A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.
Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from CATHETERIZATION in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body.
Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.
Endoscopes for examining the interior of the larynx.
The insertion of a tube into the stomach, intestines, or other portion of the gastrointestinal tract to allow for the passage of food products, etc.
Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.
The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi.
A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems.
The administration of therapeutic agents drop by drop, as eye drops, ear drops, or nose drops. It is also administered into a body space or cavity through a catheter. It differs from THERAPEUTIC IRRIGATION in that the irrigate is removed within minutes, but the instillate is left in place.
Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.
Washing liquid obtained from irrigation of the lung, including the BRONCHI and the PULMONARY ALVEOLI. It is generally used to assess biochemical, inflammatory, or infection status of the lung.
A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors.
Apparatus, devices, or supplies intended for one-time or temporary use.
A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
A process in which normal lung tissues are progressively replaced by FIBROBLASTS and COLLAGEN causing an irreversible loss of the ability to transfer oxygen into the bloodstream via PULMONARY ALVEOLI. Patients show progressive DYSPNEA finally resulting in death.
Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.
Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place.
A specialty concerned with the study of anesthetics and anesthesia.
Any hindrance to the passage of air into and out of the lungs.
The small thick cartilage that forms the lower and posterior parts of the laryngeal wall.
Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).
Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)
Infection of the lung often accompanied by inflammation.
Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.
Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)
A type of lung inflammation resulting from the aspiration of food, liquid, or gastric contents into the upper RESPIRATORY TRACT.
Round, granular, mononuclear phagocytes found in the alveoli of the lungs. They ingest small inhaled particles resulting in degradation and presentation of the antigen to immunocompetent cells.
Damage to any compartment of the lung caused by physical, chemical, or biological agents which characteristically elicit inflammatory reaction. These inflammatory reactions can either be acute and dominated by NEUTROPHILS, or chronic and dominated by LYMPHOCYTES and MACROPHAGES.
Abnormal accumulation of fluid in tissues of any part of the LARYNX, commonly associated with laryngeal injuries and allergic reactions.
A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.
Methods of creating machines and devices.
A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE.
Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.
Surgical formation of an opening into the trachea through the neck, or the opening so created.
Pathological processes involving any part of the LUNG.
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
A condition of lung damage that is characterized by bilateral pulmonary infiltrates (PULMONARY EDEMA) rich in NEUTROPHILS, and in the absence of clinical HEART FAILURE. This can represent a spectrum of pulmonary lesions, endothelial and epithelial, due to numerous factors (physical, chemical, or biological).
Substances and drugs that lower the SURFACE TENSION of the mucoid layer lining the PULMONARY ALVEOLI.
A CXC chemokine that is synthesized by activated MONOCYTES and NEUTROPHILS. It has specificity for CXCR2 RECEPTORS.
A tubular duct that conveys TEARS from the LACRIMAL GLAND to the nose.
Drugs that interrupt transmission at the skeletal neuromuscular junction by causing sustained depolarization of the motor end plate. These agents are primarily used as adjuvants in surgical anesthesia to cause skeletal muscle relaxation.
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.
Interference with the secretion of tears by the lacrimal glands. Obstruction of the LACRIMAL SAC or NASOLACRIMAL DUCT causing acute or chronic inflammation of the lacrimal sac (DACRYOCYSTITIS). It is caused also in infants by failure of the nasolacrimal duct to open into the inferior meatus and occurs about the third week of life. In adults occlusion may occur spontaneously or after injury or nasal disease. (Newell, Ophthalmology: Principles and Concepts, 7th ed, p250)
The storing or preserving of video signals for television to be played back later via a transmitter or receiver. Recordings may be made on magnetic tape or discs (VIDEODISC RECORDING).
Elements of limited time intervals, contributing to particular results or situations.
Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.
The administration of drugs by the respiratory route. It includes insufflation into the respiratory tract.
The vocal apparatus of the larynx, situated in the middle section of the larynx. Glottis consists of the VOCAL FOLDS and an opening (rima glottidis) between the folds.
A group of compounds that contain the general formula R-OCH3.
Specially designed endoscopes for visualizing the interior surface of the colon.
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
Endoscopic examination, therapy or surgery of the bronchi.
The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.
A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening.
Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, QUARTZ, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid.
Hospital units equipped for childbirth.
A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.
Inflammation of the lung parenchyma that is caused by bacterial infections.
The capability of the LUNGS to distend under pressure as measured by pulmonary volume change per unit pressure change. While not a complete description of the pressure-volume properties of the lung, it is nevertheless useful in practice as a measure of the comparative stiffness of the lung. (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p562)
Services specifically designed, staffed, and equipped for the emergency care of patients.
A hydroxylated form of the imino acid proline. A deficiency in ASCORBIC ACID can result in impaired hydroxyproline formation.
Endoscopes for the visualization of the interior of the bronchi.
The restriction of the MOVEMENT of whole or part of the body by physical means (RESTRAINT, PHYSICAL) or chemically by ANALGESIA, or the use of TRANQUILIZING AGENTS or NEUROMUSCULAR NONDEPOLARIZING AGENTS. It includes experimental protocols used to evaluate the physiologic effects of immobility.
Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.
Washing out of the lungs with saline or mucolytic agents for diagnostic or therapeutic purposes. It is very useful in the diagnosis of diffuse pulmonary infiltrates in immunosuppressed patients.
A thin leaf-shaped cartilage that is covered with LARYNGEAL MUCOSA and situated posterior to the root of the tongue and HYOID BONE. During swallowing, the epiglottis folds back over the larynx inlet thus prevents foods from entering the airway.
Quartz (SiO2). A glassy or crystalline form of silicon dioxide. Many colored varieties are semiprecious stones. (From Grant & Hackh's Chemical Dictionary, 5th ed)
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Process of administering an anesthetic through injection directly into the bloodstream.
A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.
A form of pneumoconiosis resulting from inhalation of dust containing crystalline form of SILICON DIOXIDE, usually in the form of quartz. Amorphous silica is relatively nontoxic.
An unnaturally deep or rough quality of voice.
Endoscopic surgical procedures performed with visualization via video transmission. When real-time video is combined interactively with prior CT scans or MRI images, this is called image-guided surgery (see SURGERY, COMPUTER-ASSISTED).
Bleeding from the nose.
The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility.
Lipid-containing polysaccharides which are endotoxins and important group-specific antigens. They are often derived from the cell wall of gram-negative bacteria and induce immunoglobulin secretion. The lipopolysaccharide molecule consists of three parts: LIPID A, core polysaccharide, and O-specific chains (O ANTIGENS). When derived from Escherichia coli, lipopolysaccharides serve as polyclonal B-cell mitogens commonly used in laboratory immunology. (From Dorland, 28th ed)
The various ways of administering a drug or other chemical to a site in a patient or animal from where the chemical is absorbed into the blood and delivered to the target tissue.
Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.
Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)
Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (NEUROMUSCULAR NONDEPOLARIZING AGENTS) or noncompetitive, depolarizing agents (NEUROMUSCULAR DEPOLARIZING AGENTS). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc.
The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs).
Introduction of substances into the body using a needle and syringe.
The capability to perform acceptably those duties directly related to patient care.
One of a pair of small pyramidal cartilages that articulate with the lamina of the CRICOID CARTILAGE. The corresponding VOCAL LIGAMENT and several muscles are attached to it.
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.
A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.
Surgical incision of the trachea.
A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)
Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.
The diffusion or accumulation of neutrophils in tissues or cells in response to a wide variety of substances released at the sites of inflammatory reactions.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
Continuous recording of the carbon dioxide content of expired air.
Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.
The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI.
A family of hexahydropyridines.
The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve.
Non-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner.
Spasmodic contraction of the smooth muscle of the bronchi.
Paramedical personnel trained to provide basic emergency care and life support under the supervision of physicians and/or nurses. These services may be carried out at the site of the emergency, in the ambulance, or in a health care institution.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
The upper or most anterior segment of the STERNUM which articulates with the CLAVICLE and first two pairs of RIBS.
The relationship between the dose of an administered drug and the response of the organism to the drug.
A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.
Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow.
A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.
Asbestos, grunerite. A monoclinic amphibole form of asbestos having long fibers and a high iron content. It is used in insulation. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Devices that cover the nose and mouth to maintain aseptic conditions or to administer inhaled anesthetics or other gases. (UMDNS, 1999)
The proximal portion of the respiratory passages on either side of the NASAL SEPTUM. Nasal cavities, extending from the nares to the NASOPHARYNX, are lined with ciliated NASAL MUCOSA.
A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.
Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory.
Soluble mediators of the immune response that are neither antibodies nor complement. They are produced largely, but not exclusively, by monocytes and macrophages.
An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.
Injections made into a vein for therapeutic or experimental purposes.
Measurement of oxygen and carbon dioxide in the blood.
Diseases of the lacrimal apparatus.
A protease of broad specificity, obtained from dried pancreas. Molecular weight is approximately 25,000. The enzyme breaks down elastin, the specific protein of elastic fibers, and digests other proteins such as fibrin, hemoglobin, and albumin. EC 3.4.21.36.
A dark powdery deposit of unburned fuel residues, composed mainly of amorphous CARBON and some HYDROCARBONS, that accumulates in chimneys, automobile mufflers and other surfaces exposed to smoke. It is the product of incomplete combustion of carbon-rich organic fuels in low oxygen conditions. It is sometimes called lampblack or carbon black and is used in INK, in rubber tires, and to prepare CARBON NANOTUBES.
The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.
PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.
The hospital unit in which patients with respiratory conditions requiring special attention receive intensive medical care and surveillance.
Surgical fistulization of the LACRIMAL SAC for external drainage of an obstructed nasolacrimal duct.
Lung damage that is caused by the adverse effects of PULMONARY VENTILATOR usage. The high frequency and tidal volumes produced by a mechanical ventilator can cause alveolar disruption and PULMONARY EDEMA.
The mucous membrane lining the RESPIRATORY TRACT, including the NASAL CAVITY; the LARYNX; the TRACHEA; and the BRONCHI tree. The respiratory mucosa consists of various types of epithelial cells ranging from ciliated columnar to simple squamous, mucous GOBLET CELLS, and glands containing both mucous and serous cells.
Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.
The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T.
Infections with bacteria of the genus PSEUDOMONAS.
The exposure to potentially harmful chemical, physical, or biological agents by inhaling them.
A genus of the family Muridae having three species. The present domesticated strains were developed from individuals brought from Syria. They are widely used in biomedical research.
Pathological processes involving any part of the LARYNX which coordinates many functions such as voice production, breathing, swallowing, and coughing.
Residue generated from combustion of coal or petroleum.
A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.
Fixed-wing aircraft or helicopters equipped for air transport of patients.
Long, pliable, cohesive natural or manufactured filaments of various lengths. They form the structure of some minerals. The medical significance lies in their potential ability to cause various types of PNEUMOCONIOSIS (e.g., ASBESTOSIS) after occupational or environmental exposure. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p708)
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Developmental or acquired stricture or narrowing of the LARYNX. Symptoms of respiratory difficulty depend on the degree of laryngeal narrowing.
Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.
The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about.
A lavender, acid-resistant asbestos.
A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.
A range of methods used to reduce pain and anxiety during dental procedures.
Animals or humans raised in the absence of a particular disease-causing virus or other microorganism. Less frequently plants are cultivated pathogen-free.
The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
The part of a human or animal body connecting the HEAD to the rest of the body.
Narrowing of the caliber of the BRONCHI, physiologically or as a result of pharmacological intervention.
A class of chemicals that contain an anthracene ring with a naphthalene ring attached to it.
A sudden intense and continuous aggravation of a state of asthma, marked by dyspnea to the point of exhaustion and collapse and not responding to the usual therapeutic efforts.
The period of emergence from general anesthesia, where different elements of consciousness return at different rates.
A dark-gray, metallic element of widespread distribution but occurring in small amounts; atomic number, 22; atomic weight, 47.90; symbol, Ti; specific gravity, 4.5; used for fixation of fractures. (Dorland, 28th ed)
Serum glycoprotein produced by activated MACROPHAGES and other mammalian MONONUCLEAR LEUKOCYTES. It has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. Also known as TNF-alpha, it is only 30% homologous to TNF-beta (LYMPHOTOXIN), but they share TNF RECEPTORS.
Colloids with a gaseous dispersing phase and either liquid (fog) or solid (smoke) dispersed phase; used in fumigation or in inhalation therapy; may contain propellant agents.
A pair of cone-shaped elastic mucous membrane projecting from the laryngeal wall and forming a narrow slit between them. Each contains a thickened free edge (vocal ligament) extending from the THYROID CARTILAGE to the ARYTENOID CARTILAGE, and a VOCAL MUSCLE that shortens or relaxes the vocal cord to control sound production.
A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause.
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
Relating to the size of solids.
A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.
Situations or conditions requiring immediate intervention to avoid serious adverse results.
A dental specialty concerned with the diagnosis and surgical treatment of disease, injuries, and defects of the human oral and maxillofacial region.
An accumulation of air or gas in the PLEURAL CAVITY, which may occur spontaneously or as a result of trauma or a pathological process. The gas may also be introduced deliberately during PNEUMOTHORAX, ARTIFICIAL.
Congenital or acquired paralysis of one or both VOCAL CORDS. This condition is caused by defects in the CENTRAL NERVOUS SYSTEM, the VAGUS NERVE and branches of LARYNGEAL NERVES. Common symptoms are VOICE DISORDERS including HOARSENESS or APHONIA.
A CXC chemokine with specificity for CXCR2 RECEPTORS. It has growth factor activities and is implicated as a oncogenic factor in several tumor types.
Inflammation of the throat (PHARYNX).
Endoscopic examination, therapy or surgery of the luminal surface of the colon.
Strains of mice in which certain GENES of their GENOMES have been disrupted, or "knocked-out". To produce knockouts, using RECOMBINANT DNA technology, the normal DNA sequence of the gene being studied is altered to prevent synthesis of a normal gene product. Cloned cells in which this DNA alteration is successful are then injected into mouse EMBRYOS to produce chimeric mice. The chimeric mice are then bred to yield a strain in which all the cells of the mouse contain the disrupted gene. Knockout mice are used as EXPERIMENTAL ANIMAL MODELS for diseases (DISEASE MODELS, ANIMAL) and to clarify the functions of the genes.
Torn, ragged, mangled wounds.
Health care provided to a critically ill patient during a medical emergency or crisis.
Disease having a short and relatively severe course.
A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.
Hospital units providing continuous surveillance and care to acutely ill patients.
The number of WHITE BLOOD CELLS per unit volume in venous BLOOD. A differential leukocyte count measures the relative numbers of the different types of white cells.
Nanometer-sized tubes composed mainly of CARBON. Such nanotubes are used as probes for high-resolution structural and chemical imaging of biomolecules with ATOMIC FORCE MICROSCOPY.
A form of hypersensitivity affecting the respiratory tract. It includes ASTHMA and RHINITIS, ALLERGIC, SEASONAL.
Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region.
An infant during the first month after birth.
The physical or mechanical action of the LUNGS; DIAPHRAGM; RIBS; and CHEST WALL during respiration. It includes airflow, lung volume, neural and reflex controls, mechanoreceptors, breathing patterns, etc.
The largest cartilage of the larynx consisting of two laminae fusing anteriorly at an acute angle in the midline of the neck. The point of fusion forms a subcutaneous projection known as the Adam's apple.
Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C; (CHEMOKINES, C); CC; (CHEMOKINES, CC); and CXC; (CHEMOKINES, CXC); according to variations in a shared cysteine motif.
An albumin obtained from the white of eggs. It is a member of the serpin superfamily.
A polyhedral CARBON structure composed of around 60-80 carbon atoms in pentagon and hexagon configuration. They are named after Buckminster Fuller because of structural resemblance to geodesic domes. Fullerenes can be made in high temperature such as arc discharge in an inert atmosphere.
Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.
Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells.
Study of coins, tokens, medals, etc. However, it usually refers to medals pertaining to the history of medicine.
General or unspecified injuries involving the face and jaw (either upper, lower, or both).
Water content outside of the lung vasculature. About 80% of a normal lung is made up of water, including intracellular, interstitial, and blood water. Failure to maintain the normal homeostatic fluid exchange between the vascular space and the interstitium of the lungs can result in PULMONARY EDEMA and flooding of the alveolar space.
Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions.
Cyclic GLUCANS consisting of eight (8) glucopyranose units linked by 1,4-glycosidic bonds.
The oval-shaped oral cavity located at the apex of the digestive tract and consisting of two parts: the vestibule and the oral cavity proper.
Protein-lipid combinations abundant in brain tissue, but also present in a wide variety of animal and plant tissues. In contrast to lipoproteins, they are insoluble in water, but soluble in a chloroform-methanol mixture. The protein moiety has a high content of hydrophobic amino acids. The associated lipids consist of a mixture of GLYCEROPHOSPHATES; CEREBROSIDES; and SULFOGLYCOSPHINGOLIPIDS; while lipoproteins contain PHOSPHOLIPIDS; CHOLESTEROL; and TRIGLYCERIDES.

