Articles: intubation.
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Critical care medicine · Jun 1986
Case ReportsInadvertent gastric balloon inflation within the chest in the management of esophageal varices.
Balloon tamponade of esophageal variceal hemorrhage is palliative therapy which is associated with a certain incidence of morbidity, perhaps mortality. Three cases of intrathoracic inflation of the gastric balloon of such tubes are described. The precise mechanism of thoracic placement remains uncertain. Fluoroscopy or chest x-ray should be used to confirm appropriate tube tip placement.
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A 48-year-old woman with non-small cell lung cancer involving the mediastinum and producing extrinsic tracheal compression is presented. The patient failed to respond to all conventional therapy and presented with stridor and respiratory distress due to progressive airway obstruction. Continuous positive airway pressure (CPAP) by mask was used to physiologically stent the airway until a mechanical Silastic stent could be placed by tracheostomy.
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Anesthesia and analgesia · Jun 1986
Endotracheal tube leak pressure and tracheal lumen size in swine.
Endotracheal tube "leak" is often estimated in children to judge the fit of uncuffed endotracheal tubes within the trachea. Twenty-five swine were intubated with uncuffed tracheal tubes to determine whether a more sensitive measurement of leaks could be devised and whether leak pressure estimates fit between tracheal tube and trachea. ⋯ Regression analysis revealed a linear relationship between tracheal lumen size and tracheal tube size for both low leak pressure (y = -0.4 + 0.79x, r = 0.88, P less than 0.05) and high leak pressure (y = -2.9 + 0.71x, r = 0.92, P less than 0.05) groups. We conclude that leak testing with a stethoscope and aneroid manometer is sensitive and accurate, and that tracheal tube leak pressure accurately portrays fit between tube and trachea.
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Br J Oral Maxillofac Surg · Jun 1986
Case ReportsPharyngoplasty: a hazard for nasotracheal intubation.
General anaesthesia is desirable for a wide range of oral and maxillofacial operations and nasal intubation is essential for some procedures, particularly orthognathic surgery. The patient who has undergone pharyngoplasty presents with a reduced velopharyngeal orifice which may interfere with the insertion of the nasal tube. It is suggested that nasal pharyngoscopy or a similar investigation should be included as part of the preoperative assessment for these patients if nasotracheal intubation is anticipated.