Articles: intubation.
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Laser surgery can be performed using either endotracheal intubation, apnoea or jet ventilation. For operations performed under endotracheal intubation the same technical rules apply as for any other type of anaesthesia. To facilitate intubation a special laser tube is required. ⋯ For monitoring purposes during jet ventilation or procedures under apnoea, transcutaneous oximetry, ECG recording as well as non-invasive blood pressure measurements at short intervals is mandatory. In addition video monitoring is desirable to allow visual anaesthesiological surveillance of the larynx. The jet ventilator must meet established standards; the option must be available to survey inspiratory peak pressure and end-exspiratory pressure as well as the setting of appropriate alarm limits.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of verapamil on the cardiovascular responses to tracheal intubation.
We have studied the efficacy of verapamil in attenuating the cardiovascular responses to tracheal intubation in three groups of ASA grade I patients given verapamil 0.05 mg kg-1 or 0.1 mg kg-1 or saline 45 s before the start of laryngoscopy. Anaesthesia was induced with thiopentone 5 mg kg-1 i.v. and tracheal intubation was facilitated with vecuronium 0.2 mg kg-1. ⋯ In patients who received saline, there was a significant increase in mean arterial pressure and rate-pressure product associated with tracheal intubation. The increases were significantly less in verapamil-treated patients compared with those in the control group, although verapamil failed to prevent tachycardia caused by laryngoscopy and intubation.
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Intensive care medicine · Jan 1992
Randomized Controlled Trial Clinical TrialPrevention of nosocomial pneumonia in intubated patients: respective role of mechanical subglottic secretions drainage and stress ulcer prophylaxis.
Chronic microaspiration through a tracheal cuff is the main culprit in the penetration and colonization of the lower respiratory tract. A total of 145 patients intubated for more than 3 days were randomly assigned to a double nosocomial pneumonia (NP) prevention: 1--Prevention of aspiration by hourly subglottic secretion drainage (SSD) with a specific endotracheal tube (HI-LO Evac tube, Mallinckrodt); 2--Prevention of gastric colonization using either sucralfate or antacids. ⋯ Subglottic secretion drainage treatment was associated with: a) a twice lower incidence of NP (no-SSD: 29.1%, SSD: 13%); b) a prolonged time of onset of NP (no-SSD: 8.3 +/- 5 days, SSD: 16.2 +/- 11 days); c) a decrease in the colonization rate from admission to end-point day in tracheal aspirates (no-SSD: +21.3%, SSD: +6.6%) and in subglottic secretions (no-SSD: +33.4%, SSD: +2.1%). Sucralfate was not associated with a significantly lower incidence of NP (antacids: 23.6%, sucralfate: 17.8%), but with a lower increase in the colonization rate in subglottic and gastric aspirates, from admission to end-point day.
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To determine how well Laser-Guard protects polyvinyl chloride (PVC) endotracheal tubes from the carbon dioxide (CO2) laser. ⋯ Laser-Guard protects the shafts of combustible PVC endotracheal tubes from direct, high-power, continuous CO2 laser radiation.