Articles: intubation.
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The laryngeal mask (LM), a recently commercialized device, provides a totally patent airway when positioned in the hypopharynx. The major advantages of the LM are its ease of insertion, the absence of contact with the vocal cords, and the fact that if frees the hands of the anesthesiologist. Contraindications to its use result from its failure to seal the airway against regurgitation of gastric content. ⋯ Only 13% of patients complained of mild pharyngeal discomfort postoperatively. We conclude that this device is reliable, easy to use, and causes minimal postoperative problems. Its use, for both spontaneous and controlled ventilation, is increasing in our hospital.
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Norcuron has been used for intubation and short-term relaxation in 21 cases and for maintaining neuromuscular blockade during major operations of 48 patients suffering from severe clinical conditions. The drug assured in all cases relaxation for the required period and longer operations could also be performed, if required, with the repetition of doses. According to the observations Norcuron proved to be a muscle relaxant of medium duration of action which may be combined with drugs commonly used for premedication, as well as with narcotics introducing and maintaining anaesthesia. The special advantage of the drug is that virtually it does not influence the circulatory parameters and its action may be reliably antagonized.
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The passage of a nasogastric tube may be met with some difficulty. The indications and contraindications for, and the method of insertion of, the tube are described, as are the difficulties that may be encountered, their solutions, and the complications that may result from the procedure.
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[Search for early indications for reintubation after mechanical ventilation weaning of the newborn].
Early predictive factors for successful extubation were investigated, in order to determine the best moment for respiratory weaning of the newborn, and the risk of subsequent reintubation. PaO2/FiO2 ratio, PCO2 and respiratory rate were measured 2 h after extubation in 100 newborn infants. There was no statistically significant difference for the PaO2/FiO2 ratio and PCO2 between infants who were successfully extubated (group 1) and those who required subsequent reintubation (group 2). By contrast, the respiratory rate 2 h after extubation was significantly higher in group 2, and a respiratory rate greater than 70/min appears to be the earliest ventilatory modification predictive of the need for further mechanical ventilation before the occurrence of hypoxemia and respiratory acidosis.