Mechanisms of bronchoprotection by anesthetic induction agents: propofol versus ketamine. (1/1952)

BACKGROUND: Propofol and ketamine have been purported to decrease bronchoconstriction during induction of anesthesia and intubation. Whether they act on airway smooth muscle or through neural reflexes has not been determined. We compared propofol and ketamine to attenuate the direct activation of airway smooth muscle by methacholine and limit neurally mediated bronchoconstriction (vagal nerve stimulation). METHODS: After approval from the institutional review board, eight sheep were anesthetized with pentobarbital, paralyzed, and ventilated. After left thoracotomy, the bronchial artery was cannulated and perfused. In random order, 5 mg/ml concentrations of propofol, ketamine, and thiopental were infused into the bronchial artery at rates of 0.06, 0.20, and 0.60 ml/min. After 10 min, airway resistance was measured before and after vagal nerve stimulation and methacholine given via the bronchial artery. Data were expressed as a percent of baseline response before infusion of drug and analyzed by analysis of variance with significance set at P< or =0.05. RESULTS: Systemic blood pressure was not affected by any of the drugs (P>0.46). Baseline airway resistance was not different among the three agents (P = 0.56) or by dose (P = 0.96). Infusion of propofol and ketamine into the bronchial artery caused a dose-dependent attenuation of the vagal nerve stimulation-induced bronchoconstriction to 26+/-11% and 8+/-2% of maximum, respectively (P<0.0001). In addition, propofol caused a significant decrease in the methacholine-induced bronchoconstriction to 43+/-27% of maximum at the highest concentration (P = 0.05) CONCLUSIONS: The local bronchoprotective effects of ketamine and propofol on airways is through neurally mediated mechanisms. Although the direct effects on airway smooth muscle occur at high concentrations, these are unlikely to be of primary clinical relevance.  (+info)

Bioavailability and metabolism of hydroquinone after intratracheal instillation in male rats. (2/1952)

The purpose of this study was to investigate the rate and extent of hydroquinone (HQ) absorption and first pass metabolism in the lungs of male rats in vivo. [14C]HQ in physiological saline was administered intratracheally via an indwelling endotracheal tube to simulate inhalation exposure to HQ dust. The bioavailability of HQ was determined by blood sampling simultaneously at arterial and venous sites beginning immediately after administration to conscious rats. Pulmonary absorption and metabolism, and systemic metabolism and elimination were determined by chromatographic analysis of parent compound and metabolites in blood samples after intratracheal administration of [14C]HQ at 0.1, 1.0, and 10 mg/kg. Pulmonary absorption of HQ was found to be very rapid with [14C]HQ detectable in arterial blood, and to a lesser extent in venous blood, within 5 to 10 s after dose administration. Only [14C]HQ was detected in the initial (5-10 s) arterial blood samples at all dose levels, indicating that pulmonary metabolism of HQ was not extensive. However, later blood samples (45-720 s) indicated rapid metabolism and elimination of the parent compound and metabolites after intratracheal absorption. The elimination half-life from the 0.1 mg/kg dose was allometrically scaled to human proportions and used to estimate the steady-state (maximum) human blood concentrations of HQ resulting from presupposed workplace exposures. The estimates indicated minimal levels of HQ in human blood after respiratory exposures of greater than 1 h at 0.1 or 2.0 mg/m3; these levels were less than background concentrations of HQ detected in human blood in previous studies.  (+info)

Inhalation exposure of animals. (3/1952)

Relative advantages and disadvantages and important design criteria for various exposure methods are presented. Five types of exposures are discussed: whole-body chambers, head-only exposures, nose or mouth-only methods, lung-only exposures, and partial-lung exposures. Design considerations covered include: air cleaning and conditioning; construction materials; losses of exposure materials; evenness of exposure; sampling biases; animal observation and care; noise and vibration control, safe exhausts, chamber loading, reliability, pressure fluctuations; neck seals, masks, animal restraint methods; and animal comfort. Ethical considerations in use of animals in inhalation experiments are also discussed.  (+info)

Correlating fibreoptic nasotracheal endoscopy performance and psychomotor aptitude. (4/1952)

We have investigated the correlation between the scores attained on computerized psychometric tests, measuring psychomotor and information processing aptitudes, and learning fibreoptic endoscopy with the videoendoscope. Sixteen anaesthetic trainees performed two adaptive tracking tasks (ADTRACK 2 and ADTRACK 3) and one information management task (MAZE) from the MICROPAT testing system. They then embarked on a standardized fibreoptic training programme during which they performed 15 supervised fibreoptic nasotracheal intubations on anaesthetized oral surgery patients. There was a significant correlation between the means of the 15 endoscopy times and both ADTRACK 2 (r = -0.599, P = 0.014) and ADTRACK 3 (r = -0.589, P = 0.016) scores. The correlation between the means of the 15 endoscopy times and MAZE scores was not significant. The ratios of the mean endoscopy time for the last seven endoscopies to the mean endoscopy time for the first seven endoscopies were not significantly correlated with ADTRACK 2, ADTRACK 3 or MAZE scores. Psychomotor abilities appeared to be determinants of trainees' initial proficiency in endoscopy, but did not appear to be determinants of trainees' rates of progress during early fibreoptic training.  (+info)

Evaluation of routine tracheal extubation in children: inflating or suctioning technique? (5/1952)

