-wise fashion with each breath. Her ventilator circuit was intact. These abnormalities improved with suctioning but soon recurred. Bronchoscopy revealed necrotic tissue that created an intermittent ball-valve effect allowing for inspiratory flow but prevented expiratory flow through her ETT (Figure 2). The tissue was removed with suctioning and the patient-ventilator synchrony ensued (Figure 3). She subsequently underwent tracheostomy. DISCUSSION: ETI can cause acute traumatic injury to laryngeal and subglottic tissues, often due to prolonged or multiple attempts. Proximal airway tissues can also suffer sub-acutely from tissue ischemia caused by pressure from the endotracheal tube—both high cuff pressures and prolonged intubation may contribute to this injury. Removal of the endotracheal tube through extubation or conversion to tracheotomy are protective.Patient-ventilator asynchrony may occur during breath initiation (trigger), breath delivery (flow), or cessation of inspiration (cycle). Auto-trigger asynchrony occurs commonly with circuit leaks, but can occur whenever expiratory tidal volumes are not detected, resulting in rapid cycles of inspiratory flow. In this case, tissue obstructed exhalation, and stacked breaths from auto-trigger lead to serial overdistension placing the patient at risk of ventilator-induced lung injury. An abrupt drop in expiratory volume graphic demonstrate expiratory volume failing to return prior to the next ventilator breath. CONCLUSIONS: This case is an atypical presentation of various complications from ETI; It highlights the importance of ventilator waveform interpretation and effectively identifying causes of patient-ventilator asynchrony. REFERENCE #1: Gonzalez-Bermejo J, Janssens J, Rabec C On behalf of the SomnoNIV group, et al. Framework for patient-ventilator asynchrony during long-term non-invasive ventilation. Thorax 2019;74:715-717. REFERENCE #2: Sottile, P. D., Albers, D., Smith, B. J., & Moss, M. M. (2020). Ventilator dyssynchrony - Detection, pathophysiology, and clinical relevance: A Narrative review. Annals of thoracic medicine, 15(4), 190–198. https://doi.org/10.4103/atm.ATM_63_20 REFERENCE #3: Touman, Abdelfattah A., and Grigoris K. Stratakos. 2018. 'Long-Term Complications of Tracheal Intubation'. Tracheal Intubation. InTech. doi:10.5772/intechopen.74160. DISCLOSURES: No relevant relationships by Desmond Barber No relevant relationships by Kevin Doerschug No relevant relationships by Miles Hagner" @default.
• W4387248654 created "2023-10-03" @default.
• W4387248654 creator A5003419487 @default.
• W4387248654 creator A5017150956 @default.
• W4387248654 creator A5079871190 @default.
• W4387248654 date "2023-10-01" @default.
• W4387248654 modified "2023-10-03" @default.
• W4387248654 title "COMPLICATIONS OF ENDOTRACHEAL INTUBATION: OSCILLATING ENDOBRONCHIAL OBSTRUCTION CAUSING DANGEROUS DYSSYNCHRONY" @default.
• W4387248654 doi "https://doi.org/10.1016/j.chest.2023.07.1362" @default.
• W4387248654 hasPublicationYear "2023" @default.
• W4387248654 type Work @default.
• W4387248654 citedByCount "0" @default.
• W4387248654 crossrefType "journal-article" @default.
• W4387248654 hasAuthorship W4387248654A5003419487 @default.
• W4387248654 hasAuthorship W4387248654A5017150956 @default.
• W4387248654 hasAuthorship W4387248654A5079871190 @default.
• W4387248654 hasBestOaLocation W43872486541 @default.
• W4387248654 hasConcept C105922876 @default.
• W4387248654 hasConcept C141071460 @default.
• W4387248654 hasConcept C2775970820 @default.
• W4387248654 hasConcept C2777080012 @default.
• W4387248654 hasConcept C2778333281 @default.
• W4387248654 hasConcept C2778716859 @default.
• W4387248654 hasConcept C2778996910 @default.
• W4387248654 hasConcept C42219234 @default.
• W4387248654 hasConcept C71924100 @default.
• W4387248654 hasConcept C81182388 @default.
• W4387248654 hasConceptScore W4387248654C105922876 @default.
• W4387248654 hasConceptScore W4387248654C141071460 @default.
• W4387248654 hasConceptScore W4387248654C2775970820 @default.
• W4387248654 hasConceptScore W4387248654C2777080012 @default.
• W4387248654 hasConceptScore W4387248654C2778333281 @default.
• W4387248654 hasConceptScore W4387248654C2778716859 @default.
• W4387248654 hasConceptScore W4387248654C2778996910 @default.
• W4387248654 hasConceptScore W4387248654C42219234 @default.
• W4387248654 hasConceptScore W4387248654C71924100 @default.
• W4387248654 hasConceptScore W4387248654C81182388 @default.
• W4387248654 hasIssue "4" @default.
• W4387248654 hasLocation W43872486541 @default.
• W4387248654 hasOpenAccess W4387248654 @default.
• W4387248654 hasPrimaryLocation W43872486541 @default.
• W4387248654 hasRelatedWork W1980062584 @default.
• W4387248654 hasRelatedWork W2090473051 @default.
• W4387248654 hasRelatedWork W2113028538 @default.
• W4387248654 hasRelatedWork W2348727334 @default.
• W4387248654 hasRelatedWork W2403764458 @default.
• W4387248654 hasRelatedWork W3029577031 @default.
• W4387248654 hasRelatedWork W3176304498 @default.
• W4387248654 hasRelatedWork W4293101301 @default.
• W4387248654 hasRelatedWork W4295290026 @default.
• W4387248654 hasRelatedWork W4366492714 @default.
• W4387248654 hasVolume "164" @default.
• W4387248654 isParatext "false" @default.
• W4387248654 isRetracted "false" @default.
• W4387248654 workType "article" @default.