Articles: intubation.
-
Critical care medicine · Jun 1988
Incidence and morbidity of extubation failure in surgical intensive care patients.
The rate of extubation failure (reintubation rate) was determined for 700 consecutive extubations in surgical patients admitted to one of two ICUs. Patients were weaned in a standardized fashion and extubated using a standardized gas exchange and mechanics criteria. Of 400 extubations in the general surgical ICU, there were 22 reintubations in 20 patients. ⋯ In no group studied were any predictors of extubation failure detected. We conclude that the incidence, reasons for, and outcome of reintubations in surgical ICU patients varies dramatically depending on the underlying disease process. Overall failure rate was 4%.
-
Randomized Controlled Trial Clinical Trial
Nifedipine prevents the pressor response to laryngoscopy and tracheal intubation in patients with coronary artery disease.
The efficacy of sublingual nifedipine, administered one minute before anaesthetic induction, in order to minimise the pressor response to laryngoscopy and tracheal intubation was studied in a group of 15 patients who underwent coronary artery bypass surgery. Another group of 15 similar patients served as control. Premedication consisted of oral diazepam 5-10 mg, intramuscular morphine 0.2 mg/kg and promethazine 0.4 mg/kg. ⋯ This increase was absent in the patients pretreated with nifedipine. The nifedipine group also maintained a lower rate-pressure-product than the control group during the period of study. It is concluded that nifedipine 10 mg is a useful pretreatment to prevent the pressor response to laryngoscopy and tracheal intubation in patients with coronary artery disease.
-
Randomized Controlled Trial Clinical Trial
Effects of beta-adrenoceptor antagonism on the cardiovascular and catecholamine responses to tracheal intubation.
The catecholamine and cardiovascular responses to laryngoscopy and tracheal intubation were studied in 20 patients who underwent elective gynaecological surgery and who were allocated randomly to receive either practolol 10 mg or saline intravenously prior to induction of anaesthesia. Anaesthesia was induced with fentanyl and thiopentone; atracurium was administered and the lungs were ventilated artificially with 67% nitrous oxide in oxygen. Tracheal intubation was performed when muscle relaxation was adequate. ⋯ A significant increase in catecholamine concentrations occurred in both groups in response to tracheal intubation but the magnitude of the increase in adrenaline was greater in the practolol group. There were no significant differences in arterial pressure or heart rate changes between the groups. We conclude that pretreatment with practolol is of no value in the attenuation of the hypertensive response to direct laryngoscopy and tracheal intubation in previously normotensive patients.
-
Anesthesia and analgesia · Jun 1988
Letter Case ReportsRetrograde intubation with a modified Eschmann stylet.
-
The reliability of two signs of tracheal placement of a gum elastic bougie was studied. These signs were clicks (produced as the tip of the bougie runs over the tracheal cartilages) and hold up of the bougie as it is advanced (when the tip reaches the small bronchi). Ninety-eight simulated and two genuine Grade 3 difficult intubations were attempted with the aid of a gum elastic bougie. ⋯ Clicks were recorded in 89.7% of tracheal placements of the bougie. Hold up at between 24-40 cm occurred in all tracheal placements. We conclude that these signs are reliable and that they should be taught as part of any difficult intubation drill in which the gum elastic bougie is used.