We studied prospectively the effects of the technique of tracheal extubation on arterial haemoglobin oxygen saturation (SpO2) in 120 ASA I-III children, mean age 5.3 (range 0.25-16.9) yr. At completion of surgery, tracheal extubation was performed when spontaneous ventilation had resumed, children were fully awake and SpO2 was 99-100%. Children were allocated randomly to receive a single lung inflation manoeuvre with 100% oxygen before tracheal extubation (group I; n = 59) or to have the tracheal tube removed while applying suction through the tube (group S; n = 61). SpO2 was monitored during the first 5 min after tracheal extubation in the operating room. Supplementary oxygen was given if SpO2 decreased to less than 92%. The time between tracheal extubation and decrease in SpO2 to 92% (T92) was recorded. Children in group S required oxygen administration more frequently after tracheal extubation than those in group I (65.6% vs 45.8%; P = 0.04), and had a three-fold shortening of T92 (mean 25 (SD 19) s vs 85 (63) s; P = 0.0001). These effects were more pronounced in children less than 4 yr of age compared with older children. We conclude that tracheal extubation greatly impaired oxygenation and therefore administration of oxygen was appropriate. This impairment was more marked when suction was used, and in young children. Lung inflation with 100% oxygen before removal of the tracheal tube is advised before routine tracheal extubation in children.  (+info)

Effect of remifentanil on the auditory evoked response and haemodynamic changes after intubation and surgical incision. (6/1952)

We have observed the effect of intubation and incision, as measured by the auditory evoked response (AER) and haemodynamic variables, in 12 patients undergoing hernia repair or varicose vein surgery who received remifentanil as part of either an inhaled anaesthetic technique using isoflurane or as part of a total i.v. technique using propofol. Anaesthesia was induced with remifentanil 1 microgram kg-1 and propofol, neuromuscular block was achieved with atracurium 0.6 mg kg-1 before intubation, and anaesthesia was maintained with a continuous infusion of remifentanil in combination with either a continuous infusion of propofol or inhaled isoflurane. The AER and haemodynamic variables were measured before and after intubation and incision. The effects of intubation and incision on the AER and haemodynamic variables were not significantly different between the remifentanil-propofol and remifentanil-isoflurane groups. However, the study had a low power for this comparison. When the data for the two anaesthetic combinations were pooled, the only significant effects were increases in diastolic arterial pressure and heart rate immediately after intubation; these were not seen 5 min after intubation. There were no cardiovascular responses to incision. There were no significant changes in the AER after intubation or incision.  (+info)

Large goitre causing difficult intubation and failure to intubate using the intubating laryngeal mask airway: lessons for next time. (7/1952)

A 63-yr-old woman was anaesthetized for sub-total thyroidectomy. The thyroid gland was large, deviating the trachea to the right and causing 30% tracheal narrowing at the level of the suprasternal notch. Mask ventilation was easy but laryngoscopy was Cormack and Lehane grade 3. Despite being able to see the tip of the epiglottis, tracheal intubation was impossible. An intubating laryngeal mask was inserted and although the airway was clear and ventilation easy, it was not possible to intubate the trachea either blindly or with the fibreoptic bronchoscope. Tracheal intubation was eventually achieved using a 6.5-mm cuffed oral tracheal tube via a size 4 laryngeal mask under fibreoptic control. We describe the case in detail and discuss the use of the intubating laryngeal mask, its potential limitations and how to optimize its use in similar circumstances.  (+info)

The presence and sequence of endotracheal tube colonization in patients undergoing mechanical ventilation. (8/1952)

Endotracheal tube colonization in patients undergoing mechanical ventilation was investigated. In the first part of this prospective study, the airway access tube was examined for the presence of secretions, airway obstruction and bacterial colonization, in cases undergoing extubation or tube change. In the second part of the study, the sequence of oropharyngeal, gastric, respiratory tract and endotracheal tube colonization was investigated by sequential swabbing at each site twice daily for 5 days in consecutive noninfected patients. In the first part, it was noted that all airway access tubes of cases undergoing extubation had secretions lining the interior of the distal third of the tube which were shown on scanning electron microscopy to be a biofilm. Gram-negative micro-organisms were isolated from these secretions in all but three cases. In the second part, it was noted that the sequence of colonization in patients undergoing mechanical ventilation was the oropharynx (36 h), the stomach (3660 h), the lower respiratory tract (60-84 h), and thereafter the endotracheal tube (60-96 h). Nosocomial pneumonia occurred in 13 patients and in eight cases identical organisms were noted in lower respiratory tract secretions and in secretions lining the interior of the endotracheal tube. The endotracheal tube of patients undergoing mechanical ventilation becomes colonized rapidly with micro-organisms commonly associated with nosocomial pneumonia, and which may represent a persistent source of organisms causing such infections.  (+info)

