Articles: intubation.
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Critical care medicine · Apr 1992
Site of pressure measurement during spontaneous breathing with continuous positive airway pressure: effect on calculating imposed work of breathing.
To describe the importance of measuring pressure at the tracheal end of the endotracheal tube during spontaneous breathing with continuous positive airway pressure in order to correctly assess: a) the changes in airway pressure and b) the work imposed by the breathing apparatus. ⋯ The results indicate that pressure should be measured as close to the patient's airway as possible, i.e., at the tracheal end of the endotracheal tube, rather than using the traditional approach of measuring pressure and assessing work at the inspiratory or expiratory limbs, or "Y" piece of the breathing tubing.
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J. Cardiothorac. Vasc. Anesth. · Apr 1992
Comparative StudyBronchial cuff pressures of two tubes used in thoracic surgery.
The pressure/volume characteristics of the bronchial cuff of a polyvinylchloride (PVC) double-lumen endobronchial tube (DLT) was compared with the inflatable cuff of a bronchial blocker. At the volumes needed to seal a series of rigid model bronchi the PVC DLT bronchial cuff consistently generated significantly lower pressures than the bronchial blocker cuff.
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Randomized Controlled Trial Comparative Study Clinical Trial
Nosocomial sinusitis in ventilated patients. Nasotracheal versus orotracheal intubation.
A total of 68 postoperative patients whose lungs were ventilated for more than 4 days were studied prospectively during a one-year study period to investigate the effect of the mode of intubation on the paranasal sinuses. After an initial X ray of the skull showing no pathological findings, patients were assigned randomly to one of the study groups; the lungs of patients in group A were ventilated via an orotracheal tube (n = 32), and patients in group B via a nasotracheal tube (n = 36). X ray examinations of the sinuses were performed at regular intervals. ⋯ Two patients in group A developed signs of sinusitis in comparison to 15 patients in group B (p less than 0.01). However, there were significantly more airway complications in the orotracheal group, particularly during the period of weaning from ventilation. We conclude that orotracheal intubation should be preferred as the routine route of intubation.
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Comparative Study
Cardiovascular responses to insertion of the laryngeal mask.
We have compared, in 40 healthy patients, the cardiovascular responses induced by laryngoscopy and intubation with those produced by insertion of a laryngeal mask. Anaesthesia was induced with thiopentone and maintained with enflurane and nitrous oxide in oxygen; vecuronium was used for muscle relaxation. ⋯ Increases in maximum heart rate were similar, (26.6% v 25.7%) although heart rate remained elevated for longer after tracheal intubation. We conclude that insertion of the laryngeal mask airway is accompanied by smaller cardiovascular responses than those after laryngoscopy and intubation and that its use may be indicated in those patients in whom a marked pressor response would be deleterious.