Articles: intubation.
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The ability to breathe spontaneously through an endotracheal tube is a usual prerequisite before an intubated patient can have it removed. Other researchers have measured air flow resistance through endotracheal tubes. In this study, we evaluated work of breathing in joules per min and tension-time index while three normal volunteers breathed through different sized endotracheal tubes. ⋯ By increasing respiratory frequency, minute ventilation was increased from 5 to 30 L/min. As tube diameter decreased, work and the tension-time index increased. Changes were magnified at higher minute ventilations through the 6- and 7-mm endotracheal tubes, and the tension-time index critical fatigue level of 0.15 was approached or exceeded.
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It is well documented that prolonged endotracheal intubation can lead to subglottic trauma and stenosis. Newborn infants with hyaline membrane disease often require assisted ventilation for prolonged periods of time. We examined 11 such children ranging in age from four months to 4.25 years by endoscopy. Some abnormality was found in every child, and in nine there was minor narrowing of the airway.
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Southern medical journal · Dec 1986
Case ReportsUnrecognized esophageal placement of endotracheal tubes.
Unrecognized esophageal placement of endotracheal tubes during general anesthesia or in apneic unanesthetized patients is not an uncommon occurrence. Allowing this mishap to proceed to asphyxia and catastrophe is inexcusable. If one is uncertain, proper placement can be quickly verified by mouth-to-tube insufflation of a subject's lungs with one's own expired air immediately after intubation. This method of verification may be useful in areas other than the operating room, where intubations are performed for resuscitation or airway control.