Articles: intubation.
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It is described eight tracheostomised patients, advising an early and gradual tracheal decanulation using silver tracheostomy tube with a window in the posterior curvature (fenestrated tube, Alder Hey pattern) and proper sedation at the moment of definitive decanulation. Decanulation techniques and the mechanical and functional difficulties that can occur and how to avoid them are described: Finally the tracheostomy tubes that have been used are mentioned.
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Anesthesia and analgesia · May 1975
Comparative StudySquamous metaplasia of tracheal epithelium associated with high-volume, low pressure airway cuffs.
The tracheas of 12 patients, intubated from 2 hours to 20 days with tracheal airways equipped with the newer style, high-volume, low-pressure (HVLP) cuffs, were examined at autopsy. The type and severity of iatrogenic damage to the epithelium and submucosa was determined and compared to that seen in a previous study of 54 patients, who had been intubated with the older-style low-volume, high-pressure (LVHP) cuffed airways. ⋯ However, the pseudostratified ciliated epithelium, which normally lines the trachea, was often replaced by stratified squamous epithelium. If such a zone of nonciliated epithelium remains in the trachea of a long-term survivor, its detrimental effect on the removal of particulate matter from the tracheobronchial tree may have to be considered.