Articles: intubation.
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Difficulty was encountered during extubation due to a fold in cuff of a tracheal tube at its distal end. Management of this unexpected and rare complication is described.
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A tracheal-esophageal airway for field or hospital use is described. The airway consists of a clear plastic mask and endotracheal low pressure cuffed tube with a Murphy tip. ⋯ The endotracheal tube is attached to the mask by a tubular coupler and easily disconnected by removing a metal clip in the event of tracheal insertion of the tube. Our four-year experience with the tracheal-esophageal airway in 400 cardiac arrests has shown it to be safe, simple, and useful.
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A retrospective review of 100 surviving infants, all requiring nasotracheal intubation in the neonatal period for greater than 24 hr. was performed to assess the morbidity of this form of airway management. Seventy infants needed only one intubation, 22 were intubated twice and 8 infants required 3 intubations. No infant had evidence of laryngeal or tracheal sequelae, either in the immediate newborn period or on follow-up. Nasotracheal intubation by an experienced practitioner with appropriate tube fixation and toilet coupled with the use of low pressure ventilation and a consistent extubation routine will result in very low long-term tracheal morbidity in the neonate.
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It is widely accepted and taught that the accidental placement of a tracheal tube in the oesophagus can be readily detected if it is looked for, though it is recognised that death from this cause occurs from time to time. Evidence is now presented of instances where anaesthetists have been misled by a range of tests which are commonly used to check the correct placement of a tracheal tube. An explanation is offered for this unexpected finding, and some recommendations are formulated to improve patient safety.
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AJR Am J Roentgenol · Apr 1980
Case ReportsStomach rupture associated with esophageal atresia, tracheoesophageal fistula, and ventilatory assistance.
When infants with tracheoesophageal fistula require ventilatory assistance, gastric distention may ultimately result in perforation and pneumoperitoneum. This report describes four neonates with esophageal atresia and tracheoesophageal fistula who experienced such a complication.