Definition of Rapid Sequence Intubation in the Financial Dictionary - by Free online English dictionary and encyclopedia. What is Rapid Sequence Intubation? Meaning of Rapid Sequence Intubation as a finance term. What does Rapid Sequence Intubation mean in finance?
Orotracheal intubation following general anesthesia requires blades to be performed. The risk of patients contamination with infectious agents related to reusable metal blades leads to promote single-use blades. Some of these latter are plastic and this material may need more strength to lift the jaw and expose the larynx before orotracheal intubation. Sometimes, change of blade, from plastic to metal, during the procedure is necessary to increase the larynx exposure. This change of blade may increase the frequency of sore throat following orotracheal intubation.. Consequently, the study hypothesis is an increase of both sore throat intensity and frequency with the plastic blades compared with the metal blades.. The primary purpose of the present study is to compare the impact of these two types of blades, metal versus plastic, on sore throat intensity and frequency following scheduled orotracheal intubation for general anesthesia ...
TY - JOUR. T1 - Emergency Department use of Apneic Oxygenation Versus Usual Care During Rapid Sequence Intubation. T2 - A Randomized Controlled Trial (The ENDAO Trial). AU - Caputo, Nicholas. AU - Azan, Ben. AU - Domingues, Rui. AU - Donner, Lee. AU - Fenig, Mark. AU - Fields, Douglas. AU - Fraser, Robert. AU - Hosford, Karlene. AU - Iuorio, Richard. AU - Kanter, Marc. AU - Mccarty, Moira. AU - Parry, Thomas. AU - Raja, Andaleeb. AU - Ryan, Mary. AU - Williams, Blaine. AU - Sharma, Hemlata. AU - Singer, Daniel. AU - Shields, Chris. AU - Scott, Sandra. AU - West, Jason R.. PY - 2017. Y1 - 2017. N2 - Objectives: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. Methods: A ...
BACKGROUND:This retrospective study was conducted at a single center in China and aimed to compare rocuronium with succinylcholine for rapid sequence induction intubation in the Emergency Department of a hospital. MATERIAL AND METHODS:An orotracheal intubation procedure was performed in a total of 267 patients by direct laryngoscopy using an intravenous bolus injection of 1 mg/kg of succinylcholine (n=141; SY group) or 1.2 mg/kg of rocuronium (n=126; RM group) for a rapid sequence induction in the emergency department. The success of orotracheal intubation was evaluated by a capnography curve. The modified Cormack-Lehane score was used to grade the direct laryngoscopy. RESULTS:There was no statistically significant difference in numbers of patients with successful first-attempt orotracheal intubation between the groups (112 vs. 87, P=0.067). Fewer intubation failures under direct laryngoscopy were reported in the SY group than in the RM group (23 [16%] vs. 34 [27%], P=0.037). The number of intubation
Airway management is one of the most important skills for an emergency department practitioner to master because failure to secure an adequate airway can quickly lead to death or disability. Endotracheal intubation using rapid sequence intubation (RSI) is the cornerstone of emergency airway management.
OBJECTIVE. Endotracheal intubation of newborn infants is a mandatory competence for many pediatric trainees. The Neonatal Resuscitation Program recommends a 20-second limit for intubation attempts. Intubation attempts by junior doctors are frequently unsuccessful, and many infants are intubated between 20 and 30 seconds without apparent adverse effect. Little is known about the proficiency of more senior medical staff, the time taken to determine endotracheal tube (ETT) position, or the effects of attempted intubation on infants heart rate (HR) and oxygen saturation (Spo2) in the delivery room (DR). The objectives of this study were to determine (1) the success rates and duration of intubation attempts during DR resuscitation, (2) whether experience is associated with greater success rates and shorter time taken to intubate, (3) the time taken to identify ETT position after intubation, and (4) the frequency with which infants deteriorated during intubation attempts and the time at which this ...
Background: Etomidate is the standard induction agent used during rapid sequence intubation (RSI) in the emergency department (ED). Etomidate shortages require providers to utilize alternative agents. The purpose of this study is to compare the safety and procedural outcomes of propofol and etomidate for RSI in the ED. Methods: This was a retrospective chart review of adult patients in the ED who received propofol or etomidate for induction during RSI. The main endpoint was hypotension, defined as a systolic blood pressure | 90 mmHg or diastolic blood pressure | 60 mmHg, within the first hour of intubation. Time to intubation, intensive care unit length of stay, hospital length of stay, and in-hospital mortality were also evaluated. Results: Two hundred and seventy five patient charts were reviewed. Of the 98 patients included, 43 patients received propofol and 55 patients received etomidate. Propofol was associated with an increased incidence of hypotension within the first hour of intubation (65.1% vs
The Practical Emergency Airway Management 2 day course provides an in-depth look at effective airway management techniques that you will actually use in your next emergency airway. This course provides an in-depth look at effective surgical airway management techniques that you will actually use in your next emergency airway. There is a unique focus on airway anatomy and imaging combined with one-of-a-kind opportunity to practice the techniques on a large variety of non-embalmed, specially prepared cadavers. This is the only cadaver airway course available. This course teaches practical, effective skills and strategies for adult and pediatric intubation that promote patient safety and increase provider confidence.. Topics covered include orotracheal intubation, laryngoscopy, surgical airways (cricothyrotomy, tracheotomy), video laryngoscopy, fiberoptic intubation, nasotracheal intubation, pediatric intubation, and rescue ventilation devices such as the laryngeal mask airway. The intubation and ...
The Practical Emergency Airway Management 2 day course provides an in-depth look at effective airway management techniques that you will actually use in your next emergency airway. This course provides an in-depth look at effective surgical airway management techniques that you will actually use in your next emergency airway. There is a unique focus on airway anatomy and imaging combined with one-of-a-kind opportunity to practice the techniques on a large variety of non-embalmed, specially prepared cadavers. This is the only cadaver airway course available. This course teaches practical, effective skills and strategies for adult and pediatric intubation that promote patient safety and increase provider confidence.. Topics covered include orotracheal intubation, laryngoscopy, surgical airways (cricothyrotomy, tracheotomy), video laryngoscopy, fiberoptic intubation, nasotracheal intubation, pediatric intubation, and rescue ventilation devices such as the laryngeal mask airway. The intubation and ...
Sean P. Kane, PharmD, BCPS, speaks with Joseph Muench, PharmD, BCPS about airway pharmacology. In the episode, the most common sedatives and paralytics for rapid sequence intubation are discussed, including concepts regarding dosing, adverse effects, onset and duration of effect, and clinical pearls.
TY - JOUR. T1 - Incidence and associated factors of difficult tracheal intubations in pediatric ICUs. T2 - a report from National Emergency Airway Registry for Children: NEAR4KIDS. AU - Graciano, Ana Lia. AU - Tamburro, Robert. AU - Thompson, Ann E.. AU - Fiadjoe, John. AU - Nadkarni, Vinay M.. AU - Nishisaki, Akira. PY - 2014/10/15. Y1 - 2014/10/15. N2 - Purpose: To evaluate the incidence and associated risk factors of difficult tracheal intubations (TI) in pediatric intensive care units (PICUs).Methods: Using the National Emergency Airway Registry for Children (NEAR4KIDS), TI quality improvement data were prospectively collected for initial TIs in 15 PICUs from July 2010 to December 2011. Difficult pediatric TI was defined as TIs by direct laryngoscopy which failed or required more than two laryngoscopy attempts by fellow/attending-level physician providers.Results: A total of 1,516 oral TIs were reported with a median age of 2 years. A total of 97 % of patients were intubated with direct ...
Paediatric Emergencies Intubation Course event. The Paediatric Emergencies Intubation Course is truly multidisciplinary, attracting healthcare professionals ...
Rapid sequence intubation (RSI) is predicated on the administration of medications in a specific sequence. The two phases of medication administration are induction and paralysis. In general, preoxyge... more
In advanced airway management, rapid sequence induction (RSI) - also described as rapid sequence intubation or as rapid sequence induction and intubation (RSII) - is a special process for endotracheal intubation that is used where the patient is at a high risk of pulmonary aspiration or impending airway compromise. It differs from other forms of general anesthesia induction in that artificial ventilation is generally not provided from the time the patient stops breathing (when drugs are given) until after intubation has been achieved. This minimizes insufflation of air into the patients stomach, which might otherwise provoke regurgitation. Classic RSI involves pre-filling the patients lungs with a high concentration of oxygen gas, followed by applying cricoid pressure, administering rapid-onset sedative or hypnotic and neuromuscular-blocking drugs that induce prompt unconsciousness and paralysis, inserting an endotracheal tube with minimal delay, and then releasing the cricoid pressure. ...
Rapid Sequence Intubation (RSI) adalah suatu prosedur tehnik intubasi yang dilakukan setelah preoksigenisasi, kemudian induksi dengan menggunakan obat induksi yang poten lalu diikuti pemberian obat pelumpuh otot dengan kerja cepat untuk dapat menyebabkan penurunan kesadaran dan paralisis motorik untuk tujuan intubasi secara cepat. Teknik ini didasari pada pasien dalam keadaan tidak puasa atau lambung penuh yang akan dilakukan intubasi, yang memiliki resiko aspirasi cairan atau isi lambung ...
Trachway video intubating stylet allows for optimization of electromyographic endotracheal tube placement for monitored thyroidectomy
An apparatus for endotracheal intubation comprises a suction stylet (10) telescopically disposed within an endotracheal tube (30) such that the suction stylet (10) is operative to aspirate fluids from the vicinity of the distal end (16) of the endotracheal tube. The apparatus further comprises a connector for releasably axially fixing the suction stylet with respect to the endotracheal tube during intubation. The suction stylet (10) and endotracheal tube (30) are advanced down the trachea simultaneously, the suction stylet (10) aspirating unwanted oral secretions from the operators field of view during intubation. Once the trachea is intubated, the connector is disconnected and the suction stylet is withdrawn, leaving the endotracheal tube in place. A method for endotracheal intubation is also disclosed in which a suction stylet (10) is telescopically disposed within an endotracheal tube (30). The suction stylet and endotracheal tube are advanced simultaneously through the trachea, aspirating unwanted
TY - JOUR. T1 - Comparison of haemodynamic responses to orotracheal intubation in anaesthetised and paralysed patients with simulated cervical spine injury. T2 - Airtraq® video laryngoscope versus fibreoptic bronchoscope. AU - Pillai, Ajith Kumar. AU - Muhamed, Shiyad. AU - Giri, Manu. AU - Shenoy, Kailasnath. AU - Mathew, Shaji. AU - Dugappa, Arunkumar Handittu. AU - Rahiman, Ramzi Aboo Abdul. PY - 2019/1/1. Y1 - 2019/1/1. N2 - Background: Endotracheal intubation may produce haemodynamic fluctuations which may be deleterious in patients with cardiovascular and neurological disorders. This is further worsened in patients with difficult airway. This study was conducted to compare haemodynamic fluctuations produced when intubation was done using Airtraq and fibreoptic bronchoscopy which are used in patients with anticipated difficult airway. Methodology: Prospective randomized study. Eighty patients, ASA PS 1 and 2 undergoing elective surgery were randomized into two groups - Group A and Group F. ...
Introduction: Filling tracheal tube cuff (TTC) after intubation is necessary to provide a safe airway in intubated patients. On the other hand, excessive increase or decrease in the pressure of TTCs balloon leads into the dangerous complications such as necrosis and/or aspiration. Accordingly, in the present study, we tried to evaluate the most two common fixed volume and pilot balloon palpitation methods to control TTC pressure. Methods: In a prospective cross-sectional study that was carried out in the emergency department of Tabriz Imam Reza hospital upon 194 patients who needed intubation and from April 2015 to June 2016. The patients were randomly allocated into two equal groups. For the first the Pilot Balloon Palpation technique and for the second group 10 cc fixed volume cuff filling technique was assigned. After that, the pressure was checked with manometer and data were analyzed using SPSS software. Results: TTC pressure average in fixed volume group was 44.96±21.77 cmH2O and for
PURPOSE: Intubation in ICU strongly differs from intubation in operative rooms. The results of studies about risk factors of difficult intubation performed in operative rooms cannot therefore be extrapolated directly to ICU.. The primary purpose of this trial (cf Part Design of this registration) is other and more particularly Prognosis because it is is an assessment of risk factors of difficult airway in intensive care units.. DESIGN AND METHODOLOGY: This is an open prospective multicentric study of intubation in ICU in more than 50 centres. Consecutive intubations will be included in each centre, in order to reach the sample size required (at least 1000 procedures intubations). The usual risk factors of difficult intubation in operative rooms, the demographic parameters and the complications of intubation will be assessed, as well as survival status at 28 days. ...
