Articles: intubation.
-
Comparative Study
Pre-hospital tracheal intubation versus esophageal gastric tube airway use: a prospective study.
A prospective study compared the respiratory effectiveness of the endotracheal tube (ET) with that of the esophageal gastric tube airway (EGTA) for victims of nontraumatic cardiac arrest in the pre-hospital setting. Arterial blood gases were obtained within 3 minutes of hospital arrival, and survival (defined as discharge from the hospital) was determined. ⋯ During ET ventilation, mean pH was 7.34 +/- 0.2, mean P02 was 265 +/- 151 mm Hg, mean PC02 was 35 +/- 20.5 mm Hg; the survival rate was 7%. The authors conclude that endotracheal intubation remains the procedure of choice for airway management in the victim of cardiopulmonary arrest.
-
Comparative Study
Laboratory evaluation of low-pressure tracheal tube cuffs: large-volume v. low-volume.
Large- and low-volume low-pressure tracheal tube cuffs were compared during exposure to nitrous oxide. The compliance of both types of cuff when measured inside and outside an artificial rigid trachea, the volume of intubated cuff, the residual volume, the nitrous oxide diffusion time, and the specific diffusion rate of the cuff membrane to nitrous oxide were measured in the laboratory. From these variables, the diffusion rate of nitrous oxide, the surface area available for nitrous oxide diffusion, the tracheal wall pressure exerted by cuff, and the degree of folding of the intubated cuff were derived. The results showed that the rapid increase in pressure of the large-volume cuff when intubated was caused by low compliance, the large surface area available for nitrous oxide diffusion, and the considerable permeability of the cuff membrane to nitrous oxide.
-
We have described a patient in whom tracheal rupture occurred during prolonged mechanical ventilation. Appropriate intensive respiratory care management, including the use of the minimal leak technique, was used. Our patient unfortunately had nearly every known predisposing factor for tracheal damage.