Articles: intubation.
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An unconscious victim of an overdose was intubated with an endotracheal tube to prevent aspiration. The respiratory therapist deflated the cuff of the endotracheal tube to allow for a retrograde oral air leak and then tightly attached the oxygen tube directly to the endotracheal tube. ⋯ The patient sustained both a hemodynamic and a neurologic decompensation as the result of marked pulmonary overinflation, with bilateral pneumothoraces and probable cerebral and coronary artery air emboli. We present the case in the hope that it will help avoid any such future occurrences.
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Following amniotic embolism a severe ARDS developed in a 21 year-old women. After two months of respirator therapy a giant tracheoesophageal fistula arose. ⋯ Our two step surgical management consisted of esophageal diversion and reconstruction of the intestinal passage by retrosternal gastric tube. The advantages and disadvantages of esophageal diversion in giant tracheoesophageal fistulas are discussed.