Articles: intubation.
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Randomized Controlled Trial Clinical Trial
Effect of lung hyperinflation and endotracheal suctioning on heart rate and rhythm in patients after coronary artery bypass graft surgery.
We examined the effect of lung hyperinflation and suction on PaO2, heart rate, and rhythm in patients after coronary artery bypass graft surgery (N = 26). Three lung hyperinflation breaths, at one of five randomly ordered volumes (tidal volume, 12 cc/kg, 14 cc/kg, 16 cc/kg, or 18 cc/kg of lean body weight) were delivered, by a ventilator (fraction of inspired oxygen 1.0), followed by 10 seconds of continuous suction. Lung hyperinflation and suctioning were repeated three times. ⋯ The majority of rhythm changes for lung hyperinflation and suctioning were from normal sinus rhythm to sinus tachycardia. Suction was associated with a greater incidence of rhythm (53.9%) and arrhythmia (80.8%) changes. The most frequent arrhythmia was premature atrial contraction.
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Anesthesia and analgesia · Sep 1991
Randomized Controlled Trial Comparative Study Clinical TrialEmergence airway complications in children: a comparison of tracheal extubation in awake and deeply anesthetized patients.
We compared the differences in oxygen saturation and airway-related complications after tracheal extubation in pediatric patients undergoing elective strabismus surgery or adenoidectomy and/or tonsillectomy who were awake versus anesthetized. Seventy otherwise healthy patients between 2 and 8 yr of age were studied. Anesthesia was induced with halothane or thiamylal and maintained with nitrous oxide and halothane. ⋯ There were no differences between the two groups in the number of patients requiring supplemental oxygen. The incidence of airway-related complications such as laryngospasm, croup, sore throat, excessive coughing, and arrhythmias was not different between the two groups. We conclude that the anesthesiologist's preference or surgical requirements may dictate the choice of extubation technique in otherwise healthy children undergoing elective surgery.
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To compare a new, clear, unmarked polyvinylchloride (PVC) tracheal tube marketed for use during Neodymium-Yttrium-Aluminum-Garnet (Nd-YAG) laser surgery with a conventional marked PVC tracheal tube. ⋯ The clear, unmarked Sheridan PVC tracheal tube is not recommended for laser airway surgery.
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Case Reports
Application of the Mizus endotracheal obturator in tracheostomy and tentative extubation.
A variety of catheters, stylets, and obturators have been used to assist with problems in airway management. Obturators specifically designed for airway use are now available in different sizes. ⋯ Use of these obturators to preserve a path to the airway is described in cases of tracheostomy and tentative extubation. The advantages and disadvantages inherent in the use of such obturators are described.