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Related Concept Videos

Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

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Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
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Tracheostomy Decannulation01:21

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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
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Endotracheal Intubation I: Procedure01:15

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
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Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
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Related Experiment Video

Updated: Sep 29, 2025

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
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Postextubation Stridor in Severe COVID-19.

Georges Abi Abdallah1, Alexis Ferré1, Antoine Gros1

  • 1Medical-Surgical Intensive Care Department Centre Hospitalier de Versailles - Site Andre Mignot, Le Chesnay, France.

Respiratory Care
|March 23, 2022
PubMed
Summary
This summary is machine-generated.

Postextubation stridor (PES) occurred in nearly a quarter of COVID-19 patients, significantly more than in non-COVID-19 patients. COVID-19, female sex, and airway manipulation were key risk factors for PES.

Keywords:
COVID-19SARS-CoV-2postextubation laryngeal edemapostextubation stridorviral load

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Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • Mechanical ventilation is critical for severe COVID-19 respiratory distress.
  • Postextubation stridor (PES) is a potential complication following mechanical ventilation.
  • The incidence and risk factors for PES in COVID-19 patients remain under investigation.

Purpose of the Study:

  • To compare the frequency of postextubation stridor (PES) in COVID-19 patients versus non-COVID-19 patients.
  • To identify independent risk factors associated with PES in mechanically ventilated patients.
  • To explore the relationship between PES and viral shedding in COVID-19 patients.

Main Methods:

  • Observational retrospective study comparing COVID-19 patients (n=96) with historical controls (n=211).
  • Mechanical ventilation duration exceeded 48 hours for all included subjects.
  • Primary outcome: frequency of PES within 2 hours post-extubation.

Main Results:

  • PES occurred in 22.9% of COVID-19 patients versus 3.8% of controls (P < .001).
  • Independent risk factors for PES included COVID-19 (OR 3.72), female sex (OR 5.77), and airway interventions (OR 3.01).
  • PES was more common in COVID-19 patients with positive SARS-CoV-2 RT-PCR on tracheal samples at extubation (73.3% vs 24.3%).

Conclusions:

  • Postextubation stridor is significantly more frequent in COVID-19 patients requiring mechanical ventilation.
  • COVID-19 diagnosis, female sex, and airway manipulation are independent risk factors for PES.
  • Persistent viral shedding at extubation is associated with an increased risk of PES.