Articles: intubation.
-
Rev Esp Anestesiol Reanim · Nov 1989
Historical Article[Spanish pioneers in the technics of laryngotracheal intubation].
Tracheal intubation technique is the result of centuries of experiments, studies and clinical trials. Among the pleiad of physicians who definitely introduced tracheal intubation in clinical practice, several Spanish physicians especially contributed to its diffusion with their research work and discoveries and in some cases they were true pioneers in techniques considered as so advanced at the beginning of this century that it was thought they would never be systematically used in clinical practice. In the present work, we discuss the contributions of these Spanish pioneers to laryngotracheal intubation technique, a technique widely used in modern medicine.
-
Difficult or failed tracheal intubation is an important cause of anaesthetic-related maternal morbidity and mortality. The incidence of failed intubation in parturients is estimated to be as frequent as 1 in 500; that of mortality is unknown, although some 10-13 pregnant women in England, Scotland and Wales die each year because of anaesthetic-related complications. ⋯ Furthermore, adequate assistance, correct use of cricoid pressure, and confirmation of tracheal intubation are fundamental to safe practice. Lastly, should the anaesthetist fail to intubate the patient's trachea, a management protocol is suggested.
-
Randomized Controlled Trial Clinical Trial
Esophageal tracheal combitube, endotracheal airway, and mask: comparison of ventilatory pressure curves.
The esophageal tracheal Combitube (ETC) is a new airway especially designed for airway maintenance and ventilation in unconscious patients such as those requiring CPR. The ETC may be used as an esophageal obturator or an endotracheal airway. Previous studies yielded a significantly higher mean arterial oxygen tension (PaO2) during ventilation using an ETC in the esophageal position compared to a conventional endotracheal airway (ETA). ⋯ The following differences in intratracheal pressure and flow could be found for ETC when compared to ETA: smaller rising pressure during inspiration, prolonged expiratory flow time, and formation of a small positive end expiratory pressure (PEEP). These factors may be responsible for the improved oxygen tension with ETC. Comparing mask to ETC ventilation, PaO2 did not differ; however, mean arterial carbon dioxide tension was higher during mask ventilation.
-
Anesthesia and analgesia · Nov 1989
Comparative StudyA comparative study of methods of detection of esophageal intubation.
The trachea and esophagus of 21 patients were simultaneously intubated to comparatively evaluate methods for detecting esophageal intubation. In succession, the trachea and esophagus were ventilated with the same inspiratory volume of 621 +/- 45 mL (mean +/- SD). Carbon dioxide (CO2) levels, volumes, and temperatures of expired gas were measured from the tracheal and esophageal tubes. ⋯ Peak temperatures of expired gas recorded from the tracheal tube (32.0 +/- 0.73 degrees C) were higher than those from the esophageal tube (27.3 +/- 1.2 degrees C) (P less than 0.001). The shape of temperature waveforms with a correctly placed tracheal tube remained constant with each ventilation, contrary to that obtained from an esophageal tube. Although the occasional detected of CO2 waveforms from an esophageal tube might lead to an incorrect assessment of tube placement, this limitation of CO2 analyzer can be offset by measurement of volume and temperature of expired gas in identifying placement of an endotracheal tube.