Articles: intubation.
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A rare case of bilateral vocal cord paralysis after orotracheal intubation and inhalation anesthesia, in surgery not in relation to the neck, is presented. There was no obvious cause for the paralysis and possible etiological factors are discussed. Overextension of the neck during intubation is suspected of being the etiological agent causing stretching of both the vagus nerves. Normal laryngeal function returned after two months.
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Clinical Trial Controlled Clinical Trial
Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients.
A prospective study of the complications and consequences of translaryngeal endotracheal intubation and tracheotomy was conducted on 150 critically ill adult patients. Adverse consequences occurred in 62 percent of all endotracheal intubations and in 66 percent of all tracheotomies during placement and use of the artificial airways. The most frequent problems during endotracheal intubation were excessive cuff pressure requirements (19 percent), self-extubation (13 percent) and inability to seal the airway (11 percent). ⋯ There was no significant relationship between the duration of endotracheal intubation or tracheotomy and the over-all amount of laryngotracheal injury at autopsy, although patients with prolonged endotracheal intubation followed by tracheotomy had more laryngeal injury at autopsy (P = 0.06) and more frequent tracheal stenosis (P = 0.05) than patients with short-term endotracheal intubation followed by tracheotomy. Adverse effects of both endotracheal intubation and tracheotomy are common. The value of tracheotomy when an artificial airway is required for periods as long as three weeks is not supported by data obtained in this study.
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British medical journal · Dec 1980
The oesophageal obturator airway: a new device in emergency cardiopulmonary resuscitation.
Experience with 29 000 cases in which the oesophageal obturator airway has been used in cardiopulmonary resuscitation indicates its safety, efficacy, and ease of use. Blood gases, fractional inspired oxygen, and pH were measured in 18 patients given both the oesophageal obturator airway and the endotracheal tube; there was no significant difference between the two. The former was found to be inserted more rapidly and reliably; moreover, paramedical staff are quickly trained to use it. It is concluded that the oesophageal obturator airway provides the technique of choice whenever ideal conditions and facilities--and trained staff--for endotracheal intubation are not immediately available.