Articles: intubation.
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An emergency cricothyrotomy device was placed in 11 anesthetized dogs in order to assess airway damage and problems in placement, ventilation, and design. Posterior airway perforation without esophageal damage occurred in three animals. ⋯ When properly installed, an excellent emergency airway was achieved. Some minor design shortcomings are noted and suggestions for improvement are made.
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Twenty-one patients on mechanical ventilators for greater than 48 hours who had new localized infiltrates were evaluated using a quantitative culture technique of the involved lung compared to the non-involved lung. Based on the clinical course, response to antibiotics, or subsequent analysis of pathologic specimens, eight patients were felt to have acute bacterial pneumonia, while the remaining 13 were felt to have an alternative cause of their infiltrate. Cultures of the protected brush specimen of the involved lung in all eight cases of bacterial pneumonia had one or more organisms grown at a greater than 100 colony forming units (cfu) per ml while only one of the 13 cases of non-pneumonia had a culture from the involved area having greater than 100 cfu per ml (p less than 0.001). The non-involved area always grew fewer organisms than the involved area, and in 16 cases, there was no growth from the specimen obtained from the non-involved area.
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Fiberoptic intubation is widely accepted in the management of a "difficult airway". In the majority of these cases the underlying anatomical findings require a nasal approach. ⋯ Orotracheal fiberoptic intubation was easily performed using a Williams oral airway and a Patil-Syracuse face mask. We recommend this technique for those cases where fiberoptic intubation is indicated but contraindications to the transnasal route apply and an "asleep-intubation" is desired.
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Intensive care medicine · Jan 1987
Case ReportsAirway obstruction associated with an endotracheal tube.
A case of endotracheal tube obstruction with fatal outcome is presented. The obstruction was caused by the endotracheal tube bevel lying against the tracheal wall, the trachea being excessively displaced by the aorta at the level of the aortic knuckle.