Comparison of Alfentanil and Lignocaine in blunting the pressor response during endotracheal intubation. Laryngoscopy and tracheal intubation produce marked increases in heart rate and blood pressure, which is potentially dangerous in certain patients. Various pharmacological agents have been used before laryngoscopy and tracheal intubation in an attempt to attenuate the adrenergic response, but with varying degree of success. OBJECTIVE To compare the efficacy of lignocaine to alfentanil in blunting the pressor response to endotracheal intubation. DESIGN An open label comparative study. POPULATION Seventy eight ASA I and II adult patients between the ages of 18 and 65 years booked for elective surgery which requires endotracheal intubation. SETTING Dr George Mukhari Hospital, a tertiary level training hospital in Gauteng, South Africa. 2 METHOD After obtaining ethical clearance the study was conducted on 78 ASA class I & II patients. The patients were randomly allocated to three groups according ...
INTRODUCTION: Postoperative sore throat is listed from the top as patients most undesirable outcome in the postoperative period. It is believed to originate from mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning, and mucosal erosion from friction between delicate tissues and the endotracheal tube. Even if the problem was indicated in many literatures, it has never been studied in our country. The study aimed to assess prevalence and factors associated with postoperative sore throat among patients who were operated under general anesthesia with endotracheal intubation. METHODS: hospital based cross sectional study was conducted from February 25 - April 10, 2014 in Gondar University hospital. Patient interview and chart review were employed for data collection. Bivariate and multivariate logistic regressions were used to determine the association.
Background: Awake intubation is the standard of care for management of the anticipated difficult airway. The performance of awake intubation may be perceived as complex and time-consuming, potentially leading clinicians to avoid this technique of airway management. This retrospective review of awake intubations at a large academic medical center was performed to determine the average time taken to perform awake intubation, its effects on hemodynamics, and the incidence and characteristics of complications and failure. Methods: Anesthetic records from 2007 to 2014 were queried for the performance of an awake intubation. Of the 1,085 awake intubations included for analysis, 1,055 involved the use of a flexible bronchoscope. Each awake intubation case was propensity matched with two controls (1:2 ratio), with similar comorbidities and intubations performed after the induction of anesthesia (n = 2,170). The time from entry into the operating room until intubation was compared between groups. The ...
Tracheal intubation (usually simply referred to as intubation), an invasive medical procedure, is the placement of a flexible plastic catheter into the trachea. For millennia, tracheotomy was considered the most reliable (and most risky) method of tracheal intubation. By the late 19th century, advances in the sciences of anatomy and physiology, as well as the beginnings of an appreciation of the germ theory of disease, had reduced the morbidity and mortality of this operation to a more acceptable rate. Also in the late 19th century, advances in endoscopic instrumentation had improved to such a degree that direct laryngoscopy had finally become a viable means to secure the airway by the non-surgical orotracheal route. Nasotracheal intubation was not widely practiced until the early 20th century. The 20th century saw the transformation of the practices of tracheotomy, endoscopy and non-surgical tracheal intubation from rarely employed procedures to essential components of the practices of ...
Methods: HFNO of 60 L.min−1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3). An SpO2 of ...
The results of using a prewarmed tube for nasotracheal intubation are variable.1-3 Although studies in adults suggest reduced bleeding, its efficacy in pediatric patients seems to be poor.1-4 In the control group in the study by Watt et al .,1 where tracheal intubation was achieved by using a tube at room temperature, the incidence of bleeding was 56%, significantly higher than in the control group of Elwood et al .,4 wherein a thermosoftened tube was used and the incidence of bleeding was only 29%. Further, although Watt et al .1 report that a 39% incidence of epistaxis in patients in whom the nasotracheal tube was carried with a thermosoftened uncuffed tube is consistent with that reported by Elwood et al .4 in their thermosoftening group (29%), it is still higher in the study of Watt et al . Considering these facts, in the study by Watt et al ., the higher incidence of bleeding in patients in whom a prewarmed tube was used can be attributed to the use of a larger tube (selected by Coles ...
Driver et al., JAMA, 2018. https://jamanetwork.com/journals/jama/article-abstract/2681717. doi:10.1001/jama.2018.6496. Importance The tracheal tube introducer, known as the bougie, is typically used to aid tracheal intubation in poor laryngoscopic views or after intubation attempts fail. The effect of routine bougie use on first-attempt intubation success is unclear.. Objective To compare first attempt intubation success facilitated by the bougie vs the endotracheal tube + stylet.. Design, Setting, and Patients The Bougie Use in Emergency Airway Management (BEAM) trial was a randomized clinical trial conducted from September 2016 through August 2017 in the emergency department at Hennepin County Medical Center, an urban, academic department in Minneapolis, Minnesota, where emergency physicians perform all endotracheal intubations. Included patients were 18 years and older who were consecutively admitted to the emergency department and underwent emergency orotracheal intubation with a Macintosh ...
Yoshihiro Hirabayashi, Norimasa Seo, Jichi Medical University, Japan 20 anesthetists performed tracheal intubations on a manikin with either an in-line head and neck position or the sniffing position. There were no differences in the success rate and the time to intubation between the two positions. The overall number of teeth clicks was lower in the in-line head and neck position than in the sniffing position (P , 0.05). The score for preference of position, on a visual analogue scale, was better for the in-line head and neck position than for the sniffing position (P , 0.01). We concluded that the in-line head and neck position was preferable for tracheal intubation with the Airtraq laryngoscope compared to the sniffing position. ...
Objective To describe a simple protocol for ventilator-assisted preoxygenation (VAPOX) prior to rapid sequence intubation in the ED using a Hamilton T1 ventilator in an effort to further reduce the incidence of transient and critical hypoxaemia. Methods Ventilator-assisted preoxygenation includes the following steps; preparation for rapid sequence intubation as per institutional protocols, including departmental checklists. Hamilton T1 ventilator is setup in non-invasive spontaneous/timed mode with settings as described. The patient is optimally positioned and nasal cannula applied with an oxygen flow rate of 15 L/min. A face mask is applied with the jaw pulled forward using a two-handed thenar eminence grip and the ventilator is started. Preoxygenation occurs for 3 min. Drugs including neuromuscular blockers are administered, while the operator ensures the airway remains patent. The ventilator transitions into Pressure Controlled Ventilation once apnoea ensues. Nasal oxygen continues until endotracheal
A malleable stylet... was placed within a 4.0 cuffed tracheal tube... and shaped like a hockey stick. A 15-6 MHZ HFL50x linear array ultrasound probe attached to a Sonosite S-nerve machine (SonoSite Inc., Bothell, WA) was lightly placed transversely on the patients neck at the level of the thyrohyoid membrane. The probe was moved caudally until a view of the vocal cords and surrounding hypopharyngeal tissue was obtained. A second provider opened the mouth and performed a jaw thrust while inserting the hockey-stick-shaped styletted tube in the midline of the patients pharynx. The tube was inserted in the midline of the pharynx under the operators direct vision, it was then advanced slowly along the tongue base at which point it was visualized to the left of the glottis on the ultrasound image. The tube was withdrawn slightly and its trajectory modified to direct it into the glottis; hypoechoic shadowing and widening of the vocal cords was noted as the tube entered the trachea, a characteristic ...
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In patients undergoing emergent tracheal intubation, there is currently no universally accepted gold-standard test to confirm the location of the endotracheal tube (ETT).1 End-tidal carbon dioxide (CO2) detection is the best of the tests that are routinely utilized to confirm ETT placement, however, it has been shown to have an error rate as high as 1/10 for proper determination of ETT location in emergency intubations.2 As a result, multiple modalities are necessary to confirm ETT location, which can delay mechanical ventilation and other treatments. The lack of a single, reliable test to confirm ETT placement can potentially lead to confusion regarding the location of the tube. This confusion can result in both unrecognized esophageal intubations (false positive), as well as successful tracheal intubations that are subsequently removed (false negative), subjecting the patient to further unnecessary attempts at airway management. Both scenarios can lead to disastrous consequences.. (more…) ...
PubMed journal article: The Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope. Download Prime PubMed App to iPhone, iPad, or Android
PubMed journal article: New method of preoxygenation for orotracheal intubation in patients with hypoxaemic acute respiratory failure in the intensive care unit, non-invasive ventilation combined with apnoeic oxygenation by high flow nasal oxygen: the randomised OPTINIV study protocol. Download Prime PubMed App to iPhone, iPad, or Android
We have studied the effect of three bolus doses of remifentanil on the haemodynamic response to laryngoscopy and tracheal intubation. Using a double-blind design, 80 ASA 1 or 2 patients presenting for elective surgery received saline placebo or remifentanil 0.25, 0.5 or 1.0 microgram.kg-1 by random allocation. Anaesthesia was induced with thiopentone 5-7 mg.kg-1 and followed immediately by the study medication given as a bolus over 30s. Muscle relaxation was provided with rocuronium 0.75 mg.kg-1. The patients tracheas were intubated under direct laryngoscopy 1 min later. Noninvasive arterial blood pressure and heart rate were recorded immediately before induction of anaesthesia and then at intervals until 5 min after tracheal intubation. There was a significant increase in heart rate (p , 0.01) and systolic arterial pressure (p , 0.01) in all groups after tracheal intubation. However, this was short-lived and of a smaller magnitude in the remifentanil 1 microgram.kg-1 group in which the ...
BACKGROUND: Laryngoscopy and endotracheal intubation are known to cause increase in both arterial blood pressure and heart rate. Several strategies have been evolved to blunt the haemodynamic response to tracheal intubation but each method has its own advantages and disadvantages. Esmolol, a cardio selective Beta-1 blocking drug, can alleviate some of these problems. Esmolol, when administered parenterally, exhibits rapid onset and a short duration of action due to its rapid clearance by red blood cell esterases. Hence we conducted the present study to evaluate the efficacy and optimum time of single bolus esmolol administration in attenuating hypertensive- tachycardiac response to laryngoscopy and tracheal intubation.. MATERIALS AND METHODS: The randomized double blind prospective study was conducted in 60 patients, in the age group of 20-40 years, of both sexes, belonging to American Society of Anaesthesiologists (ASA) physical status class I or II and scheduled for elective surgery requiring ...
Objectives: To examine whether urgent orotracheal intubation (OI) can induce bacteremia. To find predictive factors for post-intubation b
ENT Procedures Tracheostomy Dressing Nasopharyngeal Airway LBH Clinical Practice Manual Intubations Intubation: Stomal Head Tilt-Chin Lift Jaw Thrust Cricothyroidotomy Cricothyrotomy Emergency Intubation Oropharyngeal Airway Orotracheal Intubation Suctioning A Patient With A Tracheostomy Tube Suctioning A Patient With An Endotracheal Tube (ETT) Needle Thoracentesis Episiotomy Esophageal Tracheal Intubation Positive Pressure Ventilation General surgery procedures Sewing… Read More » ...
OShea JE, OGorman J, Gupta A, Sinhal S, Foster JP, OConnell LA, Kamlin COF, Davis PG. Orotracheal intubation in infants performed with a stylet versus without a stylet. The Cochrane database of systematic reviews 6 : CD011791(2017) PubMed ...
In this letter, the authors wonder about the need to apply some of the precautions that have been repeatedly suggested during the recent COVID-19 (coronavirus disease 19) pandemic not only to suspected or documented cases of infection but also to all the new cases entering the hospital. In this rega …
Midazolam, Diazepam, Lorazepam. Provide excellent amnesia and sedation ... Diazepam and Lorazepam. Moderate/long acting agents. Longer onset time than midazolam ... - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 567d5-MGRmM
Prolonged time during endotracheal tube placement has been associated with poor outcomes, including cardiac arrest and death. For this reason, the accurate measurement of the duration of intubation time is an important metric in studies that evaluate interventions to improve airway outcomes. In the current study we correlated the gaps in routinely measured ventilatory parameters with duration of the intubation procedure to determine if these intervals could be used to accurately calculate the intubation time. Fifty-six random airway management encounters were video recorded along with a continuous video feed of the patient monitor. Intubation event times were measured and correlated with gap times of end-tidal carbon dioxide, airway pressure, airway flow, tidal volume, and respiratory rate defined as the disappearance of the parameter at the end of mask ventilation to the reappearance after intubation. Scatter plots were generated for intubation times versus each parameter time gap and ...
Background and Aims: The oncologists are treating cancer more aggressively, leading to increase in number of pediatric admissions to the ICU. Due to anatomical and physiological differences, pediatric patients are at high risk of complications during intubation. We evaluated the incidence of complications during intubations in pediatric patients in our ICU. Subjects and Methods: We performed retrospective analysis of complications occurring during intubation in 42 pediatric patients. All intubations were orotracheal. We recorded number of attempts at intubation, need for use of intubation adjuncts and complications during laryngoscopy and intubation. The incidence of difficult intubation, hypoxia, and severe cardiovascular collapse was also noted. Results: Complications occurred during 13 (31%) intubations. Hypoxia and severe cardiovascular collapse occurred in during 7 (16.7%) intubations each, while 4 patients (9.5%) (n=4) had cardiac arrest during intubation. Thirty three (78.6%) intubations ...
