Chapters authored
Approach to the Difficult Airway in Laryngeal Cancer
The laryngeal cancer is the second most frequent neoplasm of the upper aerodigestive tract. In these patients, the incidence of difficult airway is very high, and sometimes the anatomy can be modified because of the previous treatments like radiotherapy, making difficult intubation and difficult mask ventilation. To prevent an emergency, it is a priority to make an approach plan, appropriate preoperative assessment, have the necessary tools, and work together with the surgical team.
Part of the book: Updates on Laryngology
Extubations Protocols in the Neurocritical Patient
Within neurosurgical procedures, it has been observed that the failure rate covers up to 70%. It has been observed that early extubation has been associated with a decrease in mortality as well as a shorter hospital stay. Delaying extubation to obtain sustained neurological improvement during the recovery phase does not guarantee successful extubation. Studies have observed that up to 80% of patients with Glasgow less than 8 have been successfully extubated. It must be remembered that the Glasgow scale does not assess the difference in disorders of consciousness nor does it evaluate stem reflexes in intubated patients, so current studies have opted for other scales that allow us to assess the state of consciousness with more criteria to evaluate. It is demonstrated that the delay in extubation for neurological recovery did not show successful extubation and was associated with an increase in nosocomial pneumonia, longer stay in the ICU, and hospital cost. It is important to emphasize the evaluation of this type of patients, placing special emphasis on the cardiac and pulmonary repercussions of patients who suffer neurological lesions, since alterations that could go unnoticed could mean a failure to extubation with repercussions on the morbidity and mortality of patients.
Part of the book: Airway Management in Emergency Medicine