Articles: intubation.
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The occurrence of an airway obstruction with a cuffed flexometallic tracheal tube is reported. The cause of the obstruction is attributed to internal herniation of the distal extremity of the tube secondary to diffusion of anaesthetic gases into the tracheal tube cuff and subsequently between the two layers of the distal extremity of the tube. Methods to avoid overdistension of the cuff volume are described.
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Tracheal stenosis is not an uncommon sequel of prolonged endotracheal intubation. In some cases, immediate reconstruction is not feasible. We use the flexible fiberoptic bronchoscope and a lucent, tapered endotracheal tube for tracheal dilation. The fiberoptic bronchoscope is passed through a special T connector into the endotracheal tube and used to guide the tube under direct vision through the stricture.
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A feeding tube can be rapidly introduced into the small intestine through a makeshift 'external channel' of the fibreoptic endoscope. To prevent dislodgement of the feeding tube upon withdrawal of the endoscope, the former may be stabilized by means of the biopsy forceps introduced through its regular channel.
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A cannula and conveniently arranged ancillary apparatus designed to assist endotracheal intubation of patients with upper respiratory tract obstruction prior to tracheostomy are described.
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Anesthesia and analgesia · Mar 1976
Circulatory changes in patients with coronary artery disease following thiamylal-succinylcholine and tracheal intubation.
Circulatory responses after thiamylal (4 mg/kg) and succinylcholine (SCh) (2 mg/kg) administration followed by direct laryngoscopy and tracheal intubation were measured in 20 patients before elective aortocoronary vein bypass graft operations. Compared with awake measurements, the mean arterial pressure (MAP) decreased 19 +/- 3 torr (mean +/- SE) and heart rate (HR) increased 9 +/- 3 bpm 1 minute after thiamylal-SCh. ⋯ Stroke volume index was decreased significantly after tracheal intubation but cardiac index was not altered. The authors conclude that thiamylal-SCh followed by tracheal intubation is an acceptable anesthetic induction sequence for patients without evidence of left ventricular heart failure who require anesthesia for elective coronary artery revascularization.