Delayed Sequence Intubation (DSI) is a procedural sedation, the procedure in this case being effective preoxygenation. Give ketamine, put them on the mask, and in 3 minutes paralyze and intubate.
For professionals, however, the bag valve mask is still the preferred ventilation method early on in cardiac arrest, Harper said. Looking at intubation success rates, Harper reported a 31 percent failure rate for prehospital intubation with about 12 percent unrecognized esophageal intubation on arrival a the hospital. Interestingly, this study showed no difference in mortality between those with failed intubation and those who were successfully intubated on arrival. Does that mean a bad tube is just as good as a good tube? In some respect this supports the idea of just working the patient longer with a BVM, Harper said ...
Stenoses of the respiratory tract are life threatening conditions of various origins. The authors give referrence on 21 patients operated for postintubation stenoses of their trachea at the IInd Surgical Clinic of the UPJŠ Medical Faculty, the Faculty Hospital of L. Pasteur in Košice, from 01. 01. 1999 to 30. 06. 2005. All patients had a tracheobronchoscopic examination and a CT examination completed prior to the procedure. Within 24 hours of their admission, 9 patients were operated, 7 underwent resection procedures and 2 patients had Montgomerys T-cannula introduced. 12 patients had their procedures planned, and were operated later than 24 hours after their admission. 10 patients underwent resections of the trachea, 2 had Montgomerys Tcannula implanted. The postoperative course following the resection of the trachea was without complications in 14 patients, 1 patient experienced transitional oedema in the anastomosis and 2 patients suffered restenoses. In this patient group, no fatal case ...
Cricoid pressure is considered to be the gold standard means of preventing aspiration of gastric content during Rapid Sequence Intubation (RSI). Its effectiveness has only been demonstrated in cadaveric studies and case reports. No randomised controlled trials comparing the incidence of gastric aspiration following emergent RSI, with or without cricoid pressure, have been performed. If improperly applied, cricoid pressure increases risk to the patient. The clinical significance of aspiration in the emergency department is unknown. This randomised controlled trial aims to; 1. Compare the application of the ideal amount of force (30 - 40 newtons) to standard, unmeasured cricoid pressure and 2. Determine the incidence of clinically defined aspiration syndromes following RSI using a fibrinogen degradation assay previously described. 212 patients requiring emergency intubation will be randomly allocated to either control (unmeasured cricoid pressure) or intervention groups (30 - 40 newtons cricoid pressure
TY - JOUR. T1 - Randomised controlled trial of intubation with the McGrath® Series 5 videolaryngoscope by inexperienced anaesthetists. AU - Walker, L.. AU - Brampton, W. J.. AU - Halai, M.. AU - Hoy, C.. AU - Lee, E.. AU - Scott, I.. AU - McLernon, D. J.. PY - 2009/9. Y1 - 2009/9. N2 - Background. The McGrath (R) Series 5 videolaryngoscope might reduce the incidence of unexpected difficult tracheal intubation. If it also performs as well as a standard laryngoscope during uncomplicated intubations, there would be an argument for the McGrath (R) to become the laryngoscope of choice in higher risk settings, such as rapid sequence induction by inexperienced anaesthetists. Therefore, we compared the McGrath and the Macintosh laryngoscopes during routine tracheal intubation performed by inexperienced anaesthetists.Methods. Single-blind randomized controlled trial with 120 adult patients allocated to intubation by first-year anaesthetic trainees, using a McGrath (R) or Macintosh laryngoscope. The ...
There is no CPT code for elective endotracheal intubation. Airway access is necessary for general anesthesia and is not separately reportable. CPT code 31500 describes an emergency endotracheal intubation and should not be reported for elective endotracheal intubation. Visualization of the airway is a component part of an endotracheal intubation, and CPT codes describing procedures that visualize the airway (e.g., nasal endoscopy, laryngoscopy, bronchoscopy) should not be reported with an endotracheal intubation. These CPT codes describe diagnostic and therapeutic endoscopies, and it is a misuse of these codes to report visualization of the airway for endotracheal intubation ...
Laryngeal mask airway (LMA) CTrach has an integrated fiber optic bundle and battery-powered monitor that enable viewing the larynx. The LMA CTrach is a step in the evolution of LMA Fastrach. This study assessed the feasibility of the two types of LMA in anesthetized non-paralyzed patients. This is a randomized controlled study where patients were allocated into two equal groups (n = 40 each), LMA CTrach group and LMA Fastrach group. All patients were scheduled for elective surgeries requiring intubation. General anesthesia with sevoflurane was used without the use of a neuromuscular blocking agent. The success of intubation from the first attempt and overall success rate were recorded. Also, the time to achieve ventilation, the time for complete tracheal intubation, and the time of the whole procedure were recorded, and any side effects were noticed. Tracheal intubation was successful on the first attempt in 92.5% in the LMA CTrach group and in 67.5% in the LMA Fastrach group. The success rate within
This report presents a case of a patient with multiple tooth fractures in posterior teeth that were diagnosed several months following emergency intubation.. Although it is probably not a rare complication of general anesthesia, with a reported incidence that ranges from less than 1% to more than 12% of cases, its presented characteristics extremely varies among studies (de Sousa and Mourao 2015; Vogel et al. 2009; Adolphs et al. 2011; Burton and Baker 1987).. It had been reported that generally the incidence of tooth injuries caused by intubation increases with age. In addition it had been reported that elderly patients suffer more from tooth luxation or avulsion due to age related chronic marginal periodontitis and attachment loss, and in contrast, younger patients primarily suffer from tooth fractures (Vogel et al. 2009). However, in the current case an elderly patient suffered from multiple tooth fractures without any evident luxation injuries.. Ascending aorta dissection is a tear in the ...
Procedure is a chapter in the book, Pulmonology, containing the following 35 pages: Needle Cricothyrotomy, Endotracheal Intubation, Endotracheal Tube, Rapid Sequence Induction, Heimlich Maneuver, Heimlich Maneuver for Infants, Mechanical Ventilation, Continuous Positive Airways Pressure, Positive End-Expiratory Pressure, Ventilator Troubleshooting, Ventilator Weaning, Thoracentesis, Polysomnogram, Advanced Airway, Chest Tube, Needle Thoracentesis, Nasotracheal Intubation, Cricothyrotomy, Small Caliber Chest Tube, Tactile Orotracheal Intubation, Simple Needle Aspiration of Pneumothorax, Extraglottic Device, Video Laryngoscope, Endotracheal Intubation Preparation, Direct Laryngoscope, Endotracheal Intubation Preoxygenation, Tracheostomy, High Flow Nasal Cannula, BIPAP, Post-Intubation Sedation and Analgesia, Noninvasive Ventilation, CPAP for Obstructive Sleep Apnea, Advanced Airway in Children, Elastic Bougie, Laryngospasm Notch Maneuver.
TY - JOUR. T1 - Endotracheal intubation training using virtual images. T2 - 15th Annual Conference on Medicine Meets Virtual Reality, MMVR 2007. AU - Boedeker, Ben H.. AU - Hoffman, Scott. AU - Murray, W. Bosseau. PY - 2007/1/1. Y1 - 2007/1/1. N2 - Airway management and intubation skills are essential for in-hospital as well as out-of-hospital health care. However, these skills are difficult to learn and maintain. We tested the hypothesis that novice endoscopists (medical students) could rapidly learn intubation skills, and achieve success in routine as well as difficult intubations using an indirect video laryngoscope. Following the success of the students, we believe that indirect laryngoscopy could become a valuable technique in disaster medicine and personnel hampered by chem.-bio suits.. AB - Airway management and intubation skills are essential for in-hospital as well as out-of-hospital health care. However, these skills are difficult to learn and maintain. We tested the hypothesis that ...
Awake video laryngoscopy is a novel option in airway management that is drawing more and more attention as an alternative to awake endoscopic guided intubation.Main issues: Intubation under preserved spontaneous breathing is the safest method to secure the expected difficult airway. In direct comparisons to awake flexible endoscopic intubation, awake videolaryngoscopy achieves satisfactory intubation times and a high acceptance of patients and anesthesiologists. Specific cases, in particular very limited mouth opening or sub-glottic masses, require awake flexible endoscopic intubation. Sufficient topical anesthesia and a sophisticated sedation protocol are prerequisites for successful awake video laryngoscopy.. ...
Background Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device. Methods The authors enrolled 1,000 adults having elective surgery with endotracheal intubation. After routine induction of general anesthesia, a supraglottic airway device was inserted and patients were ventilated intermittently. Air leak pressure was measured before and after full muscle relaxation. Up to two blind intubation attempts were performed. ...
INTRODUCTION: Airway management is still a major cause of anesthesia-associated morbidity and mortality. Supraglottic devices are recommended in difficult airway management guidelines. The aim of this study was to compare the performance of the Air-Q® and the LMA Fastrach™ for fiberoptic guided tracheal intubation. METHODS: Thirty-three anesthesia trainees participated in this randomized crossover study. Time to insert the dedicated airways (insertion of the airway into the manikin and delivery of two breaths), time to tracheal intubation (fiberoptic-guided tracheal intubation), time to remove the dedicated airway (removal of the Air-Q®/LMA Fastrach™ over the tracheal tube) and the opinion of the ease of use of the anesthesia trainees were measured ...
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The Airway Cam Guide to intubation and Practical Emergency Airway Management provides a practical approach to first pass intubation success. Techniques, airway anatomy, and case examples are illustrated using more than 450 full color photographs, including step-by-step laryngoscopy images from Dr. Levitans patented Airway Cam. This head-mounted camera aligns with the dominant pupil and permits imaging of laryngoscopy from the operators perspective. Airway Cam videotapes are used in more than 2,500 hospitals and EMS systems in 25 states ...
Background Due to the frequency and risks associated with endotracheal suctioning, there is a need to examine clinical practice critically and identify clinical research to guide practice. Correct technique and preparation by the clinicians can assist to reduce the risks of adverse events and the level of discomfort for the patients. Objectives The current study aimed to investigate the effects of routine versus the minimally invasive endotracheal tube suctioning procedure on suction-related pain, airway clearance and airway trauma in patients who were intubated. Methods In this randomized clinical trial, 64 patients with intubation in the intensive care units (ICUs) of Alzahra Hospital, Isfahan, Iran, were randomly allocated to minimally invasive endotracheal tube suctioning (MIETS) and routine endotracheal tube suctioning (RETS) groups. Pain intensity was assessed immediately before, immediately after and 10 minutes after endotracheal tube suctioning (ETS). Airway clearance was defined by numbers of
Traumatic brain injury patients frequently undergo tracheal intubation. We aimed to assess current intubation practice in Europe and identify variation in practice. We analysed data from patients with traumatic brain injury included in the prospective cohort study collaborative European neurotrauma effectiveness research in traumatic brain injury (CENTER-TBI) in 45 centres in 16 European countries. We included patients who were transported to hospital by emergency medical services. We used mixed-effects multinomial regression to quantify the effects on pre-hospital or in-hospital tracheal intubation of the following: patient characteristics; injury characteristics; centre; and trauma system characteristics. A total of 3843 patients were included. Of these, 1322 (34%) had their tracheas intubated; 839 (22%) pre-hospital and 483 (13%) in-hospital. The fit of the model with only patient characteristics predicting intubation was good (Nagelkerke R2 64%). The probability of tracheal intubation ...
Introduction: Laryngoscopy and endotracheal intubation alter cardiovascular physiology both via reflex responses and physical presence of an endotracheal tube (ETT). Stress response caused by laryngoscopic endotracheal intubation may be harmful for the coronary or cerebral circulation of high-risk patients. This study aimed to evaluate the hypothesis that placement of Proseal laryngeal mask airway (PLMA) and intubating laryngeal mask airway (ILMA) are associated with less cardiovascular response than the endotracheal intubation via conventional technique. Materials and Methods: In this hospital-based, randomized, interventional study, 105 patients of the American Society of Anesthesiologists Grade II and III undergoing coronary artery bypass grafting surgery under general anesthesia were randomly allocated into three groups, that is, PLMA, ILMA, and ETT. Hemodynamic parameters such as heart rate, blood pressure, cardiac output, cardiac index, systemic vascular resistance (SVR,) and SVR index ...
