. Nasotracheal vs Orotracheal Intubation and Post-extubation Airway Obstruction in Critically Ill Children: An Open-label Randomized Controlled Trial (Conference Abstract ID: ABS0001)
Suresh Vijay Kumar, Kumar Angurana, Arun Kumar Baranwal, Karthi Nallasamy, Bikash Soumya Sarkar, Ranjan Ray, Souvik Maitra, Dalim Kumar Baidya, Rahul Kumar Anand, Rajeshwari Subramaniam, Damarla Haritha, Shweta Ram Chandankhede, Kumar Pavan, Shrikant Reddy, Pankanti, Ziyokov Joshi, Vijay Mahajan, Tarandeep Singh, Nupur B Patel, Ashwani Suri, Divya Hirolli, Bikash R Ray, Dalim K Baidya, Deependra Kumar, Taran Deep, C H Hanumantharao, G Bhavani Prasad, Masood Mohammed, N Pavan, Kumar Reddy, Kumar Sanjib, Binita Dhar, Panigrahi, Asif Dhar, Anuprasad Binita Ahmed, Rahul Dilip Bhiwgade, Tilotamma Parate, Sarang Suresh Patil, G Tejaswi, Vedaghosh Amara, Souvik Chaudhuri, Harita Krishna, Pradeep Chinnapotahala, Subba Reddy, Swarna Deepak, MC Rahul D Bhiwgade, Bhushan Nischitha, Shobhna Shahare, Bitey, Tarun Yadav, Mayuri Golhar, Abhimanyu Kalita, Brajendra Lahkar, Pallabi Porbodoi, Mohammad Abbas, Harish M Maheshwarappa, S Saurabh Biswal, Kumar Ratnjeet, Urmila Jhamb, Pallavi Goyal, Romit Saxena, Vijay Komal, Sujata Fulmali, M C Mete, Shobhana Nischitha, Rakhee Bitey, Joshi, Deepa Das, Shivkumar Shivanna, Ivan Deepak, Tauro, Sujata Mete, M C Nischitha, Komal Fulmali, Shobhana Bitey, M M Zhurko, V V Larionov, P Darshan, Indira Menon, Sumanth Shivram, Sapna Babu Mandala, Masood Ahmed Chandsha, Tushar Parmar, Pallavi Sahoo, Nikhil Kothari, Shilpa Goyal, Ankur Sharma, Pradeep Bhatia, Vanaja Bolinedi, Mehul Shah, Kavita Shalia, Owais Tisekar, Muraleedharan Raman, M I Sahadullah, Sreeshuba Kurup, S A Ajeesh, Cherian Roy, Arun Rath, Rupali Patnaik, Shakti Bedanta Mishra, Neela Chavhan, Anuja Porwal, Rajesh Gupta, Mrinal Sircar, Abhishek Prajapati, Rachit Patel, Jagdish Varma, Amol Dongre, Bhalendu Vaishnav, Dumini Soren, Mohd Saif Khan, Jay Prakash, Sourabh Kumar, Pradip Kumar Bhattacharya, Amit Kumar, Anuj Clerk, Krunalkumar Patel, Nikita Desai, Himani Garasia, Nilesh Thumar, Priyank Savaj, Rakesh Mangrolia, Bhargav Umaretiya, Pradeep Hg, Hariprasad Kumar, Sameer Kalpakam, Nithya Bansal, Ravindra Suresh, Madhusudan Mehta, Suprith Kalluraya, Chikkabyraiah, Raghusuprith Reddy, S Jakkinaboina, Bini Mol Thampi, Jai Bhagwan, Ashok Anand, Pramod Kadam, Dev Kapil, Mehta, Khokan Debnath, Sandeep Bhapkar, Neha Keswani, Mumbai, Maharashtra, India Wockhardt Ltd, Rangappa Harshavardhan, Ankur Kuri, Sharma
doi:10.5005/jp-journals-10071-23712A.1
Aim and objectives: The data on long-term nasotracheal intubation among mechanically ventilated critically ill children are limited. The purpose of this study was to compare the rate of post-extubation airway obstruction (PEAO) with nasotracheal and orotracheal intubation. Materials and methods: This open-label randomized controlled trial was conducted in the PICU of a tertiary care and teaching hospital in North India from January to December 2020 involving intubated children aged 3 months to 12 years. After written informed consent, children were randomized into nasotracheal and orotracheal intubation groups. Post-extubation, modified Westley's croup score (mWCS) was used at 10-timepoints (0 minutes, 30 minutes, 1, 2, 3, 6, 12, 24, 36, and 48 hours after extubation) to monitor for PEAO. The primary outcome was the rate of PEAO; and secondary outcomes were time taken for intubation, number of intubation attempts, complications during intubation, unplanned extubation, repeated intubations, tube malposition/ displacement, endotracheal tube blockade, ventilator-associated pneumonia, skin trauma, extubation failure/re-intubation, duration of PICU stay, and mortality. Results: Seventy children were randomized into nasotracheal (n = 30) and orotracheal (n = 40) groups. Both the groups were similar in baseline characteristics. The rate of PEAO was similar between nasotracheal and orotracheal groups (10% vs 20%, p = 0.14). The maximum mWCS and mWCS at 10-timepoints were similar in the two groups. The time taken for intubation was significantly longer (85 seconds vs 48 seconds, p < 0.001) in the nasotracheal group, whereas other secondary outcomes were similar in the two groups. Conclusion: The rate of PEAO was not different between nasotracheal and orotracheal groups. Trial registration number and date:
ABSTRACTS CRITICARE -IJCCM2022 DOI: 10.5005/jp-journals-10071-23712A.147 A 32-year-old male was admitted with a history of loss of consciousness for a few minutes following a lightning strike while he was riding on a motorcycle. On arrival, GCS -E4M6V3, was hemodynamically stable, and there were first-degree burns over the face, chest, right thigh, and groin. Whole-body CT scan done showed no injuries except petechial hemorrhages in the left basal ganglia and left frontal lobe. The very next day patient was intubated in view of respiratory distress and shifted to ICU for further management. ECHO showed moderate left ventricle dysfunction and mild elevation of cardiac enzymes. Lab investigations showed elevated CPK (43,865 IU/L) and mild elevation of serum creatinine. Patient muscle power gradually started decreasing and he was not able to move his limbs by day 4. The nerve conduction study was normal. MRI spine with brain showed prevertebral hematoma in the entire cervical region. Multidisciplinary management was carried out. Tracheostomy was done on day 10 and the patient gradually weaned off from mechanical ventilation. In the course of management by the end of 1 month of hospital stay, the patient had gradual improvement in muscle power and tracheostomy was successfully decannulated. The patient got discharged from the hospital.
Hemophagocytic Lymphohistiocytosis after COVID-19 Vaccination: A Case Report (Conference Abstract ID: ABS0148) Nitin Rai, Syed Nabeel Muzaffar,..
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