British journal of anaesthesia
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Extracorporeal circulation techniques are being used increasingly in patients with acute cardiac or pulmonary failure. Some of these patients may subsequently require transportation, which has limited the use of these techniques in hospitals without on site transplantation facilities. We report a case of adult respiratory distress syndrome that demonstrates a solution to this problem.
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Eight patients with a history of failed tracheal intubation during pregnancy were investigated by x-ray laryngoscopy after delivery. Partial elevation of the epiglottis with no view of glottic structures was found in five patients who were therefore considered to still present difficulty. ⋯ Relatively few abnormal anatomical indices were seen in these patients and this was in keeping with the level of difficulty encountered. An angular measure of jaw protrusion from a line joining the upper incisors and a point just above and anterior to the vocal cords, to the mid-point on the inner surface of the mandible was useful: the lower angle of this triangle was as important as the angle at the incisors.