Articles: intubation.
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Ann Oto Rhinol Laryn · Jul 1983
Clinical TrialVenturi jet ventilation through the metal endotracheal tube: a nonflammable system.
In an effort to design a fireproof and reliable method of ventilation during CO2 laser laryngoscopies, a new Venturi jet endotracheal tube coupler has been designed. This allows microdirect laryngoscopy. Its design features are described. ⋯ No complications or adverse effects were noted. The Venturi jet endotracheal tube coupler allows for jet ventilation through a metal endotracheal tube with reliable ventilation. This is an alternate, reliable, and fire-safe method during laser use.
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Ann Oto Rhinol Laryn · Jul 1983
Case ReportsDifficult laryngoscopy/intubation: the child with mandibular hypoplasia.
The child with mandibular hypoplasia (Treacher Collins syndrome, Pierre Robin sequence, hemifacial microsomia, etc) presents the otolaryngologist and anesthesiologist with considerable problems when direct laryngoscopy and/or endotracheal intubation is attempted. In addition to the small mandible, several other features of these patients contribute to the difficult laryngoscopy: macroglossia, glossoptosis, trismus related to temporomandibular joint abnormalities, and prominent maxilla or maxillary incisors. Most of the techniques that have been described for laryngoscopy/intubation in problem cases are difficult or impossible to use in infants and young children with mandibular hypoplasia. We present a modification of the standard direct laryngoscopic procedure, utilizing the 9-cm anterior commissure laryngoscope and an optical stylet in the task of exposing and intubating the larynx of a child with mandibular hypoplasia.
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Double-lumen endobronchial tubes offer many advantages during thoracic operations. However, technical problems with tube placement and potentially life-threatening complications have discouraged widespread use of standard double-lumen tubes. Some of these problems may be reduced with a new polyvinyl chloride (PVC) double-lumen tube. ⋯ In 8 of 16 intubations with the Carlens tube and in 14 of 62 intubations with the Robertshaw tube, there were complications. In all, 22 of 78 intubations (28%) using conventional double-lumen tubes were complicated compared with 5 of 136 (4%) using the PVC tube. The technical problems and risks of endobronchial intubation were reduced significantly with the PVC double-lumen tube.
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Randomized Controlled Trial Comparative Study Clinical Trial
Precautions against intra-ocular pressure changes during endotracheal intubation--a comparison of pretreatment with intravenous lignocaine and diazepam.
Endotracheal intubation after administration of succinylcholine is associated with a rise in intraocular pressure (IOP). That this is likely to have harmful effects in patients with penetrating eye injuries is self-evident. The efficacy of various means of abolishing these effects is debatable. ⋯ IOP, pulse rate and systolic blood pressure were recorded after induction, after intubation and after return of spontaneous respiration. Statistical analysis of the data showed that diazepam diminished the rise in IOP, while lignocaine had little effect (P less than 0,05). It is concluded that pretreatment with diazepam 0,05 mg/kg is beneficial in reducing the ocular risks of endotracheal intubation.
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Acta Anaesthesiol Scand · Jun 1983
Comparative StudyCapnography for detection of accidental oesophageal intubation.
The clinical diagnostic signs for detecting inadvertent oesophageal intubation may all be misleading. We therefore tested the practice of recording exhaled carbon dioxide during the intubation procedure as an additional measure for detection of accidental oesophageal intubation. Twenty patients were intubated simultaneously into the trachea and oesophagus and the carbon dioxide concentration was continuously recorded from both sources. ⋯ Ventilation by mask prior to the intubation obviously resulted in some filling the stomach by exhaled gas in 9 of the 20 patients. In these cases some CO2 could be detected during oesophageal ventilation. As the oesophageal CO2 concentrations were very low initially, compared to the tracheal recordings, and carbon dioxide completely disappeared after a few ventilations into the oesophagus, distinguishing between the tracheal and oesophageal capnography tracings was easy.