Articles: intubation.
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Southern medical journal · Feb 1984
Case ReportsPneumothorax and subcutaneous emphysema complicating endotracheal intubation.
We report subcutaneous emphysema and pneumothorax as immediate complications of endotracheal intubation in a patient with diffuse interstitial lung disease. We postulate increased intra-alveolar pressure during intubation leading to rupture of a subpleural bleb or cyst as a possible mechanism causing these complications.
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A flexible fibreoptic laryngoscope was used to facilitate the passage of a long polyvinyl chloride tracheal tube into the left main bronchus during repair of a tracheo-oesophageal fistula situated near the carina in a patient in whom intubation with a double-lumen endobronchial tube was difficult. Close monitoring of neuromuscular transmission using a peripheral nerve stimulator also contributed to the successful anaesthetic management of this patient.
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Endotracheal intubation of the rat under direct vision is described together with the details of procedures and apparatus for conducting inhalation anesthesia in this species. Our intubation method requires no special manufacture of equipment, because it employs the human laryngoscope equipped with an infant blade (size 0). Using inhalation anesthetics such as enflurane or halothane for induction, clear laryngoscopic visualization of the glottis is reliably obtained, allowing rapid and routine intubation of the rat in a highly predictable amount of time. In contrast, the injected anesthetics such as ketamine or pentobarbital sodium seem unsuited to laryngoscopic intubation as a result of problems of variable induction times, copious oral secretions, and strong pharyngeal-laryngeal reflexes.
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Intensive care medicine · Jan 1984
Case ReportsSevere pulmonary interstitial emphysema of the right lung treated by selective intubation of the left main bronchus.
As an alternative to surgical treatment, we have selectively intubated the left main bronchus in children with severe pulmonary interstitial emphysema (PIE) of the right lung. Within 12-24 h the unilateral hyperinflation disappeared. We propose that when conservative treatment of unilateral PIE fails, contralateral SBI should be tried before surgical intervention, leading to loss of functioning tissue, is undertaken.