Articles: intubation.
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J Burn Care Rehabil · Jan 1988
Managing the difficult airway in patients with burns of the head and neck.
A five-phase defined protocol for airway security was developed and administered to a consecutive, selected series of surgical patients with burns to the head and neck that limited their mouth opening or neck mobility. The protocol uses fiberoptic light and scope systems to allow the anesthesia team to visually place the endotracheal tube properly before anesthesia is induced. The technique provides safe, efficient airway management for patients with burns to the head and neck and significantly diminishes patient risks.
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Ann Otolaryngol Chir Cervicofac · Jan 1988
[Nosocomial sinusitis in an intensive care unit. Role of nasotracheal intubation].
Hospital infectious sinusitis resulting from nasotracheal intubation is common. A prospective study was undertaken between October 1986 and January 1988 of 46 patients who had undergone nasotracheal intubation. ⋯ In 21 cases the existence of a complication (chest infection and/or septicemia) raised the possibility of the role played by sinusitis in their etiology. The prevalence of gram negative bacilli sinusitis in patients with a nasotracheal tube is felt to require the following from the 8th day onwards: a CT scan to detect the existence of sinusitis, sinus puncture for bacteriological identification of the organism.
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Limited data are available on the efficacy of a common endotracheal suctioning intervention to prevent decreases in arterial oxygenation (PaO2) after endotracheal suctioning. We evaluated the effect of five hyperinflation breaths with hyperoxygenation, administered before and after endotracheal tube suctioning, in anesthetized, paralyzed sheep with normal lung function and with abnormal lung function induced by pulmonary acid aspiration. Using a second ventilator to deliver hyperinflation and hyperoxygenation prevented PaO2 from falling below control values after endotracheal tube suctioning in animals with either normal or abnormal lung function. ⋯ These results highlight the difference in PaO2 response when hyperinflation and hyperoxygenation suctioning interventions are delivered with mechanical versus manual techniques. These results also emphasize that the response to hyperinflation and hyperoxygenation differs in subjects with normal versus abnormal lung function. Laboratory evaluation of endotracheal tube suctioning interventions should use abnormal lung function models, rather than normal lung function models, to approximate more closely the critically ill patient population that requires suctioning.