An Extubation Protocol for Angioedema
Angioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs as a complication from the use of angiotensin-converting enzyme inhibitors. At our institution, the otolaryngology department has incorporated the use of the endotracheal tube cuff-leak test and bedside direct laryngos...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-02-01
|
| Series: | OTO Open |
| Online Access: | https://doi.org/10.1177/2473974X17691230 |
| _version_ | 1797425507095019520 |
|---|---|
| author | Elizabeth Floyd MD Nira A. Goldstein MD, MPH Rauno Joks MD Miguel Mascaro MD Christine Liaw MD Bradley Dickson Denny Varughese MD Joshua Silverman MD, PhD |
| author_facet | Elizabeth Floyd MD Nira A. Goldstein MD, MPH Rauno Joks MD Miguel Mascaro MD Christine Liaw MD Bradley Dickson Denny Varughese MD Joshua Silverman MD, PhD |
| author_sort | Elizabeth Floyd MD |
| collection | DOAJ |
| description | Angioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs as a complication from the use of angiotensin-converting enzyme inhibitors. At our institution, the otolaryngology department has incorporated the use of the endotracheal tube cuff-leak test and bedside direct laryngoscopy to aid in timing for extubation of angioedema patients. Prospective data collection of patients presenting to the emergency department with angioedema was performed. Of 76 patients with angioedema, 9 required fiberoptic intubation. Intubation was performed at a median of 73 hours (range, 44-118). An endotracheal tube cuff-leak test was performed in 7 patients prior to extubation, and bedside direct laryngoscopy was also performed in 3 of these 7 patients to document resolution of laryngeal edema. The use of the endotracheal tube cuff-leak test and bedside direct laryngoscopy is an easy and inexpensive method to help determine eligibility for extubation in patients intubated for angioedema. |
| first_indexed | 2024-03-09T08:17:07Z |
| format | Article |
| id | doaj.art-e5f47b35483d431282f55d83f5f1cf60 |
| institution | Directory Open Access Journal |
| issn | 2473-974X |
| language | English |
| last_indexed | 2024-03-09T08:17:07Z |
| publishDate | 2017-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj.art-e5f47b35483d431282f55d83f5f1cf602023-12-02T22:09:07ZengWileyOTO Open2473-974X2017-02-01110.1177/2473974X17691230An Extubation Protocol for AngioedemaElizabeth Floyd MD0Nira A. Goldstein MD, MPH1Rauno Joks MD2Miguel Mascaro MD3Christine Liaw MD4Bradley Dickson5Denny Varughese MD6Joshua Silverman MD, PhD7Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn New York, USADepartment of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn New York, USADivision of Allergy and Immunology, State University of New York Downstate Medical Center, Brooklyn, New York, USATzikas Facial Plastic Surgery Center, Delray, Florida, USADepartment of Urology, Mount Sinai Medical Center, New York, New York, USADepartment of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn New York, USADepartment of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USADepartment of Otolaryngology, Long Island Jewish Medical Center/Northwell Health, New Hyde Park, New York, USAAngioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs as a complication from the use of angiotensin-converting enzyme inhibitors. At our institution, the otolaryngology department has incorporated the use of the endotracheal tube cuff-leak test and bedside direct laryngoscopy to aid in timing for extubation of angioedema patients. Prospective data collection of patients presenting to the emergency department with angioedema was performed. Of 76 patients with angioedema, 9 required fiberoptic intubation. Intubation was performed at a median of 73 hours (range, 44-118). An endotracheal tube cuff-leak test was performed in 7 patients prior to extubation, and bedside direct laryngoscopy was also performed in 3 of these 7 patients to document resolution of laryngeal edema. The use of the endotracheal tube cuff-leak test and bedside direct laryngoscopy is an easy and inexpensive method to help determine eligibility for extubation in patients intubated for angioedema.https://doi.org/10.1177/2473974X17691230 |
| spellingShingle | Elizabeth Floyd MD Nira A. Goldstein MD, MPH Rauno Joks MD Miguel Mascaro MD Christine Liaw MD Bradley Dickson Denny Varughese MD Joshua Silverman MD, PhD An Extubation Protocol for Angioedema OTO Open |
| title | An Extubation Protocol for Angioedema |
| title_full | An Extubation Protocol for Angioedema |
| title_fullStr | An Extubation Protocol for Angioedema |
| title_full_unstemmed | An Extubation Protocol for Angioedema |
| title_short | An Extubation Protocol for Angioedema |
| title_sort | extubation protocol for angioedema |
| url | https://doi.org/10.1177/2473974X17691230 |
| work_keys_str_mv | AT elizabethfloydmd anextubationprotocolforangioedema AT niraagoldsteinmdmph anextubationprotocolforangioedema AT raunojoksmd anextubationprotocolforangioedema AT miguelmascaromd anextubationprotocolforangioedema AT christineliawmd anextubationprotocolforangioedema AT bradleydickson anextubationprotocolforangioedema AT dennyvarughesemd anextubationprotocolforangioedema AT joshuasilvermanmdphd anextubationprotocolforangioedema AT elizabethfloydmd extubationprotocolforangioedema AT niraagoldsteinmdmph extubationprotocolforangioedema AT raunojoksmd extubationprotocolforangioedema AT miguelmascaromd extubationprotocolforangioedema AT christineliawmd extubationprotocolforangioedema AT bradleydickson extubationprotocolforangioedema AT dennyvarughesemd extubationprotocolforangioedema AT joshuasilvermanmdphd extubationprotocolforangioedema |