Articles: intubation.
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Case Reports
[Bronchial rupture. Diagnosis and therapy of a rare complication of the use of double-lumen tubes].
For anesthesia during thoracic surgery, it is common to use a double-lumen endotracheal tube for one-lung ventilation. Double-lumen tubes protect the bronchial system of the healthy lung from being occluded by blood or pus coming from the operated lung. Therefore, in cases of lung abscess, bronchial hemorrhage, lung cyst, or localized lung infection the use of a double-lumen tube is advisable. ⋯ The intraoperative symptoms of airway leakage are demonstrated, the process of locating and repairing the injury is described. In our case the postoperative course was not complicated; the patient left the hospital 10 days after operation. Causes of bronchial rupture, its therapy, and prophylactic measures are also discussed.
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The tracheas of 140 adult patients were intubated with either TFX or Portex tracheal tubes. Guide marks were printed at variable distances proximal to the tube cuffs, and during intubation the guide mark was positioned at the level of the vocal cords. The distance between the bevel end of the tube and the carina was determined with a fibreoptic bronchoscope. ⋯ The tip of the tracheal tube approaches the carina by a mean distance of 0.5 cm when the head is moved from the extended position to the neutral position. It is recommended that a guide mark be placed 2.5 cm from the proximal end of the cuff in tubes used for adult males and 2.25 cm in tubes used for adult females. The use of guide marks is a simple, safe and reliable method for correct tracheal tube placement.
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Critical care medicine · Apr 1991
Validity of a disposable end-tidal carbon dioxide detector in verifying endotracheal tube position in piglets.
the most reliable methods for confirming endotracheal tube placement are direct visualization of passage through the vocal cords and documentation of CO2 in the expired gas. We evaluated the use of a disposable colorimetric CO2 detector for verifying endotracheal tube position in small animals. The end-tidal CO2 (Petco2) detector was tested in 11 piglets with the endotracheal tube sequentially in the trachea, the esophagus, the esophagus with a carbonated beverage in the stomach, the esophagus after bag-mask ventilation. Endotracheal tube position was confirmed in all cases by direct visualization and capnometry. ⋯ This disposable Petco2 detector is highly sensitive and specific for verifying endotracheal tube placement in this nonarrest piglet model.