Articles: intubation.
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The Bullard laryngoscope is a rigid fiber-optic device that offers a new approach to oral laryngoscopy. In this report, I present five cases illustrative of the use of the Bullard laryngoscope in patients with demonstrated or suspected difficult laryngoscopy and intubation.
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J Obstet Gynecol Neonatal Nurs · Nov 1991
Randomized Controlled Trial Comparative Study Clinical TrialInfant responses to saline instillations and endotracheal suctioning.
The study examined the effects of endotracheal suction with and without saline instillation on neonates with respiratory distress. In a completely counterbalanced factorial-within-subjects design, 27 intubated neonates were randomly assigned to two orders of presentation of treatment conditions. ⋯ Results indicated that clinically stable newborns tolerated instillations of 0.25-0.5 ml. The suctioning protocol used in this study minimized changes in infants' heart rates and blood pressures.
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Randomized Controlled Trial Clinical Trial
Endotracheal suctioning in adults with head injury.
The purpose of this study was to determine the method of endotracheal suctioning (ETS) that resulted in the least compromise to the cerebrovascular status of adult patients with severe head injuries. A two-group (two vs three ETS), two-protocol (100% tidal volume [VT] vs 135% VT) design was used. The dependent variables were mean intracranial pressure (MICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), heart rate (HR), and oxygen saturation (SaO2). ⋯ No significant difference was found for SaO2 for either of the protocols regardless of number of suction passes. No significant differences were found between two- and three-ETS groups for any of the dependent variables. All groups, however, regardless of number of suction passes, demonstrated a cumulative increase in MICP, MAP, and CPP with each consecutive suction sequence.(ABSTRACT TRUNCATED AT 250 WORDS)
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Intra-ocular pressure was measured before and throughout airway establishment with either the laryngeal mask airway or tracheal tube. Similar measurements were made on removal of either airway and the amount of coughing noted in the first minute after removal. ⋯ There was a significantly greater rise in heart rate using the tracheal tube (p less than 0.01) probably related to an increased cardiovascular response. The laryngeal mask airway is recommended as an alternative to tracheal intubation in routine and emergency intra-ocular surgery.
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Data on the normal depth of insertion of double-lumen tubes have not been published. We studied 101 adult patients undergoing thoracic operations whose tracheas were intubated with a left double-lumen tube. ⋯ The correlation between depth of insertion and height was highly significant (P less than 0.0001) for both male and female patients. As depth of DLT insertion at any given height was normally distributed, a technique to confirm correct double-lumen tube position always should be used after initial placement.