Multiple drugs

Multiple drugs Reactions 1680, p240 - 2 Dec 2017 Oxygen desaturation: 5 case reports In a retrospective study, five patients [ages and sexes not stated] who experienced oxygen desaturation following administration of etomidate, fentanyl, ketamine or midazolam [outcomes not stated]. Patient 1: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation (Spo2) prior to intubation was 97%. The patient received systemic ketamine 40mg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post-endotracheal intubation, the patient experienced oxygen desaturation with lowest Spo2 level of 80%. Patient 2: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 97%. The patient received systemic midazolam 4mg and fentanyl 100µg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. The patient experienced oxygen desaturation during and post-endotracheal intubation. Within one hour post endotracheal intubation, the oxygen desaturation with Spo2 was at lowest level of 79%. Patient 3: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 96%. The patient received systemic etomidate 10mg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post-endotracheal intubation, the patient experienced oxygen desaturation with lowest Spo2 level of 72%. Patient 4: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 99%. The patient received systemic fentanyl 50µg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post endotracheal intubation, the patient experienced oxygen desaturation with lowest Spo2 level of 89%. Later, the patient developed acute kidney injury and died one hour after the intubation [cause of death not stated]. Patient 5: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 87%. The patient received systemic fentanyl 50µg and midazolam 1mg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post-endotracheal intubation, the patient experienced oxygen desaturation with Spo2 level of 73%. Author comment: ’’We speculate that deep sedation administered after intubation may contribute to derecruitment and hypoxia.’’ "[F]ive patients (56%) experienced oxygen desaturation of greater than 10%within the first hour after intubation". Johannes J, et al. A Technique of Awake Bronchoscopic Endotracheal Intubation for Respiratory Failure in Patients with Right Heart Failure and Pulmonary Hypertension. Critical Care Medicine 45: e980-e984, No. 9, Sep 2017. Available from: URL: http://doi.org/10.1097/CCM.0000000000002586 - USA 803284626 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Multiple drugs

Reactions Weekly , Volume 1680 (1) – Dec 2, 2017
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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-017-39171-2
Publisher site
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Abstract

Reactions 1680, p240 - 2 Dec 2017 Oxygen desaturation: 5 case reports In a retrospective study, five patients [ages and sexes not stated] who experienced oxygen desaturation following administration of etomidate, fentanyl, ketamine or midazolam [outcomes not stated]. Patient 1: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation (Spo2) prior to intubation was 97%. The patient received systemic ketamine 40mg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post-endotracheal intubation, the patient experienced oxygen desaturation with lowest Spo2 level of 80%. Patient 2: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 97%. The patient received systemic midazolam 4mg and fentanyl 100µg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. The patient experienced oxygen desaturation during and post-endotracheal intubation. Within one hour post endotracheal intubation, the oxygen desaturation with Spo2 was at lowest level of 79%. Patient 3: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 96%. The patient received systemic etomidate 10mg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post-endotracheal intubation, the patient experienced oxygen desaturation with lowest Spo2 level of 72%. Patient 4: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 99%. The patient received systemic fentanyl 50µg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post endotracheal intubation, the patient experienced oxygen desaturation with lowest Spo2 level of 89%. Later, the patient developed acute kidney injury and died one hour after the intubation [cause of death not stated]. Patient 5: The patient had a history of pulmonary hypertension, severe acute hypoxemic respiratory failure and right heart failure. An immediate endotracheal intubation was required. Oxygen saturation prior to intubation was 87%. The patient received systemic fentanyl 50µg and midazolam 1mg for sedation. The patient underwent awake bronchoscopic endotracheal intubation. Within one hour post-endotracheal intubation, the patient experienced oxygen desaturation with Spo2 level of 73%. Author comment: ’’We speculate that deep sedation administered after intubation may contribute to derecruitment and hypoxia.’’ "[F]ive patients (56%) experienced oxygen desaturation of greater than 10%within the first hour after intubation". Johannes J, et al. A Technique of Awake Bronchoscopic Endotracheal Intubation for Respiratory Failure in Patients with Right Heart Failure and Pulmonary Hypertension. Critical Care Medicine 45: e980-e984, No. 9, Sep 2017. Available from: URL: http://doi.org/10.1097/CCM.0000000000002586 - USA 803284626 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680

Journal

Reactions WeeklySpringer Journals

Published: Dec 2, 2017

References

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