Articles: intubation.
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Critical care medicine · Dec 1985
Resistance and inertia of endotracheal tubes used in infants during periodic flow.
To study the effects of a periodic pattern of gas flow on the dynamic behavior of infant endotracheal tubes, we measured the resistance (expressed as a function of gas flow) and inertia of endotracheal tubes of 2.5, 3.0, and 3.5-mm internal diameter under conditions of both periodic and quasisteady gas flow. We examined how resistance and inertia are affected by ventilatory rate, the direction of gas flow through the tube, and the expansion of the airway caliber at the junction of the tube and the trachea. ⋯ All tubes exhibited measureable inertia, as predicted from their small diameter. The resistive and inertial properties of the endotracheal tubes described in this report can be used to evaluate the contribution of the endotracheal tube to the dynamics of breathing in intubated infants.
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Anesthesia and analgesia · Dec 1985
Randomized Controlled Trial Clinical TrialDoes intravenous lidocaine prevent laryngospasm after extubation in children?
One hundred otherwise healthy children undergoing tonsillectomy were investigated in a double-blind study to examine the effect of intravenous lidocaine in preventing laryngospasm upon extubation. The children were anesthetized with N2O-O2-halothane and orally intubated. ⋯ Eleven children (2%) in each group of 50 developed laryngospasm. From our findings it is concluded that lidocaine, 1.5 mg/kg, does not prevent laryngospasm upon extubation when extubation is carried out at the start of swallowing activity.
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Laryngeal sequelae following prolonged endotracheal intubation are being observed with increasing frequency as this technique of airway management is being employed for extended periods of time. Many etiologic factors have been implicated in the development of these problems with the exact reasons being as yet unknown. After reviewing the records of 372 consecutive patients intubated over an 18-month period, we have observed an increased frequency of these complications in the diabetic female patient and suggest that early tracheostomy should be considered in these individuals when the use of prolonged intubation is anticipated. The possible pathophysiology of this problem in the diabetic, as well as the non-diabetic intubated patient, and its possible prevention will be discussed.
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Cricoid pressure may be performed when a sharp object such as an animal bone is lodged in the post-cricoid oesophagus. This study was undertaken to determine what damage, if any, may be caused to the oesophagus. A sharp foreign body was inserted into the post-cricoid region of 15 cadavers. ⋯ In the remaining 10 cases, intubation with and without cricoid pressure was also performed. No significant damage was visible to the naked eye when the oesophagus was subsequently examined. Cricoid pressure does not seem to result in significant damage in this situation.