In emergency settings, verification of endotracheal tube (ETT) location is important for critically ill patients. Ignorance of oesophageal intubation can be disastrous. Many methods are used for verification of the endotracheal tube location; none are ideal. Quantitative waveform capnography is considered the standard of care for this purpose but is not always available and is expensive. Therefore, this feasibility study is conducted to compare a cheaper alternative, bedside upper airway ultrasonography to waveform capnography, for verification of endotracheal tube location after intubation. This was a prospective, single-centre, observational study, conducted at the HRPB, Ipoh. It included patients who were intubated in the emergency department from 28 March 2012 to 17 August 2012. A waiver of consent had been obtained from the Medical Research Ethics Committee. Bedside upper airway ultrasonography was performed after intubation and compared to waveform capnography. Specificity, sensitivity, positive
Tracheal intubation is generally considered the best method for airway management under a wide variety of circumstances, as it provides the most reliable means of oxygenation and ventilation and the greatest degree of protection against regurgitation and pulmonary aspiration.[2] However, tracheal intubation requires a great deal of clinical experience to master[81] and serious complications may result even when properly performed.[82]. Four anatomic features must be present for orotracheal intubation to be straightforward: adequate mouth opening (full range of motion of the temporomandibular joint), sufficient pharyngeal space (determined by examining the back of the mouth), sufficient submandibular space (distance between the thyroid cartilage and the chin, the space into which the tongue must be displaced in order for the larygoscopist to view the glottis), and adequate extension of the cervical spine at the atlanto-occipital joint. If any of these variables is in any way compromised, ...
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23 year old male. Tracheal injury. With the mouth open at rest, entire tonsil is clearly visible. Mouth opens to a width of two finger(s). The distance between the mentum (chin) and hyoid bone is two finger width(s). The distance from the hyoid bone to the thyroid notch is one finger widths. ...
BACKGROUND: The use of cuffed tracheal tubes (TTs) in small children is still controversial. The aim of this study was to compare post-extubation morbidity and TT exchange rates when using cuffed vs uncuffed tubes in small children. METHODS: Patients aged from birth to 5 yr requiring general anaesthesia with TT intubation were included in 24 European paediatric anaesthesia centres. Patients were prospectively randomized into a cuffed TT group (Microcuff PET) and an uncuffed TT group (Mallinckrodt, Portex, Rüsch, Sheridan). Endpoints were incidence of post-extubation stridor and the number of TT exchanges to find an appropriate-sized tube. For cuffed TTs, minimal cuff pressure required to seal the airway was noted; maximal cuff pressure was limited at 20 cm H(2)O with a pressure release valve. Data are mean (SD). RESULTS: A total of 2246 children were studied (1119/1127 cuffed/uncuffed). The age was 1.93 (1.48) yr in the cuffed and 1.87 (1.45) yr in the uncuffed groups. Post-extubation stridor ...
The purpose of this study was to compare the cuff pressures of three tracheostomy tubes, MERA sofit CLEAR, Blue Line Tracheostomy Tube, and Tracheosoft. Each tracheostomy tube with an internal diameter of 7.0 mm was put into a plastic column. The cuff was then inflated with air to seal the column, and the column was filled with water. The air in the cuff was withdrawn gradually and the cuff pressure at the point of water leakage was measured. Six columns of different size were used. In columns with an internal diameter of 18â€21 mm, the water leakage pressure was lower in the following order: MERA sofit CLEAR < Tracheosoft ≤ Blue Line Tracheostomy Tube. A mongrel dog was tracheotomized, and each tracheostomy tube with an internal diameter of 7.5 mm was intubated. The cuff air was increased by 1 ml from 4 ml to 10 ml, and the intracuff pressure was then measured. The intracaff pressure of the Blue Line Tracheostomy Tube was the highest at the same cuff volume, and that of the ...
Accurate localisation of the cricoid cartilage is a key step in the successful application of cricoid pressure during rapid sequence induction. Poorly localised pressure is unlikely to confer any protective benefit to our patients and may have deleterious effects on laryngoscopy. We postulated that the use of ultrasound would greatly improve the accuracy of cricoid cartilage localisation prior to the application of cricoid pressure.
The observational study design chosen for this study enabled the group to research rare events that are difficult to investigate in a prospective randomized design. Observational data from registries and large data sets remain an effective tool to compare interventions to their associated outcomes. Work from the American Society of Anesthesiologists closed claims data set helped us determine that multiple attempts at intubation are associated with poor patient outcomes.4 Other observational studies have similarly informed the anesthesia community about strategies to manage the difficult airway. The United Kingdoms 4th National Audit Project was an enhanced observational study that prospectively examined airway management procedures across the country to capture key events in difficult airway management.5 This study group highlighted that poor airway planning, problems with aspiration, and failed rescue surgical airway management are important areas for attention. Subsequent edits to the ...
DRAFT Basic Structure of DAS Guidelines flow chart* 2015 *Includes RSI Plan A: Mask ventilation and tracheal intubation Laryngoscopy succeed Tracheal intubation failed intubation STOP AND THINK Assess risks and benefits of: awakening the patient and postponing surgery tracheal intubation through the supraglottic airway device proceeding without intubating the trachea Plan B: Airway management using SAD, maintenance of oxygenation and review succeed Supraglottic Airway Device failed oxygenation Plan C: Attempt oxygenation, & ventilation succeed Revert to face mask ventilation Postpone surgery Awaken patient CICO Plan D: Rescue techniques for
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0030] In certain embodiments, the pressure transducer 20 may be associated with an adapter assembly 90 configured to be inserted into opening formed in the pilot balloon 74 as shown in FIG. 4. In such an embodiment, a distal end 92 of the adapter assembly 90 may be configured to couple to an opening formed in the proximal pilot balloon end 78. A barb 94 or other retention feature may retain the adapter assembly 90 on the pilot balloon 74 through an interference fit with the proximal pilot balloon end 78. The adapter assembly 90 may be removable or, in embodiments, may be adhered to the pilot balloon 74. For example, in other embodiments, the adapter assembly 90 may be adhered to, welded, heat bonded, or overmolded to the pilot balloon assembly 72. A proximal opening 96 of the adapter assembly 90 is coupled to a valve 98. The valve 98 may operate in a manner similar to valve 80, allowing inflation or deflation of the cuff 14 via a syringe. Accordingly, a tube 12 with the adapter assembly 90 ...
We identified 22 trials on use of a pre-procedure check-list (1 study), pre-oxygenation or apneic oxygenation (6 studies), sedatives (3 studies), neuromuscular blocking agents (1 study), patient positioning (1 study), video laryngoscopy (9 studies), and post-intubation lung recruitment (1 study). Pre-oxygenation with non-invasive ventilation (NIV) and/or high-flow nasal cannula (HFNC) showed a possible beneficial role. Post-intubation recruitment improved oxygenation while ramped position increased the number of intubation attempts and thiopental had negative hemodynamic effects. No effect was found for use of a checklist, apneic oxygenation (on oxygenation and hemodynamics), videolaryngoscopy (on number and length of intubation attempts), sedatives and neuromuscular blockers (on hemodynamics). Finally, videolaryngoscopy was associated with severe adverse effects in multiple trials ...
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Literature Review:. Airway management is a cornerstone of both basic and advanced life support. Paramedics and other EMS providers frequently encounter patients who can no longer protect their own airways (traumatic brain injury, major polytrauma, intoxication and overdose) or who are experiencing impending respiratory failure (exacerbations of congestive heart failure and obstructive lung disease). In-hospital management for these patients typically includes endotracheal intubation (ETI), which provides definitive control of the airway, reduces aspiration risk, and allows for mechanical ventilatory support. Do any of these patients benefit from pre-hospital ETI? Should EMS providers intubate in the field, or should they use airway adjuncts such as bag-valve mask ventilation, supraglottic airway devices, or non-invasive positive pressure ventilation to temporize their patients during rapid transport to the hospital?. As one might expect, the data on this issue are mixed and generally poor in ...
The Airtraq laryngoscope is a new tracheal intubation device that has been developed for the management of normal and difficult airways. As with the lightwand, the Airtraq can be used without placing the patient in the sniffing position for direct
TY - JOUR. T1 - Shoulder and head elevation improves laryngoscopic view for tracheal intubation in nonobese as well as obese individuals. AU - Lebowitz, Philip W.. AU - Shay, Hamilton. AU - Straker, Tracey. AU - Rubin, Daniel. AU - Bodner, Scott. PY - 2012/3. Y1 - 2012/3. N2 - Study Objective: To determine whether shoulder and head elevation, such that the patients ear lies at or higher than the sternum (ramp), improves laryngoscopic grade in adult patients of various body mass index (BMI) values. Design: Prospective, unblinded study, with patients and laryngoscopists acting as their own controls. Setting: Operating room of a university-affiliated hospital. Patients: 189 adult ASA physical status 1, 2, and 3 patients. Interventions: After performing a standard preoperative airway evaluation and inducing general anesthesia, the anesthetist performed and graded two laryngoscopies: one in the ramp position and one in the sniff position. Measurements: Patient BMI, Mallampati airway class, ...
In two patients, one with Klippel-Feil syndrome and one with fibrous dysplasia of the maxilla, no part of the larynx could be visualized by direct laryngoscopy. In both cases, the use of an intubation device equipped with a charge-coupled device camera, the endotracheal intubation device (EID), allowed smooth tracheal intubation ...
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Subclavian venous catheterization is common technique for a variety of purposes, but this procedure is associated with complications that include damage to the lung, pleura, thoracic duct, nerve and subclavian artery. We recently encountered a case of the tracheal puncture and endotracheal cuff perforation during the subclavian catheterization in a 67-year-old female who was scheduled for tracheal reconstruction. Tidal volume was escaping from around the endotracheal tube during the subclavian catheterization, however, repeated inflation of the cuff failed to maintain the necessary cuff pressure to seal the trachea. After the operation, by using the fiberoptic bronchoscope and injecting dye into the cuff, we confirmed the site of tracheal puncture and endotracheal cuff perforation which caused by the introducer needle of the central venous kit. We suggest that tracheal puncture and endotracheal cuff perforation be added to the list of complication of subclavian catheterization. This complication ...
Anesthesiology Research and Practice is a peer-reviewed, Open Access journal that provides a forum for health care professionals engaged in perioperative medicine, critical care, and pain management. The journal publishes original research articles, review articles, and clinical studies related to anesthetic administration, preoperative and postoperative considerations, perioperative care, critical care, pediatric anesthesia, obstetric anesthesia, analgesia, clinical and experimental research, administration and efficacy, as well as technology and monitoring.
Conventionally, nasotracheal intubation has consisted of blind nasal passage and external manipulation of the tube through the glottis (conventional technique), a technique associated with a high incidence of nasal trauma. We evaluated a novel technique for routine asleep (i.e. post‐induction) nasotracheal intubation using a bougie (bougie technique), which uses a nasopharyngeal airway to guide a paediatric bougie nasotracheally for use as a Seldinger tracheal intubation guide. Two hundred and fifty‐seven older children (, 8 years) and adults were randomly assigned to videolaryngoscopy‐assisted nasotracheal intubation using either the conventional or the bougie technique. The hypothesis was that the bougie technique would result in less nasopharyngeal trauma. The bougie technique was associated with significantly less nasopharyngeal bleeding than the conventional technique at both 60-90 s (55% vs. 68%; p = 0.033) and 5 min (51% vs. 70%; p = 0.002). The severity of bleeding was also ...
PURPOSE: We compare the Soft Seal and Unique single-use, plastic laryngeal mask airway devices with respect to intracuff pressure, directly measured mucosal pressure and in vitro elastance. METHODS: Ten fresh male cadavers were studied. Microchip pre
TY - JOUR. T1 - Journal of Clinical Monitoring and Computing 2018-2019 end of year summary. T2 - respiration. AU - Karbing, D S. AU - Perchiazzi, G. AU - Rees, S E. AU - Jaffe, M B. PY - 2020/1/24. Y1 - 2020/1/24. N2 - This paper reviews 28 papers or commentaries published in Journal of Clinical Monitoring and Computing in 2018 and 2019, within the field of respiration. Papers were published covering endotracheal tube cuff pressure monitoring, ventilation and respiratory rate monitoring, lung mechanics monitoring, gas exchange monitoring, CO2 monitoring, lung imaging, and technologies and strategies for ventilation management.. AB - This paper reviews 28 papers or commentaries published in Journal of Clinical Monitoring and Computing in 2018 and 2019, within the field of respiration. Papers were published covering endotracheal tube cuff pressure monitoring, ventilation and respiratory rate monitoring, lung mechanics monitoring, gas exchange monitoring, CO2 monitoring, lung imaging, and ...
Self-directed practice using VFI software may improve the initial acquisition of fibreoptic intubation skills for anesthesia residents.
