Non-Invasive Ventilation for Weaning
Non-invasive ventilation can be used as adjunct for weaning patients from mechanical ventilation
Extubation Assessment in the ICU
The criteria used to assess a patient to determine whether they are ready for extubation is complex and multi-factorial.
Extubation Assessment: Hot Case
Extubation Assessment: Hot Case. List reasons -> present clinical signs that prove reasons
Cuff Leak Test
The cuff leak test is used to predict risk of post-extubation stridor in intubated patients. Use and interpretation of the test needs to take into account the overall context of the patient's condition and the management implications
ICU Mind Maps
The ICU Mind Maps covering the CICM Fellowship Exam curriculum are in pdf format. They were created by Dr. Paul Young
Post-extubation stridor
Post-extubation stridor is the presence inspiratory noise post-extubation indicated narrowing of the airway (can be supraglottic, but usually glottic and infraglottic)
Laryngospasm
Laryngospasm is potentially life-threatening closure of the true vocal chords resulting in partial or complete airway obstruction unresponsive to airway positioning maneuvers.
Indices that predict difficulty weaning
Numerous objective indices have been studied to predict failure of ventilator liberation or weaning. None of these indexes alone are sufficiently sensitive and specific to be useful in predicting the success of ventilation discontinuation in an individual patient.
Spontaneous Breathing Trial
Spontaneous breathing trials (SBT) are used to identify patients who are likely to fail liberation from mechanical ventilation
Tracheostomy Complications
Tracheostomy complications can be immediate, delayed or late
Anatomy for Tracheostomy
To perfrom a tracheostomy, knowledge of the following is required: surface anatomy, course of the trachea, structure of the tracheal rings, layers of dissection, components of the larynx and related structures
Assessment of Swallow in a Tracheostomy Patient
The presence of a tracheostomy tube can adversely effect swallowing: in patients who previously had no dysphagia; and further impair swallowing function in those who already have neurological or mechanical disorders of swallowing.