Articles: intubation.
-
A technique of blind nasal intubation for anaesthesia using the Samson modification of the Mapleson 'A' circuit is described. Adequate depth of anaesthesia is maintained by continuous insufflation, and scavenging is continuously used to remove waste anaesthetic gases. The position of the tube in relation to the larynx is estimated by movement of the reservoir bag and intermittent condensation of expired water vapour in the clear plastic of the circuit.
-
Am. J. Gastroenterol. · Aug 1985
Case ReportsAn unusual complication of balloon tamponade in the treatment of esophageal varices: a case report and brief review of the literature.
A Sengstaken-Blakemore tube was unable to be withdrawn 14 h after its initial insertion. Despite a number of recognized maneuvers, both gastric and esophageal balloons remained inflated leading to impaction of the tube. This uncommon complication along with other complications peculiar to the Sengstaken-Blakemore tube are described.
-
The Journal of pathology · Aug 1985
The histopathology of the larynx in the neonate following endotracheal intubation.
Subglottic stenosis is the most common serious complication of endotracheal intubation in the neonate with an incidence of between 1-8 per cent. While considered a complication of traumatic injury to the larynx and possibly associated with prolonged intubation, the pathogenesis is poorly understood and the pathology has not been described in detail. The nature of intubation induced injury has been investigated by examining step-sections of 43 larynges removed from neonates post-mortem who had been intubated for periods ranging from 10 min to 12 weeks. ⋯ Similar injury was seen in the posterior glottis and subglottis but with more prolonged intubation there was full thickness mucosal necrosis, perichondritis and partial destruction of the arytenoid and cricoid cartilages. Although the severity of the injury progressed with time and many of the most severe injuries occurred early, in the second and third weeks of intubation, the larynx usually healed despite the continued presence of the endotracheal tube. Prolonged intubation on its own does not appear to be an important factor in the production of severe laryngeal injury nor, therefore, the subsequent complications such as subglottic stenosis.
-
Am. Rev. Respir. Dis. · Aug 1985
The effect of a gas leak around the endotracheal tube on the mean tracheal pressure during mechanical ventilation.
Infants requiring mechanical ventilation are usually intubated with uncuffed endotracheal tubes, which permit gas to leak between the tube and the trachea. This gas leak may alter the mean pressure transmitted to the trachea by changing the pattern of airway flow and modifying the resistive behavior of the endotracheal tube. To test this hypothesis, we measured mean tracheal pressure, gas flow through the endotracheal tube, and resistance of the tube in rabbits ventilated with and without a leak. ⋯ A ventilatory pattern of short inspiratory times and high peak pressures was associated with a proportionally greater decrease in mean tracheal pressure caused by the leak. These findings suggest that the mean proximal airway pressure, measured at the ventilator, may overestimate the mean tracheal pressure in the presence of a gas leak around the tube. Furthermore, the decrease in mean tracheal pressure caused by the leak may decrease oxygenation despite a constant mean proximal airway pressure.