Articles: intubation.
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The human larynx is complex and serves multiple functions. Unfortunately, endotracheal tubes do not reproduce all these functions. They serve well as air passages but cannot do so without damaging the mucosa of the posterior larynx. ⋯ It is hoped that this reduction in complications will carry over into the chronic care setting as such monitoring becomes the standard after intubations. Compared with malposition of the tube, most of the other complications of intubation are minor. However, knowledge of the various complications can ensure avoidance of many and early detection and correction of others.
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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.