Articles: intubation.
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For a two-month period, 71 nasotracheal intubations done in the emergency department or inpatient units at Detroit General Hospital were studied. Sixty-five of 71 intubations, or 91%, were successful. Mild or moderate complications occurred in 15 of 71 patients, and consisted of mild or moderate bleeding. ⋯ Retropharyngeal perforation may be a more common complication of nasotracheal intubation than realized. The major technical error is failure to appreciate that loss of flow of air from the tube, once the tube has passed the turbinates, means that the lumen of the tube is abutting the pharyngeal mucosa. Even slight pressure at this point can lead to retropharyngeal perforation.
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A new use of the cuffed endotracheal tube as a right atrial venous return cannula in emergency cardiopulmonary bypass operations is described. The ready availability, low cost, and design of the cuffed endotracheal tube make it ideal in this situation. We have used it successfully on three occasions.
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Letter Case Reports
An infrequent cause of pulmonary atelectasis during mechanical ventilation.
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Letter Case Reports
The use of the fibre-optic bronchoscope for the passage of a double lumen tube.