Articles: intubation.
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Comparative Study
Incidence of pulmonary aspiration in intubated patients receiving enteral nutrition through wide- and narrow-bore nasogastric feeding tubes.
A descriptive study was performed to compare the incidence of pulmonary aspiration in 25 critically ill patients who had endotracheal tubes in place and were receiving enteral nutrition through a narrow-bore nasogastric tube (n = 10) or a wide-bore nasogastric tube (n = 15). Results of chi-square analysis of this comparison were not significant, p less than 0.05. Aspiration occurred in one subject. ⋯ The number of checks for residual feeding was found to be significantly greater in the wide-bore tube group. A comparison of the assessment of nasogastric tube placement on x-ray examination showed that tube placement was reported on x-ray results with more frequency in the wide-bore group. Questions are raised by these observations regarding the use of narrow-bore tubes in the critically ill population with endotracheal tubes in place.
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Annales de chirurgie · Jan 1991
Case Reports[Surgical repair of a tracheal tear caused by an endotracheal tube via dual surgical approach].
We report a case of large tracheal (cervical thoracic) rupture after using an endotracheal tube, which needed to be repaired via a double surgical approach: cervicotomy and right thoracotomy. To our knowledge, no similar cases have been previously reported in the medial literature.
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The Laryngeal Mask (LM) can be used to intubate patients in whom conventional direct laryngoscopy is difficult. Tracheal intubation can be achieved using the LM alone but the use of a fibre-optic laryngoscope increases the chances of success.
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Clin Intensive Care · Jan 1991
Physiological responses to endotracheal and oral suctioning in paediatric patients: the influence of endotracheal tube sizes and suction pressures.
To study the influence of varying outer suction catheter (SC) diameter (OD) to inner endotracheal tube (ETT) diameter (ID) and suction pressures (SP) on heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), arterial oxygen saturation (SaO 2) and intracranial pressure (ICP) during ETT and oral suctioning. An additional aim was to define an optimal suction catheter size that would prove easy to introduce and be rapidly effective in clearing secretions with the least physiological alteration. ⋯ Our study suggests that: 1. Tracheal toilet using variations in OD/ID ratios and SP within limits tested resulted in similar significant adverse changes in HR, ICP and SaO 2 and similar trends in RR and MAP. 2. Based on the ease of introduction and the effectiveness of clearing secretions, a medium SC (OD/ID = 0.7) is most appropriate for infants and children. 3. Oral suctioning also results in adverse physiological changes, therefore similar precautions to those taken during tracheal suctioning should be followed for oral suctioning.
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Detection of expired carbon dioxide is one of the most reliable methods of avoiding accidental esophageal intubation. Although capnography has become a standard monitoring technique in the hospital operating room, it is rarely available in the office setting or other arenas where emergency endotracheal intubation may be required. ⋯ This semi-quantitative detector fits between the endotracheal tube and the breathing circuit and uses a pH-sensitive indicator that changes color in response to different concentrations of carbon dioxide. Clinical studies indicate that this device provides similar results to standard capnography, and its inclusion in the emergency kit is strongly recommended.