Articles: intubation.
-
Southern medical journal · Jul 1978
Case ReportsComplications from unrecognized defects in endotracheal tubes.
Considerable effort has been made to improve endotracheal tubes and make them safer than they have been in the past; yet complications continue to occur, due, in most instances, to inherent defects in the tube. It is not possible to identify these defects in a routine preoperative examination. ⋯ Other possible complications and contributing factors causing obstruction of endotracheal tubes are also reviewed. Until some way is devised for the automatic compensation of the increases in volumes and pressures in endotracheal tube cuffs, hourly deflation is recommended to prevent complications.
-
Acute epiglottitis is a disease with significant mortality. The patient, usually an otherwise healthy pre-school child, develops a sore throat and muffled voice from swollen supraglottic structures, and may progress rapidly to respiratory arrest. Early diagnosis and airway maintenance can prevent these fatalities. ⋯ These patients were treated as follows: Tracheostomy = 348 (3 deaths - 0.86%); Endotracheal intubation = 216 (2 deaths - 0.92%); medical management with no artificial airway = 214 (13 deaths - 6.1%). The difference in morbidity and mortality between tracheostomy or nasotracheal intubation is so slight that the choice should be determined by local factors. Medical management with no artificial airway should not be used in children.
-
Clinical Trial Controlled Clinical Trial
Factors influencing intraoperative gastric regurgitation: a prospective random study of nasogastric tube drainage.
A prospective study was conducted to determine the incidence of "silent" gastric regurgitation and aspiration during general anesthesia in 146 patients randomized with respect to presence of a nasogastric tube. A bland dye was instilled in the stomach to serve as the determinant marker. ⋯ The primary agent used, difficulty of endotracheal intubation, location of surgical incision, and duration of anesthesia did not alter the incidence of regurgitation or aspiration. No correlation was found between the detection of subclinical aspiration and the development of postoperative pulmonary complications.
-
Comparative Study
Physical characteristics of and rates of nitrous oxide diffusion into tracheal tube cuffs.
Physical characteristics and time-related volume changes in air-inflated tracheal tube cuffs exposed to nitrous oxide were measured in an environmental chamber. Cuff wall diameter, thickness, residual volume, and length were also measured. Gas volumes in most air-inflated tracheal tube cuffs increased 1.7 to 7 ml within 30 min of exposure to pure nitrous oxide. ⋯ Cuff diameters ranged from 13.8 to 32 mm; thicknesses from .033 to .55 mm; residual volumes from .22 to 19.4 ml; lengths from 23.1 to 49.1 mm. Intracuff volume and pressure increase related to gas diffusion into air-inflated cuffs should be periodically adjusted or pressure automatically controlled during nitrous oxide anesthesia. Large-diameter, thin-walled cuffs are recommended.