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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.
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Endotracheal Intubation II: Nursing Management01:17

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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.
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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.
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Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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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.
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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

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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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Barriers to Adoption of the Pre-Epiglottic Baton Plate (Tübingen Palatal Plate) for Infants With Robin Sequence.

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Updated: Jan 17, 2026

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
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What Factors Affect Safe Bedside Extubation After Mandibular Distraction?

Cory M Resnick1,2, Andrew J Deek3, Ryan Caprio4

  • 1Harvard School of Dental Medicine and Harvard Medical School, Boston, MA, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|September 24, 2025
PubMed
Summary
This summary is machine-generated.

Reintubation after mandibular distraction osteogenesis (MDO) surgery for infants with Robin sequence (RS) is rare. Most infants can be safely extubated in the intensive care unit, minimizing resources and simplifying care.

Keywords:
Pierre Robin sequencemandiblesleep disordersteam careupper airway obstruction

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Area of Science:

  • Pediatric Surgery
  • Craniofacial Surgery
  • Neonatal Intensive Care

Background:

  • Mandibular distraction osteogenesis (MDO) is a surgical procedure used to treat infants with Robin sequence (RS).
  • There is no standardized protocol for extubation following MDO in infants with RS, leading to variations in care.
  • Identifying factors influencing extubation success is crucial for optimizing patient outcomes and resource allocation.

Purpose of the Study:

  • To determine the frequency of reintubation within 24 hours after extubation in infants with RS following MDO.
  • To identify factors associated with an increased risk of reintubation or postextubation respiratory events.
  • To establish optimal conditions for planned extubation after MDO in this patient population.

Main Methods:

  • Retrospective observational study of infants with RS undergoing MDO between 2013 and 2021.
  • Data collection included patient demographics, comorbidities, surgical details, and postextubation respiratory events.
  • Primary outcome: reintubation within 24 hours; Secondary outcome: oxygen saturation <95%.

Main Results:

  • One out of 52 (1.9%) infants required reintubation. Forty-one (78.8%) experienced transient oxygen desaturations, managed with oxygen or CPAP.
  • Risk factors for postextubation respiratory events included Stickler syndrome, comorbidities (musculoskeletal, neurologic, endocrine), low birthweight, and high preoperative AHI.
  • Extubation occurred at a mean of 3.6 days post-surgery.

Conclusions:

  • Reintubation following MDO in infants with RS is infrequent.
  • Minor oxygen desaturations are common but manageable with standard ICU protocols.
  • Most infants with RS can be safely extubated in the ICU post-MDO, reducing resource utilization and hospital costs.