Author Of 2 Presentations
EVALUATION OF OXYGEN DELIVERY SYSTEMS DURING FIBEROPTIC BRONCHOSCOPY: HIGH FLOW NASAL CANNULA VERSUS CONVENTIONAL NASAL PRONGS
Abstract
Background
Acute hypoxia induced by fiberoptic bronchoscopy (FBS) is a life-threatening complication and a limiting factor for the procedure requiring oxygen delivery systems for prevention and treatment.
Objectives
Assessing efficiency and safety of high flow nasal cannula (HFNC) compared to conventional nasal prongs (CNP) during FBS.
Methods
We conducted a prospective, controlled (non-blinded) clinical trial from 2015 to 2019 including 104 paediatric patients (n=104) from 0 to 16 years who were randomly allocated to two study groups (HFNC versus CNP) undergoing elective FBS. Oxygen administration through HFNC or CNP was given throughout the procedure and in case of hypoxia gas flow was increased. We performed a statistical analysis including demographic and clinical characteristics, number and severity of desaturations, adverse events, Ramsay Sedation Scale and bronchoscopic satisfaction score.
Results
Not included
Conclusion
Oxygen delivery through HFNC is safe and reduces number and severity of hypoxic events during FBS compared to CNP.
POINT OF CARE ULTRASOUND (POCUS) IN PICUS: ANALYSIS OF ITS USE AND CLINICAL IMPACT
- Rafael González Cortés, Spain
- Pilar Sanchez Yáñez,
- Patricia García-Soler, Spain
- Juan J. Menéndez Suso,
- Raul Montero Yéboles,
- Jose L. Vázquez Martínez,
- Jorge López, Spain
- Borja De Paz Vaquero,
- Ana M. Llorente De La Fuente,
- Laia Vega,
- Daniel Palanca Arias,
- Nuria Chaves Caro,
- Paula Santos Herraiz, Spain
- Sonia Sanchiz Cárdenas,
- Ignacio Oulego Erroz,
- Alberto Salas Ballestin,
- Antonio Rodríguez Núñez,
- Patricia Rodríguez Campoy,
- Javier Gil Antón,
- Eva Rodríguez Carrasco,
- Juan Mayordomo Colunga, Spain
- Marta Muñoyerro Sesmero,
- Clara Sorribes Ortí,
- Ángela Ferrer Barba,
- Jorge Rodríguez Ozcodi,
- Jose M. Gómez Luque,
- Carolina González Miño,
- Renata Marqués Rodríguez,
Abstract
Background
Point of care ultrasound (POCUS) use is becoming widespread tool in the management of critically ill patients. Despite its increasing use there are not clear recommendations for the use of POCUS by pediatric intensive care providers.
Objectives
Describe current use of POCUS in Pediatric Intensive Care Units (PICUs) in an European country. Define factors related to clinical impact of explorations.
Methods
A prospective cross-sectional multicenter study was carried out in 26 PICUs. During 7 consecutive days data from all POCUS explorations performed by the medical and nursing staff of the participating units were registered.
Results
269 POCUS explorations were registered involving 136 patients. POCUS operators were attending physicians (73.6%), residents (20.8%) and nurses (5.6%). 57.6% of explorations included thorax and 29.4% echocardiography. A new diagnosis was obtained in 53.9%, resulting in therapeutic modifications (TM) in 36.4%. Explorations were more likely to result in TM when performed by attending physicians (82.7% vs 17.3%, p=0.031), in cardiac patients (52.1% vs 34.6%, p=0.011), including thorax (45.6% vs 29.4%, p=0.010) or urological examination (77.8% vs 37.6%, p=0.015). TM were also more likely when the objective of the exploration was diagnostic (46.2% vs 18.5%, p<0.001), and less likely when objective was teaching (18.4% vs 42.7%, p=0.005). Operator previous experience on POCUS teaching was related with TM (59.2% vs 40.8%, p=0.003).
Conclusion
POCUS is becoming a highly used tool in PICUS frequently resulting in new diagnostic findings and therapeutic modifications. Clinical experience and previous training in POCUS seem to be related to clinical impact of POCUS explorations.