Articles: intubation.
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J. Thorac. Cardiovasc. Surg. · Oct 1981
Case ReportsUse of the silicone tracheal T-tube for the management of complex tracheal injuries.
This paper reports on the use of the silicone Montgomery T-tube for the management of 18 patients with complex tracheal injuries. Our use of the tube was as follows: prior to definitive resection, as a better alternative to tracheostomy tube, while we were awaiting the most appropriate time for resection; at the time of resection, as an adjunct to segmental subglottic resection, used to stent residual abnormal laryngeal mucosa: following tracheal resection for uncertain or unsatisfactory healing: as sole treatment, when resection was deemed unsuitable or inappropriate. ⋯ In contrast to a tracheostomy tube, the T-tube provides respiration through the the nasopharynx, so that humidification and phonation are maintained. It is generally trouble free, requires little if any maintenance, and can remain in place for a year or more when necessary.
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Acta Anaesthesiol Scand · Oct 1981
Randomized Controlled Trial Clinical TrialEffects of precurarization on the blood pressure and heart rate changes induced by suxamethonium facilitated laryngoscopy and intubation.
The effects of precurarization on blood pressure and heart rate increases during laryngoscopy and intubation were studied in 60 surgical patients, who were randomly allocated to four groups, receiving as a pretreatment d-tubocurarine (0.05 mg/kg), alcuronium (0.03 mk/kg) , pancuronium (0.008 mg/kg) or saline in a double-blind fashion. d-Tubocurarine and alcuronium pretreatments seemed to attenuate the blood pressure increase during laryngoscopy and intubation under suxamethonium. Moreover, d-tubocurarine pretreatment protected effectively against high blood-pressure increases. Heart-rate increases were of the same magnitude in all the pretreated groups. d-Tubocurarine pretreatment abolished suxamethonium-induced fasciculations completely, whereas alcuronium pretreatment gave protection in 93% and pancuronium pretreatment in 43% of patients.
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From July 1975 to September 1979, 6 patients were treated with truly prolonged endotracheal intubation; the duration ranged from 55--155 days. Only patients who survived after extubation and were discharged from the hospital were included in this study. Of the 6 patients, 4 were still alive as of November 1980, 23 patients died from causes not related to the intubation. ⋯ In none of these cases was the patient's death related to the intubation. The authors believe that the risk of long-term intubation has been reduced significantly by the use of nasotracheal tubes and to the newer tube materials, which are completely biocompatible, and to improved techniques of cuff inflation. Complications to tracheostomy are less frequent, but often more serious, than complications of long-term nasotracheal intubation.