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Protection of respiratory integrity and haemodynamic stabilization

X Muschart, V Domjan, E Mergny and Jean-Baptiste Watelet UGent (2016) B-ENT. 12(suppl. 26). p.55-66
abstract
Objectives: To perform an analysis of the protection of respiratory integrity and haemodynamic stabilization based on the literature review and the experiences and perspectives of emergency and ENT specialists. Methodology: A comprehensive literature search was undertaken through PubMed and MEDLINE, using the following keywords: [protection of the respiratory integrity], [intubation], [hypotension] and [haemodynamic stabilization]. Articles were selected if the topic was relevant to current ENT and emergency practice. Additional articles were identified through a careful review of reference lists in Uptodate. A critical review of ENT and emergency specialists was carried out. Evidence staging and recommendation levels were established using the Paul Shekelle scale. Results : Firstly, protection of the airway is necessary before starting haemodynamic stabilization. Fibre-optic examination and laryngeal intubation form the gold standard of diagnosis and treatment in the protection of the airway. For circulation, a short catheter with a large size allows the management of intravenous fluids, with vasopressors if necessary. Aetiologic and specific treatments are also very important. Conclusions : Appropriate and collaborative management is necessary with the "ABCDE" approach: Airway and immobilization of the neck; Breathing; Circulation; Disability and Exposure. A fibre-optic examination is the gold standard of airway diagnosis. Laryngeal intubation is the most effective treatment for protection of the respiratory integrity. The management of circulation includes the implementation of a venous route to initiate administration of IVFs, preferably with isotonic saline. Vasopressors and inotropes are used as second line agents. A multidisciplinary and team approach is preferred, in order to achieve diagnosis and therapeutics simultaneously.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Protection of the respiratory integrity, airway, haemodynamic stabilization, circulation, HOSPITAL CARDIAC-ARREST, EMERGENCY CARDIOVASCULAR CARE, RESUSCITATION-COUNCIL GUIDELINES, DIFFICULT TRACHEAL INTUBATION, ADVANCED AIRWAY MANAGEMENT, ADVANCED LIFE-SUPPORT, ENDOTRACHEAL INTUBATION, SUPRAGLOTTIC AIRWAY, CARDIOPULMONARY-RESUSCITATION, TRANEXAMIC ACID
journal title
B-ENT
B-ENT
volume
12
issue
suppl. 26
pages
55 - 66
Web of Science type
Article
Web of Science id
000391156400008
JCR category
OTORHINOLARYNGOLOGY
JCR impact factor
0.578 (2016)
JCR rank
40/42 (2016)
JCR quartile
4 (2016)
ISSN
0001-6497
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
8511029
handle
http://hdl.handle.net/1854/LU-8511029
date created
2017-02-23 14:55:48
date last changed
2017-05-17 12:37:19
@article{8511029,
  abstract     = {Objectives: To perform an analysis of the protection of respiratory integrity and haemodynamic stabilization based on the literature review and the experiences and perspectives of emergency and ENT specialists. 
Methodology: A comprehensive literature search was undertaken through PubMed and MEDLINE, using the following keywords: [protection of the respiratory integrity], [intubation], [hypotension] and [haemodynamic stabilization]. Articles were selected if the topic was relevant to current ENT and emergency practice. Additional articles were identified through a careful review of reference lists in Uptodate. A critical review of ENT and emergency specialists was carried out. Evidence staging and recommendation levels were established using the Paul Shekelle scale. 
Results : Firstly, protection of the airway is necessary before starting haemodynamic stabilization. Fibre-optic examination and laryngeal intubation form the gold standard of diagnosis and treatment in the protection of the airway. For circulation, a short catheter with a large size allows the management of intravenous fluids, with vasopressors if necessary. Aetiologic and specific treatments are also very important. 
Conclusions : Appropriate and collaborative management is necessary with the {\textacutedbl}ABCDE{\textacutedbl} approach: Airway and immobilization of the neck; Breathing; Circulation; Disability and Exposure. A fibre-optic examination is the gold standard of airway diagnosis. Laryngeal intubation is the most effective treatment for protection of the respiratory integrity. The management of circulation includes the implementation of a venous route to initiate administration of IVFs, preferably with isotonic saline. Vasopressors and inotropes are used as second line agents. A multidisciplinary and team approach is preferred, in order to achieve diagnosis and therapeutics simultaneously.},
  author       = {Muschart, X and Domjan, V and Mergny, E and Watelet, Jean-Baptiste},
  issn         = {0001-6497},
  journal      = {B-ENT},
  keyword      = {Protection of the respiratory integrity,airway,haemodynamic stabilization,circulation,HOSPITAL CARDIAC-ARREST,EMERGENCY CARDIOVASCULAR CARE,RESUSCITATION-COUNCIL GUIDELINES,DIFFICULT TRACHEAL INTUBATION,ADVANCED AIRWAY MANAGEMENT,ADVANCED LIFE-SUPPORT,ENDOTRACHEAL INTUBATION,SUPRAGLOTTIC AIRWAY,CARDIOPULMONARY-RESUSCITATION,TRANEXAMIC ACID},
  language     = {eng},
  number       = {suppl. 26},
  pages        = {55--66},
  title        = {Protection of respiratory integrity and haemodynamic stabilization},
  volume       = {12},
  year         = {2016},
}

Chicago
Muschart, X, V Domjan, E Mergny, and Jean-Baptiste Watelet. 2016. “Protection of Respiratory Integrity and Haemodynamic Stabilization.” B-ent 12 (suppl. 26): 55–66.
APA
Muschart, X., Domjan, V., Mergny, E., & Watelet, J.-B. (2016). Protection of respiratory integrity and haemodynamic stabilization. B-ENT, 12(suppl. 26), 55–66.
Vancouver
1.
Muschart X, Domjan V, Mergny E, Watelet J-B. Protection of respiratory integrity and haemodynamic stabilization. B-ENT. 2016;12(suppl. 26):55–66.
MLA
Muschart, X, V Domjan, E Mergny, et al. “Protection of Respiratory Integrity and Haemodynamic Stabilization.” B-ENT 12.suppl. 26 (2016): 55–66. Print.