Articles: intubation.
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A study was undertaken to assess the applicability of transtracheal ventilation in the instance of total upper airway obstruction. The effect of transtracheal jet ventilation through a variety of inflow catheters in the dog was studied. Arterial blood gas values, intratracheal pressure and minute ventilation were compared. ⋯ A dual-lumen needle, to provide exclusive respiratory access and support was then designed based on the preliminary data. Prolonged transtracheal jet ventilation with a totally obstructed upper airway was successfully conducted in a live canine subject. A review of the literature is presented.
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Four hundred and twenty-seven patients with severe blunt chest trauma were treated resulting in (1) flail chest, (2) pulmonary contusions, (3) pneumothorax, (4) hemothorax, or (5) multiple rib fracture. The need for endotracheal intubation and mechanical ventilation was determined selectively by standard clinical criteria. Avoidance of fluid overload and vigorous pulmonary toilet was attempted in all patients. ⋯ Half of the flail chest patients were intubated, but 69.5% were intubated less than three days. Twenty per cent of the patients with pulmonary contusion required mechanical ventilation, usually for less than three days. This study demonstrates that patients with severe blunt chest trauma can be managed safely by selective intubation and mechanical, ventilation and that the incidence of complications associated with controlled mechanical ventilation can be greatly reduced.
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Otolaryngol Head Neck Surg · Sep 1982
Experimental induction of squamous metaplasia in the dog trachea with cuffed endotracheal tubes.
Clinical reports cite the development of squamous metaplasia in tracheas following tracheostomy, laryngectomy, and cuffed intubation. The purpose of this study was (1) to develop an experimental model using the dog trachea and study the effects of prolonged cuffed intubation and (2) to determine whether squamous metaplasia is produced by prolonged contact of the endotracheal cuff with the tracheal mucosa. ⋯ The dogs remained intubated for 14 days, at which time they were killed; seven animals were available for histologic study. Varying degrees of squamous metaplasia were produced in all animals.
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Bull Eur Physiopathol Respir · Sep 1982
A method for measuring tidal volume and lung compliance in intubated neonates in the presence of endotracheal tube leakage.
Leakage around the uncuffed endotracheal tube is a major cause of error in the measurement of tidal volume and compliance in intubated neonates. A correction for the leakage can be made if the intratracheal pressure is measured during inflation provided the compliance is linear and the inflation flow is held constant. ⋯ The validity of the function has been tested using a model of the system tube-trachea-lung. In practice, the calculation is done from data obtained by graphical analysis of the pressure-time curve.