Articles: intubation.
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Use of continuous transtracheal oxygen delivery systems combined with rhythmic chest compressions can provide excellent oxygenation and ventilation during cardiopulmonary resuscitation. However, occasional displacement of the transtracheal catheter results in life-threatening pneumomediastinal complications. We investigated using the pharyngeal lumen of a pharyngeal-tracheal lumened airway (PtL) as an alternative delivery system for continuous oxygen flow in 21 large mongrel dogs. ⋯ Successful resuscitation was achieved in 8 of 11 (73 percent) animals, which is similar to the results in historical controls with endotracheal intubation. No pneumomediastinal complications were seen with use of the PtL. We conclude that using the pharyngeal lumen of the PtL for continuous delivery of oxygen combined with external chest compressions can provide a safe and effective mode of oxygenation and ventilation during cardiac arrest.
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As a referral centre for cervical spine injuries, we have routinely performed awake tracheal intubation when intubation was indicated. A retrospective case control study was undertaken to review the frequency of neurological deterioration and aspiration associated with our approach. Neurological deterioration was assessed by a change in level of injury or neurological grade at admission and discharge. ⋯ This occurred despite a greater injury severity score in the case group. No evidence of aspiration during intubation was documented. We conclude that awake tracheal intubation is a safe method of airway management in patients with cervical spine injuries.
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Randomized Controlled Trial Clinical Trial
[Atropine in the premedication of patients at risk. Its effect on hemodynamics and salivation during intubation anesthesia using succinylcholine].
Should atropine be administered for premedication? This question continues to be controversial; in particular, the combined administration of atropine and succinylcholine has been investigated with conflicting results by numerous researchers. The present study was carried out to assess the effect of premedication with atropine on hemodynamic variables and salivation in patients assigned to ASA class II and III. METHODS. ⋯ No increase in heart rate occurred in the control groups during tracheal intubation. Neither i.m. nor i.v. atropine had any significant effect on blood pressure. Arrhythmias occurred in a few cases with both routes of administration; several instances of marked tachycardia were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)
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Am. Rev. Respir. Dis. · Feb 1992
Resolution of laryngeal injury following translaryngeal intubation.
Translaryngeal intubation (TLI) causes mucosal ulcerations of the vocal cords and posterior laryngeal commissure. Usually these ulcers heal by primary reepithelialization, but occasionally laryngeal granulomas or strictures develop at these ulcer sites. The incidence of granuloma and stricture formation and the variables influencing abnormal laryngeal healing following TLI are not well understood. ⋯ Laryngeal symptoms, particularly hoarseness, resolved as the larynx healed. Performance of tracheostomy, age, TLI for more than 10 days, and severe laryngeal injury at extubation did not influence the median time to resolution of laryngeal abnormalities. Abnormal laryngeal healing following TLI is uncommon but is not exacerbated by prolonged TLI (more than 10 days), severe laryngeal injury at extubation, or performance of a tracheostomy.