Articles: intubation.
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Aichi Gakuin Daigaku Shigakkai Shi · Jun 1989
[Effects of intravenous injections of lidocaine on hemodynamics and catecholamine levels during endotracheal intubation in infants and children].
It is known that during anesthesia, administering medication and endotracheal intubation often cause stress for the patient which induces sthenia of the endocrinal system as well as changes in hemodynamics, sometimes leading to further systemic complications. Various changes in hemodynamics caused by endotracheal intubation in infants and children were studied, including tachycardia and increased blood pressure. Changes in catecholamine levels in blood plasma and in cardiovascular parameters were observed, with patients divided into two groups for comparison. ⋯ The results also indicate that systemic complications during the induction of general anesthesia may be due to an increased secretion of endogenous catecholamines. These results further suggest that an intravenous injection of lidocaine is not effective in suppressing the increase of catecholamines in the plasma during endotracheal intubation. The intravenous injection of lidocaine, however, inhibits tachycardia and also inhibits the increase in blood pressure often caused by endotracheal intubation, and also serves to reduce the general oxygen demand in the cardiac tissue.
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This study compares some physical characteristics of a selection of cuffed endotracheal tubes with large-volume, low-pressure cuffs currently used in the United Kingdom. Six types of endotracheal tubes of Sizes 7, 8 and 9 were studied. There was considerable variation in physical characteristics of endotracheal tubes and cuffs from different manufacturers and even from the same manufacturer.
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We describe a modification of retrograde guided intubation. With the help of a gliding knot fixed around the side hole of the tracheal tube, we use the catheter to pull and guide the tracheal tube down the larynx and trachea. The technique offers several advantages: it is surprisingly fast, relatively atraumatic, easy to perform, and eliminates most causes of failure.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
The oesophageal detector device. A prospective trial on 100 patients.
Misplacement of a tracheal tube in the oesophagus remains a significant cause of mortality and morbidity in anaesthesia, despite decades of effort aimed at prevention, or perhaps more importantly, detection, of such an event. We have evaluated a cheap, simple and quick device which relies mainly on the reflation or otherwise of an Ellick's evacuator applied to the supposed 'tracheal' tube. ⋯ There were no false positive results and the correct deduction of which was the tracheal tube was reached in 100 tests using this device. Its use is recommended for widespread evaluation as a valuable adjunct to existing methods of detecting misplacement.
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Although a number of studies have described endotracheal intubation of adult patients in the prehospital setting, there are few studies on prehospital endotracheal intubation of pediatric patients. The purposes of our study were to determine how frequently prehospital endotracheal intubation was used in pediatric cardiopulmonary arrests when a paramedic trained in endotracheal intubation was present, to determine the success rate and complications associated with the procedure in the field, and to compare resuscitation rates and outcome in patients with and without prehospital endotracheal intubation. Our retrospective study covered a 38-month period and included all prehospital victims of medical cardiopulmonary arrest under the age of 19 years. ⋯ In patients less than 1 year old, only six of 16 (38%) had endotracheal intubation attempted and only three of six (50%) attempts were successful. Of the 18 patients who were intubated successfully before arrival at the hospital, nine (50%) survived to hospital admission and one (6%) survived to discharge. The remainder died in the emergency department.(ABSTRACT TRUNCATED AT 250 WORDS)