Articles: intubation.
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Critical care medicine · Jul 1982
Predictive value of stridor in detecting laryngeal injury in extubated neonates.
We evaluated 73 consecutively extubated neonates for evidence of acute laryngeal injury from intubation. Hoarseness and stridor were graded by a clinical scoring system. ⋯ All patients with stridor had moderate or major injury, as did 38% of patients without stridor. Stridor was quite specific for detecting moderate or major injury but did not identify the type of injury.
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Randomized Controlled Trial Clinical Trial
Postoperative sore throat related to tracheal tube cuff design.
Recent reports of the incidence of postoperative sore throat following anaesthesia with tracheal intubation have claimed that low volume high pressure cuffs are preferable to those with high volume and low pressure. In this study similar methods were used for evaluating postoperative sore throat. Randomly selected tracheal tubes were used in 56 patients undergoing elective abdominal surgery, followed by direct questioning about sore throat on the first postoperative day. ⋯ Therefore the validity of this method for evaluating the influence of cuff design must be questioned. Postoperative sore throat is a symptom caused by many factors, such as the intubation procedure and the use of stylets or lubricants. The incidence of postoperative sore throat does not necessarily reflect damage caused by the tracheal tube cuff.
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Thirty adult patients were intubated with the help of a flexible fiberoptic instrument (FOI). The endotracheal tube was passed through the right nostril as in blind nasal intubation. At the same time the FOI was passed through the left nostril. ⋯ By this means, it was also possible to alter exactly the position of the tube visually. This procedure presents distinct didactic advantages and helps to prevent false positioning of the tube and subsequent injuries. Indications, in particular its potential use in paediatric anesthesia, as well as its disadvantages, are discussed in the conclusion of this paper.
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Ann Oto Rhinol Laryn · Jul 1982
Cricothyroidotomy: the impact of antecedent endotracheal intubation.
In light of the current debate regarding cricothyroidotomy, we elected to study the procedure at our institution. Cricothyroidotomy was instituted whenever tracheotomy was necessary for airway management. After a fairly short period of time, some significant complications of cricothyroidotomy were apparent and the study was aborted prior to achieving statistically significant results. ⋯ The major underlying factor in patients who developed complications was prolonged intubation prior to the institution of cricothyroidotomy. The study suggests that cricothyroidotomy should not be performed after prolonged intubation. The issue of primary cricothyroidotomy for short-term airway control remains unanswered.