Articles: intubation.
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Multicenter Study Clinical Trial
A prospective multicenter trial testing the SCOTI device for confirmation of endotracheal tube placement.
We sought to characterize the Sonomatic Confirmation of Tracheal Intubation (SCOTI) device's ability to confirm endotracheal tube location during real-time intubation in emergency and elective settings. Data were prospectively collected during a multicenter convenience-sample observational trial of emergency and elective intubation cases. In addition to tracheal and inadvertent esophageal intubations in emergency patients, intentional esophageal intubations were also performed to improve specificity calculations in consenting elective surgical patients. ⋯ We conclude that the SCOTI device has high sensitivity and specificity for tube placement confirmation during tracheal intubation attempts in both emergency and elective settings. It also facilitates tube placement itself during difficult intubations. As such it may be considered an adjunctive device to minimize the potentially fatal complication of esophageal intubation.
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Rev Esp Anestesiol Reanim · Feb 2001
Multicenter Study[Multicenter study on the usefulness of the NasOral system for the denitrogenation and apneic oxygenation in anesthesia].
To study the usefulness of the NasOral system for denitrogenation prior to anesthetic induction for improving pulmonary oxygen storage that maintains SpO2 within the normal range during induced apnea and facilitates apneic oxygenation. ⋯ The NasOral system facilitates denitrogenation before induction of anesthesia in all patients with permeable nasal fossae as well as apneic oxygenation during laryngoscopy.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Intramuscular rapacuronium in infants and children: a comparative multicenter study to confirm the efficacy and safety of the age-related tracheal intubating doses of intramuscular rapacuronium (ORG 9487) in two groups of pediatric subjects.
This multicenter, assessor, blinded, randomized study was conducted to confirm and extend a pilot study in which intramuscular rapacuronium was given to infants and children to confirm efficacy and to evaluate tracheal intubating conditions. ⋯ Only 27% of patients achieved clinically acceptable tracheal intubating conditions at 1.5 or 3 min after administration of 2.8 mg/kg and 4.8 mg/kg rapacuronium during 1 minimum alveolar concentration halothane anesthesia. Tracheal intubation conditions at 4 min were acceptable in 69% of subjects. The duration of action of 4.8 mg/kg of rapacuronium in children was longer than 2.8 mg/kg of rapacuronium in infants.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Rapacuronium 2.0 or 2.5 mg kg-1 for rapid-sequence induction: comparison with succinylcholine 1.0 mg kg-1.
The purpose of this nine-centre study in 602 patients was to show that the frequency of acceptable intubating conditions after rapacuronium 2.0 or 2.5 mg kg-1 is not more than 10% lower than the frequency after succinylcholine 1.0 mg kg-1 during rapid-sequence induction of anaesthesia with fentanyl 1-2 micrograms kg-1 and thiopental 2-7 mg kg-1. Laryngoscopy and intubation were carried out 60 s after administration of muscle relaxant by an anaesthetist blinded to its identity. Intubating conditions were clinically acceptable (excellent or good) in 91.8% of patients given succinylcholine and in 84.1 and 87.6% of patients given rapacuronium 2.0 and 2.5 mg kg-1 respectively. ⋯ The increase in heart rate was significantly greater during the first 5 min in the rapacuronium groups, but the arterial pressure increased significantly only in the succinylcholine group (P < 0.001). Respiratory side-effects were observed in 4.0, 13.5 and 18.5% of patients after succinylcholine and rapacuronium 2.0 and 2.5 mg kg-1 respectively (P < 0.05). As the non-inferiority of intubating conditions after rapacuronium 2.0 and 2.5 mg kg-1 could not be proven, succinylcholine should be considered the neuromuscular blocking agent that provides better intubating conditions for rapid-sequence induction.
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In the South Thames (West) region of the United Kingdom, during a 6-year period from 1993 to 1998, there was a significant increase in the Caesarean section rate accompanied by a significant decrease in the use of general anaesthesia for operative delivery. During this time, there were 36 failed tracheal intubations occurring in 8970 obstetric general anaesthetics (incidence 1/249). There was no significant difference in the incidence of failed tracheal intubation in each of the six years. In 24 of the 26 cases for which the patients' notes could be examined, there was either no recording of preoperative assessment, a failure to follow an accepted protocol for failed tracheal intubation, or no follow-up.