Articles: intubation.
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Jpen Parenter Enter · Jul 1990
Effects of gas leak around endotracheal tubes on indirect calorimetry measurement.
The use of uncuffed endotracheal tubes (ETT) in pediatric patients raises concern over the accuracy of indirect calorimetry measurement in the presence of a gas leak around an ETT. We examined the effects of ETT gas leak on respiratory gas measurements in a dog model. Mongrel dogs (n = 12) were sedated, paralyzed, intubated, and placed on mechanical ventilation. ⋯ Measurements made with TVratio greater than 0.80 required no correction. Measurements made with TVratio greater than 0.45 could be corrected to actual values in our model with regression equations based on TVratio and Pdiff. We conclude that indirect calorimetry measurements can be useful in the presence of tracheal gas leak around an ETT.
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A new oesophageal intubation detector device, the Fenem CO2 detector, was used in 100 patients intubated during anaesthesia for elective surgery. This new device was 100% accurate in the differentiation between tracheal and oesophageal placement of a tube.
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J Cardiothorac Anesth · Jun 1990
Sufentanil and succinylcholine for rapid-sequence anesthetic induction and tracheal intubation: hemodynamic and hormonal responses.
Rapid-sequence induction and tracheal intubation are used in the management of patients at risk of aspiration. Patients with coronary artery disease (CAD) are at additional risk of adverse hemodynamic responses to intubation. The hemodynamic and hormonal responses to intubation with sufentanil, 7 micrograms/kg, and succinylcholine, 1.5 mg/kg, were studied in patients with CAD and good left ventricular function (ejection fraction greater than or equal to 0.4) who were undergoing elective coronary artery bypass grafting. ⋯ Rapid-sequence administration of sufentanil and succinylcholine resulted in a moderate decrease (24%) in mean arterial pressure from 95 to 72 mm Hg, and the mean arterial pressure remained less than the control value at 1, 3, and 5 minutes after intubation. Systemic vascular resistance also decreased (23%) after administration of sufentanil and returned to control values 5 minutes after intubation. There were no changes in cardiac index until 5 minutes after intubation, at which time it decreased (18%) from 2.8 to 2.3 L/min/m2.(ABSTRACT TRUNCATED AT 250 WORDS)