Articles: intubation.
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Randomized Controlled Trial Clinical Trial
Assessing the position of the tracheal tube. The reliability of different methods.
Various methods have been developed to confirm proper intubation of the trachea. This blind, randomised study evaluates some of these quantitatively and qualitatively. Forty patients had both their trachea and oesophagus intubated. ⋯ Auscultation of the lungs resulted in a wrong conclusion in 15% (6-30, 95% confidence limits) of the cases when the oesophagus was ventilated: the sounds were misinterpretated as normal breath sounds. Suction on the tubes with a 60-ml syringe was also a reliable test. Other methods assessed were observation for condensation of water vapor, and abnormal movements of the upper abdomen; these were unreliable.
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Randomized Controlled Trial Clinical Trial
Modification by fentanyl and alfentanil of the intraocular pressure response to suxamethonium and tracheal intubation.
We have measured in a double-blind study the changes in intraocular pressure (IOP) in 40 consecutive patients (pretreated with fentanyl or alfentanil) who received suxamethonium and tracheal intubation. Although IOP increased significantly following administration of suxamethonium, mean IOP in both groups remained significantly less than control values (P less than 0.002). ⋯ There were no significant differences in mean IOP between the fentanyl and alfentanil groups. Both opioids reduced, but did not abolish the haemodynamic responses to tracheal intubation.
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Ann Oto Rhinol Laryn · Dec 1989
Comparative Study Clinical Trial Controlled Clinical TrialProspective studies evaluating the standard endotracheal tube and a prototype endotracheal tube.
Two prospective studies were designed to evaluate laryngeal injury sustained with the standard endotracheal tube (ETT) and the relative safety of a new prototype ETT. The first study followed patients after prolonged intubation with the standard ETT. Potential patient host factors were recorded and correlated with subjective complaints and objective findings on fiberoptic laryngoscopy. ⋯ The mechanisms of TVC granulomas and immobility are probably different, as suggested by the different host factor associations and onset times. The second study compared the standard ETT with the prototype ETT in short-term intubations. The prototype ETT was associated with no complications in this setting and is considered relatively safe for further testing in the patient with prolonged intubation.
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Critical care medicine · Dec 1989
Randomized Controlled Trial Clinical TrialSuccinylcholine and atropine for premedication of the newborn infant before nasotracheal intubation: a randomized, controlled trial.
Twenty preterm newborn infants were randomized to receive either atropine alone (20 micrograms/kg) or atropine plus succinylcholine (2 mg/kg) before nasotracheal intubation. Heart rate, BP, transcutaneous PO2, and intracranial pressure were monitored continuously before, during, and after intubation. No infants developed bradycardia or hypoxia. ⋯ BP increased during intubation in both groups, and the overall peak BP was not significantly different between the groups. Intubation was significantly shorter in the infants receiving succinylcholine. Premedication with succinylcholine and atropine will facilitate intubation of neonates, and ameliorate the adverse physiologic consequences of this procedure.