Anaesthesia
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At the First International Symposium on the History of Modern Anaesthesia (1982), Professor Keuskamp mentioned that the introduction of breathing machines for lung ventilation during operations had taken over 'the tiresome handwork of ventilation'. This paper traces some aspects of Keuskamp's professional career and his role in the development of the Amsterdam Infant Ventilator. ⋯ Other clinicians from the United States and Europe echoed this satisfactory clinical evaluation. At present, this paediatric ventilator is still in use for the initial ventilation of small infants and for the mechanical ventilation of different animal species in a variety of experimental settings.
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This study examines the incidence and site of tracheal tube impingement during nasotracheal fibreoptic intubation, and the efficacy of anticlockwise tube rotation to overcome the problem. Forty-three patients underwent fibreoptic-assisted nasotracheal intubation using a preformed nasal tube, and a second fibrescope was used to observe any obstruction to passage of the tracheal tube. ⋯ Rotation resulted in successful intubation in all 10 cases, but proximal rotation did not always result in an equal degree of rotation at the tube tip. We conclude that the site of impingement for nasotracheal intubation with preformed nasal tubes is located at the posterior structures of the laryngeal inlet and that anticlockwise rotation is a simple and effective solution.
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Letter Case Reports
User damage to the tracheal tube used with the Intubating Laryngeal Mask Airway.