Articles: intubation.
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Acta Anaesthesiol Scand · Apr 1989
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous administration of isosorbide dinitrate attenuates the pressor response to laryngoscopy and tracheal intubation.
In order to evaluate the effect of isosorbide dinitrate (ISDN), administered as a bolus intravenous injection, on the circulatory response to tracheal intubation, mean arterial pressure (MAP), and heart rate (HR) in response to laryngoscopy for 30 s followed by tracheal intubation were compared in patients not receiving ISDN (control) and receiving 40 micrograms/kg or 80 micrograms/kg of ISDN 45 s before starting laryngoscopy. Each group consisted of 10 patients undergoing elective surgery. ⋯ HR increased to a similar extent in the three groups. These results indicate that a bolus injection of ISDN (80 micrograms/kg) is a simple, practical and highly effective means of attenuating the hypertensive response to direct laryngoscopy and tracheal intubation.
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The Christiansen-Douglas-Haldane effect describes the reduced CO2 binding capacity of oxygenated as compared to deoxygenated hemoglobin on the basis of its increased acidity. This study describes the development of the above effect during the first 2 min of hyperoxic intubation apnea. METHODS. ⋯ During early hyperoxic apnea, venoarterial pH and pCO2 reversal can be observed due to the Christiansen-Douglas-Haldane effect. pH reversal starts earlier than pCO2 reversal. Reversal time is dependent on arterial-mixed-venous pCO2 difference (avDpCO2) before apnea, arterial-mixed-venous O2 saturation difference (avDsO2) and cardiac output. The amount of reversal is dependent on avDsO2, i.e. the pH difference of arterial and m
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Randomized Controlled Trial Comparative Study Clinical Trial
Successful extubation of newborn infants without preextubation trial of continuous positive airway pressure.
Sixty newborn infants who had been mechanically ventilated through 3.0- or 3.5-mm endotracheal tubes were studied to examine the necessity of a preextubation trial of continuous positive airway pressure (CPAP). Thirty randomly assigned study infants were directly extubated from intermittent mandatory ventilation rates of six per minute; 30 randomly assigned control infants were extubated after a six-hour trial of continuous positive airway pressure of 3 cm H2O. Changes in respiratory rate, in PCO2, and in PO2/FIO2 were similar. ⋯ Five control and no study infants had apneic episodes greater than or equal to 0.5 per hour (chi 2 = 5.5, P less than .02). The results of this study suggest that newborn infants may tolerate direct extubation from low intermittent mandatory ventilation rates without a preextubation trial of CPAP. A preextubation trial of CPAP appears to be unnecessary and may cause more frequent apnea in newborn infants if used for more than several hours.
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Minerva anestesiologica · Mar 1989
Comparative Study[Tracheal cannulation technics in cervical vertebral and spinal cord injuries. A comparative study].
Cervical vertebral dislocations and fractures require the complete immobility of the neck until an intervention of stabilization of the spinal cord, by surgery or external means, is performed. Endotracheal intubation, which might represent a harmful operation, can become difficult when the stabilization of the spinal cord has been obtained by external means. ⋯ Each method presents advantages with regard to the grading of visualization of the larynx, but also limitations due to the time required to perform the intubation and the appearance of complications. It seems therefore useful to continue the search for the ideal method for tracheal intubation, which should be absolutely atraumatic, fast, and completely successful.