Articles: intubation.
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To examine the incidence of bacteremia associated with emergent nasotracheal intubation. ⋯ The risk of bacteremia associated with emergency nasotracheal intubation is substantial and is accompanied by organisms that may produce serious morbidity in the patient with valvular heart disease or compromised immunity. Our findings suggest that, whenever possible, the nasotracheal route should be avoided for emergency intubation in patients with valvular heart disease and if used, prophylactic antibiotics should be strongly considered.
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Anaesth Intensive Care · Aug 1990
Management of failed endotracheal intubation at caesarean section.
A review of the history of endotracheal intubation and endotracheal tubes is presented and a plan of management of failed endotracheal intubation at caesarean section is described. The importance of preparation for such an event by incorporation of certain features into anaesthesia training programs is emphasised.
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A 64-year old female requiring prolonged ventilatory support was scheduled for an elective tracheostomy. Anesthesia consisted of surgical infiltration of 1% lidocaine and supplemental isoflurane. The patient was mechanically ventilated with an FIO2 of 1.0. ⋯ Proper management of an endotracheal tube fire includes stopping ventilation, disconnecting the oxygen source, removing the endotracheal tube, diagnosing injury, administering short-term steroids, administering antibiotics if indicated, providing ventilation and medical support as necessary and monitoring the patient for at least 24 hours. Extreme caution is necessary when using electrocautery in close proximity to an endotracheal tube. If electrocautery is used in close proximity to an endotracheal tube, an FIO2 of 0.3 or less with helium should be used.
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Nihon Kyobu Geka Gakkai Zasshi · Aug 1990
Case Reports[A case of thyroid carcinoma required the incision of the thyroid cartilage for inserting the silicone T tube after extensive tracheal resection and reconstruction].
A 57-year-old female with thyroid carcinoma, who had developed tracheal stenosis, underwent extensive tracheal resection and reconstruction. After the tracheal sleeve resection 5.2 cm in length, primary tracheal reconstruction was performed. Although complication did not occur at the anastomotic site, the patient had dyspnea due to cord dysfunction by bilateral recurrent nerve paralysis. ⋯ The patient inserting the T tube through the laryngeal stoma had no dyspnea and no aspiration about two years after the operation in spite of palliative operation. It seemed likely that the trouble that tracheostomy could not be done would occur in some patients who had undergone extensive tracheal resection and reconstruction. But the insertion of silicone T tube through the laryngeal stoma provided a satisfactory result for airway problem.