Articles: intubation.
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The history is outlined of the development from metal through rubber to PVC of the endotracheal tube. The technical advantages of the plastics material both for product performance and for processing are summarized. Design features of the modern product are described. Finally, a view is presented of the need now to combine polymer science and clinical research towards further improvement of intubation anaesthesia.
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The endotracheal route for the administration of epinephrine has been studied extensively in dogs. There has been little in the medical literature to document the successful use of this technique in humans. The successful use of endotracheally administered epinephrine in two patients with cardiorespiratory collapse is reported. Specific points concerning endotracheal drugs are discussed and a set of guidelines for clinical use is offered.
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Critical care medicine · Dec 1979
Case ReportsUse of positive airway pressure without endotracheal intubation.
Continuous positive airway pressure (CPAP) and expiratory positive airway pressure (E-PAP) may be used safely without endotracheal intubation in patients with acute respiratory failure when strict selection criteria are adhered to. The therapy should be titrated to reduce intrapulmonary shunting, improve PaO2, and reduce FIO2. Other considerations include balancing oxygen consumption against cardiac output and oxygen transport. Absolute or relative indications for abandoning the technique and using endotracheal intubation with mechanical ventilatory support include unrelenting hypoxia, patient exhaustion, rising PaCO2, development of metabolic acidosis, presence of ventricular arrhythmias, and inability to protect the airway.