Articles: intubation.
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Ugeskrift for laeger · Sep 1989
Case Reports[Obstruction of a naso-tracheal tube by an avulsed nasal concha].
Avulsion of a nasal concha by a nasotracheal tube obstructed the tube in a valvelike manner. The result was increased intrapulmonary pressure, hemodynamic instability, alveolar rupture, pneumomediastinum and pneumoperitoneum without pneumothorax. The case was successfully managed by removal of the nasotracheal tube and immediate oral reintubation.
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Journal of anesthesia · Sep 1989
Anesthesia for a patient with recessive dystrophic epidermolysis bullosa.
Two different anesthetic methods were employed for a patient with recessive dystrophic epidermolysis bullosa (R-DEB). One was plexus brachial block in combination with ketamine infusion. ⋯ In the later, however, some blisters were newly formed on the region where the anesthesist's fingers were attached to hold a face mask. Although mask anesthesia was considered to be not always suitable for patients with DEB, we chose it because tracheal intubation may cause more serious damage to the upper airway leading to airway obstruction.
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The extent to which pH values of aspirates from feeding tubes could be used to differentiate between (a) gastric and intestinal placement, and (b) gastric and respiratory placement were determined in a clinical study. The sample consisted of 181 adult subjects, 94 with small-bore nasogastric tubes and 87 with nasointestinal tubes. Data were collected at the time of initial tube placement and again, when possible, after one or two days of tube feedings. ⋯ Findings indicated that pH readings were often effective in differentiating between gastric and intestinal placement (p less than .0001). For example, approximately 81% of the aspirates from nasogastric tubes had pH values ranging from 1 through 4, while almost 88% of the aspirates from nasointestinal tubes had pH values of 6 or greater. Only one aspirate from a tube inadvertently placed in the lung was tested; as expected it had an alkaline pH.