Articles: intubation.
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Critical care medicine · May 1983
Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study.
The purpose of this study was to assess the incidence, evolution and long-term effects of laryngotracheal lesions due to endotracheal intubation and to evaluate the import of factors in the genesis of laryngotracheal injury. Over a 12-month period, we performed fiberoptic bronchoscopy (FBS) in 19 critically ill patients with endotracheal intubation. ⋯ In 6 (31%) patients, early tracheal lesions appeared in the form of ring-shaped tracheitis at the cuff level and granulomas at the tube-tip level; in 2 (10%) patients, an established tracheal stenosis developed and early detected ring-shaped tracheitis preceded circumferential fibrous stenosis. Severe respiratory failure, high cuff pressure, and secretion infection showed a statistical correlation to tracheal injury.
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Case Reports
[Lung injury after use of respiratory revival materials sterilized with ethylene oxide].
One of the most used method of medical appliances sterilization uses ethylene oxide. At high concentration, this very reactive product, causes caustic burns of skin and mucous membranes. ⋯ This led us to review the toxicological data on this substance. It should be emphasized that the sterilization and the desorption according to simple and precise rules should prevent such acute accidents.
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Acta Anaesthesiol Scand · Apr 1983
Randomized Controlled Trial Clinical TrialLidocaine given intravenously as a suppressant of cough and laryngospasm in connection with extubation after tonsillectomy.
The preventive effect of lidocaine against coughing in the recovery period after general anaesthesia was observed. The study was carried out as a double-blind sequential trial. At the same time the incidence of laryngospasm was registered. ⋯ Nineteen patients for tonsillectomy, all of them over the age of 15, randomly received a 2% solution of lidocaine 2 mg/kg body weight or placebo (saline) 2 min prior to expected extubation. We found that lidocaine in this dose given prophylactically just before extubation was able to inhibit and prevent coughing in the recovery period after general anaesthesia. None of the patients included in this study got laryngospasm, and none of the patients developed serious side-effects.
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The Esophageal Obturator Airway (EOA) has been considered an effective ventilatory technique for cardiopulmonary resuscitation; however, few studies of its field effectiveness have been performed. We evaluated the EOA in 158 cases of prehospital cardiac arrest resuscitated by EMT II personnel utilizing the EOA for airway maintenance. The time of insertion from arrival of the unit and the number of unsuccessful attempts were recorded. ⋯ There was marked improvement in all parameters following ET intubation. The EOA presents technical problems which make it inferior to ET tubes in resuscitation of individuals in the field with cardiac arrest. Close monitoring of its use should be undertaken in areas where it is the primary method for airway maintenance.