Anästhesie, Intensivtherapie, Notfallmedizin
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Anasth Intensivther Notfallmed · Jun 1987
Comparative Study[The esophageal tracheal Combitube (ETC): animal experiment results with a new emergency tube].
Prompt and effective ventilation, essential for patients with cardiopulmonary arrest, may be provided by a new airway for emergency resuscitation. The "Esophageal Tracheal Combitube (ETC)" offers endotracheal or esophageal obturator ventilation according to choice. Ventilation is therefore always possible after blind intubation. ⋯ We intend to use the ETC as a device for emergency cardiopulmonary resuscitation in humans. It is especially suitable for medical personnel not trained in endotracheal intubation. The ETC has been conceived to bridge the gap of the prehospital phase.
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Anasth Intensivther Notfallmed · Apr 1987
[Diagnostic and therapeutic blockade of the celiac ganglia].
Neurolytic celiac plexus block is the therapy of choice for visceral upper abdominal pain that is resistant to therapy. In order to ensure that the treatment is indicated a temporary block for diagnostic purposes (application of a local anesthetic) has to be carried out. A diagnostic block can be performed as a blind puncture according to anatomic criteria if new computed tomograms are available providing the necessary information on the patient's anatomy. ⋯ The location, angle and depth of the puncture can be calculated by the computer tomograph. Of 14 patients in whom we performed a CT-guided block of the celiac ganglion, 10 were free from pain afterwards or showed considerably reduced pain symptoms. The side effects that could be observed were but slight and passed after a few days.
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Fiberoptic intubation is widely accepted in the management of a "difficult airway". In the majority of these cases the underlying anatomical findings require a nasal approach. ⋯ Orotracheal fiberoptic intubation was easily performed using a Williams oral airway and a Patil-Syracuse face mask. We recommend this technique for those cases where fiberoptic intubation is indicated but contraindications to the transnasal route apply and an "asleep-intubation" is desired.
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Anasth Intensivther Notfallmed · Aug 1986
Comparative Study[High frequency jet ventilation in patients with acute respiratory failure. A comparison with conventional artificial respiration].
The major advantage of High Frequency Jet Ventilation (HFJV) in the treatment of patients with ARDS was commonly seen in better oxygenation and lower airway pressures, compared to conventional ventilation. Furthermore, HFJV seemed to be successful even in those patients in whom conventional ventilation had failed. We compared HFJV (f = 100/min, inspiratory time 40% to 50%) to conventional ventilation (f = 10/min, PEEP 5 to 10 cm H2O). ⋯ Pulmonary artery pressure (PAP 25.0 +/- 5.0 mmHg compared to 19.9 +/- 4.7 mmHg), central venous pressure (10.5 +/- 4.2 mmHg compared to 8.8 +/- 3.0 mmHg), pulmonary capillary pressure (13.3 +/- 4.4 mmHg compared to 11.3 +/- 3.7 mmHg), pulmonary vascular resistance (131.4 +/- 55.0 dyn . s . cm-5 compared to 96.7 +/- 33.7 dyn . s . cm-5) and right cardiac work index (1.38 +/- 0.55 kg . m/m2 compared to 1.05 +/- 0.33 kg . m/m2) were significantly increased (P less than 0.01) under HFJV. The other haemodynamic variables showed no difference between the two ventilatory modes. HFJV was inferior to conventional artificial ventilation in all patients and caused severe hypoxia in several patients, leading to pulmonary vasoconstriction and increased work of the right heart.(ABSTRACT TRUNCATED AT 250 WORDS)