Articles: intubation.
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Eur Arch Otorhinolaryngol · Jan 1991
Case ReportsEmergency ventilation using the Combitube in cases of difficult intubation.
The esophageal-tracheal Combitube (Sheridan, Argyle, NY) is a new device for emergency intubation, which can be inserted blindly without the use of a laryngoscope. Ventilation is independent of the position of the Combitube in either the esophagus or the trachea, since ventilation is always provided by the tube's double channel. The "tracheal" channel acts as a conventional endotracheal airway and has an open distal end. ⋯ Endotracheal intubation failed because the glottis could not be visualized with a laryngoscope. In both cases the Combitube was applied successfully and adequate ventilation was provided via the Combitube placed esophageally. To better secure each patient's airway, tracheotomy was performed during ventilation without any complications.
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Pediatric pulmonology · Jan 1991
Effects of endotracheal tube size and ventilator settings on the mechanics of a test system during intermittent flow ventilation.
The effect of varying the size of standard neonatal endotracheal tubes on delivered tidal volumes (VT), resistance (R), dynamic compliance (Cdyn), and resistive work of breathing (WOB) was measured in a test system during intermittent flow ventilation at different ventilator settings. The experiments were performed with a Sechrist infant ventilator connected to a Dräger Test Lung via standard neonatal endotracheal tubes. R, inspiratory (Ri), and expiratory resistance (Re) as well as WOB were significantly affected by endotracheal tube size. ⋯ Also, ventilator settings with respect to the peak inspiratory pressure (PIP) - positive end-expiratory pressure (PEEP) difference had a significant influence on Cdyn for both tube sizes. On the other hand, flow and inspiratory time adjustments had no significant effect on ventilatory parameters. Endotracheal tube size and ventilator settings should be considered when comparing the pulmonary function tests in intubated and non-intubated newborn infants.
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The passage of a nasogastric tube may be met with some difficulty. The indications and contraindications for, and the method of insertion of, the tube are described, as are the difficulties that may be encountered, their solutions, and the complications that may result from the procedure.
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[Search for early indications for reintubation after mechanical ventilation weaning of the newborn].
Early predictive factors for successful extubation were investigated, in order to determine the best moment for respiratory weaning of the newborn, and the risk of subsequent reintubation. PaO2/FiO2 ratio, PCO2 and respiratory rate were measured 2 h after extubation in 100 newborn infants. There was no statistically significant difference for the PaO2/FiO2 ratio and PCO2 between infants who were successfully extubated (group 1) and those who required subsequent reintubation (group 2). By contrast, the respiratory rate 2 h after extubation was significantly higher in group 2, and a respiratory rate greater than 70/min appears to be the earliest ventilatory modification predictive of the need for further mechanical ventilation before the occurrence of hypoxemia and respiratory acidosis.
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Case Reports Randomized Controlled Trial Clinical Trial
A management option for leaking endotracheal tube cuffs: use of lidocaine jelly.
To evaluate the effectiveness of methods for sealing a small endotracheal tube cuff perforation. ⋯ The authors' in vitro results, in conjunction with the observations from their two cases, suggest that lidocaine jelly mixed with 1 to 3 parts normal saline may be useful in managing certain types of endotracheal tube cuff incompetence.