In the vast majority of cases endotracheal intubation precedes tracheostomy tube placement. The trach is generally opted for in the course of ventilation support when the patient is unable to be extubated within a period that varies from institution to institution and specialist to specialist but is usually from as quickly as 3 to as long as 30 days depending on the clinical situation and practice of the physician or institution. Endotracheal intubation carries a great many risks and complications similar to tracheostomy. It is an invasive, but not a surgically invasive procedure. Avoiding intubation is the most basic way to avoid a tracheostomy. In some cases every means to avoid intubation fail or where the patients rapidity and severity of deterioration prevent attempts at alternatives to intubation then intubation must be performed. When intubation is the only alternative, then successful extubation or removal of the endotracheal tube becomes the goal as soon as clinically safe and ...
2017 The Association of Anaesthetists of Great Britain and Ireland Cuffed tracheal tubes are increasingly used in paediatric anaesthetic practice. This study compared tidal volume and leakage around cuffed and uncuffed tracheal tubes in children who required standardised mechanical ventilation of their lungs in the operating theatre. Children (0-16 years) undergoing elective surgery requiring tracheal intubation were randomly assigned to receive either a cuffed or an uncuffed tracheal tube. Assessments were made at five different time-points: during volume-controlled ventilation 6 ml.kg -1 , PEEP 5 cmH 2 O and during pressure-controlled ventilation 10 cmH 2 O/ PEEP 5 cmH 2 O. The pressure-controlled ventilation measurement time-points were: just before a standardised recruitment manoeuvre; just after recruitment manoeuvre; 10 min; and 30 min after the recruitment manoeuvre. Problems and complications were recorded. During volume-controlled ventilation, leakage was significantly less with cuffed ...
Endotracheal tube (ETT) cuff herniation is a rare, and often difficult to diagnose, cause of bronchial obstruction. We present a case of outside cuff herniation of an endotracheal tube that caused pulmonary right lung atelectasis. A 29-year-old man ,a case of car accident with multiple fractures, was admitted to the emergency ward and transferred to the operating room(OR) for open reduction and internal fixation (ORIF) of all fractures .The procedures were done under general anesthesia (G/A). The past medical history of the patient did not indicate any problem. Anesthesia was induced with thiopental, atracurium and then maintained by propofol and remifentanyl infusions and 100% O2 via orally inserted ETT. The patient was positioned in left lateral decubitus position for operation. Two hours after induction of anesthesia, the oxygen saturation level dropped to 85 % and the breath sounds in the right side of the chest were weakened. The chest x-ray images showed right lung atelectasis especially ...
After World War I, further advances were made in the field of intratracheal anesthesia. Among these were those made by Sir Ivan ... In the 20th century, the safety and efficacy of general anesthesia was improved by the routine use of tracheal intubation and ... With this in mind, he developed a laryngoscope designed for the sole purpose of tracheal intubation. Similar to Jackson's ... The concept of using a fiberoptic endoscope for tracheal intubation was introduced by Peter Murphy, an English anesthetist, in ...
These devices are widely employed for tracheal intubation, especially in the setting of the difficult intubation (see below). ... Janeway, Henry H. (1913). "Intra-Tracheal Anesthesia from the Standpoint of the Nose, Throat and Oral Surgeon with a ... Tracheal intubation with the GlideScope can be facilitated by the use of the Verathon Stylet, a rigid stylet that is curved to ... Lee JJ, Lim BG, Lee MK, Kong MH, Kim KJ, Lee JY (March 2012). "Fiberoptic intubation through a laryngeal mask airway as a ...
Tracheal intubation Driscoll, Kevin E.; Costa, Daniel L.; Hatch, Gary; Henderson, Rogene; Oberdorster, Gunter; Salem, Harry; ... Intratracheal instillation is the introduction of a substance directly into the trachea. It is widely used to test the ... Intratracheal instillation was reported as early as 1923 in studies of the carcinogenicity of coal tar. Modern methodology was ... Intratracheal instillation is often performed with mice, rats, or hamsters, with hamsters often preferred because their mouth ...
Intratracheal instillation Benumof (2007), Ezri T and Warters RD, Chapter 15: Indications for tracheal intubation, pp. 371-8 ... Previous experiences with tracheal intubation, especially difficult intubation, intubation for prolonged duration (e.g., ... Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea ( ... For infants and young children, orotracheal intubation is easier than the nasotracheal route. Nasotracheal intubation carries a ...
After World War I, further advances were made in the field of intratracheal anesthesia. Among these were those made by Sir Ivan ... Tracheal intubation (usually simply referred to as intubation), an invasive medical procedure, is the placement of a flexible ... Nasotracheal intubation was not widely practiced until the early 20th century. The 20th century saw the transformation of the ... In November of that year, he published another study, this time on the use of orotracheal intubation to secure the airway of a ...
Jackson, C (1913). "The technique of insertion of intratracheal insufflation tubes". Surgery, Gynecology & Obstetrics. 17: 507- ... Previous experiences with tracheal intubation, especially difficult intubation, intubation for prolonged duration (e.g., ... Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea ( ... Wikimedia Commons has media related to Tracheal intubation.. Video of endotracheal intubation using C-MAC D-blade and bougie ...
... (born 1942) is a pediatrician and the inventor of the INSURE (Intubation Surfactant Extubation) method combined ... treatment of RDS in spontaneously breathing premature infants with surfactant administered intratracheal thought laryngeal mask ...
Intratracheal" by people in Harvard Catalyst Profiles by year, and whether "Intubation, Intratracheal" was a major or minor ... "Intubation, Intratracheal" is a descriptor in the National Library of Medicines controlled vocabulary thesaurus, MeSH (Medical ... Below are the most recent publications written about "Intubation, Intratracheal" by people in Profiles. ... Below are MeSH descriptors whose meaning is more general than "Intubation, Intratracheal". ...
Inhalation, intranasal instillation, intratracheal instillation, and intratracheal intubation are the most widely used ... intratracheal instillation, and intratracheal intubation1-4. The latter procedure has not been routinely used because it is ... Noninvasive Intratracheal Intubation to Study the Pathology and Physiology of Mouse Lung. Yan Cai1, Shioko Kimura1 ... Intratracheal intubation described herein is a noninvasive, simple, and quick method to deliver materials of interest to mouse ...
Cai, Y., Kimura, S. Noninvasive Intratracheal Intubation to Study the Pathology and Physiology of Mouse Lung. J. Vis. Exp. (81 ... BioLite Intubation Illumination System. Braintree Scientific. BIO MI-KIT. For mice. 22 G, 1 inch i.v. catheter. Terumo. SR- ... Das, S., Macdonald, K., Chang, H. Y., Mitzner, W. A simple method of mouse lung intubation. J. Vis. Exp. (73), e50318 (2013). ... For mice below 30 g. Catheter is used only for the case where the Intubation Illumination System is not used.. ...
Effects of Intratracheal Lidocaine on Circulatory Responses to Tracheal Intubation J. Kenneth Denlincer, M.D.; Norig Ellison, M ... Effects of Intratracheal Lidocaine on Circulatory Responses to Tracheal Intubation You will receive an email whenever this ... Effects of Intratracheal Lidocaine on Circulatory Responses to Tracheal Intubation. Anesthesiology 10 1974, Vol.41, 409-412. ... Effects of Intratracheal Lidocaine on Circulatory Responses to Tracheal Intubation. Anesthesiology 1974;41(4):409-412. ...
Effects of intratracheal lidocaine on circulatory responses to tracheal intubation. by J Kenneth Denlinger et al. ... Effects of intratracheal lidocaine on circulatory responses to tracheal intubation.. @article{Denlinger1974EffectsOI, title={ ... Cardiovascular responses to fiberoptic intubation: A comparison of orotracheal and nasotracheal intubation. *Yoshihiro Shibata ... Effects of intratracheal lidocaine on circulatory responses to tracheal intubation.}, author={J Kenneth Denlinger and Norig ...
... , Laryngoscopy, Direct Laryngoscopy, Video Laryngoscopy, Post-intubation Management, Post-Intubation ... Intratracheal Intubation, Intratracheal Intubations, Intubation, Endotracheal, Intubation, Intratracheal, Intubations, ... endotracheal intubation, endotracheal intubations, intubation endotracheal, intubation tracheal, intratracheal intubation, ... Endotracheal, Intubations, Intratracheal, Endotracheal Intubation, Endotracheal intubation NOS, Endotracheal tube insertion, ...
Tracheal intubation Driscoll, Kevin E.; Costa, Daniel L.; Hatch, Gary; Henderson, Rogene; Oberdorster, Gunter; Salem, Harry; ... Intratracheal instillation is the introduction of a substance directly into the trachea. It is widely used to test the ... Intratracheal instillation was reported as early as 1923 in studies of the carcinogenicity of coal tar. Modern methodology was ... Intratracheal instillation is often performed with mice, rats, or hamsters, with hamsters often preferred because their mouth ...
Intubation, Intratracheal. *Device: Ram cannula. *Device: Short nasal prongs. Interventional. *Rambam Health Care Campus ...
Intubation, Intratracheal. *Postoperative Complications. *Sore Throat. *(and 3 more...). *Procedure: Bronchoscope guided ... Intubation conditions directly after induction of anesthesia. *Hemodynamic parameters, change in HR (Heart Rate) is being ... Endobronchial Intubation of Double-lumen Tube: Conventional Method vs Fiberoptic Bronchoscope Guide Method. * ... Incidence and Severity of Postoperative Sore Throat And Intubation Response by Using Different Devices for Endotracheal ...
... produced superior intubating conditions and a more favourable haemodynamic response to laryngoscopy and tracheal intubation. An ... Outcomes measured included laryngoscopy view, intubation success, haemodynamic response to laryngoscopy and tracheal intubation ... Intubation, Intratracheal / methods * Ketamine / administration & dosage * Laryngoscopy * Male * Middle Aged * Neuromuscular ... is the recommended method to facilitate emergency tracheal intubation in trauma patients. In emergency situations, a simple and ...
After World War I, further advances were made in the field of intratracheal anesthesia. Among these were those made by Sir Ivan ... Tracheal intubation (usually simply referred to as intubation), an invasive medical procedure, is the placement of a flexible ... Nasotracheal intubation was not widely practiced until the early 20th century. The 20th century saw the transformation of the ... In November of that year, he published another study, this time on the use of orotracheal intubation to secure the airway of a ...
... endotracheal intubation is associated with a high risk of complications, including severe hypoxemia and hypotension. The ... Intubation Intratracheal Critical care Critically ill This is a preview of subscription content, log in to check access. ... Cormack RS, Lehane J (1984) Difficult tracheal intubation in obstetrics. Anaesthesia 39:1105-1111PubMedCrossRefGoogle Scholar ... Incidence of post-intubation hemodynamic instability associated with emergent endotracheal intubations: a systematic review. ...
If a tracheostomy has already been performed, the distinction can be made by the use of intratracheal pressure monitoring while ... Intubation, Intratracheal * Monitoring, Physiologic * Pressure * Time Factors * Tracheotomy * Vocal Cord Paralysis / diagnosis ... If a tracheostomy has already been performed, the distinction can be made by the use of intratracheal pressure monitoring while ...
CPAP neither reduced the need for intubation nor improved outcomes in patients with acute hypoxemic, nonhypercapnic respiratory ... Context: Continuous positive airway pressure (CPAP) is widely used in the belief that it may reduce the need for intubation and ... Main outcome measures: Improvement in PaO(2)/FIO(2) ratio, rate of endotracheal intubation at any time during the study, ... Treatment with CPAP failed to reduce the endotracheal intubation rate (21 [34%] vs 24 [39%] in the standard therapy group; P =. ...
Intubation, Intratracheal. Male. Middle Aged. Oxygen / blood. Partial Pressure. Plethysmography. Positive-Pressure Respiration ...
Intubation, Intratracheal. Male. Middle Aged. Predictive Value of Tests. Prospective Studies. ROC Curve. Respiratory Mechanics* ...
Intubation, Intratracheal. A procedure involving placement of a tube into the trachea through the mouth or nose in order to ... intubation and videolaryngoscopic intubation with C-MAC videolaryngoscope and McGrath videolar... ... In McGrath videolaryngoscopic intubation, lifting of the blade to raise the.... Airtraq® is superior to the Macintosh ... Comparison of the ease of tracheal intubation using a McGrath Mac videolaryngoscope and a standard Macintosh laryngoscope in ...
Jackson, C (1913). "The technique of insertion of intratracheal insufflation tubes". Surgery, Gynecology & Obstetrics. 17: 507- ... Previous experiences with tracheal intubation, especially difficult intubation, intubation for prolonged duration (e.g., ... Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea ( ... Wikimedia Commons has media related to Tracheal intubation.. Video of endotracheal intubation using C-MAC D-blade and bougie ...
Keywords: Cuff pressure, intratracheal, intubation, trachea Abstract View Paper Research/Original Article Original: English ...
These cases required artificial ventilation or intratracheal intubation. The majority of neonates recovered within hours to a ...
Assessment of Remifentanil for Rapid Sequence Induction and Intubation in Full Stomach Patient Compared to Muscle Relaxant ... Primary endpoint is the rate of tracheal intubation without major complications as defined by 1/ tracheal intubation with less ... for anesthetic rapid sequence intubation in terms of major complications (difficult intubation, gastric liquid aspiration, ... Orotracheal intubation will be performed 30 to 60 seconds later by a graduated anesthesiologist or a resident with 4 validated ...
Intubation [E05.497]. *Intubation, Intratracheal [E05.497.578]. *Laryngeal Masks [E05.497.578.475]. *Equipment and Supplies [ ... A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain ... Continuous ventilation during flexible fiberscopic-assisted intubation via supraglottic airways. Paediatr Anaesth. 2016 Apr; 26 ...
Categories: Intubation, Intratracheal Image Types: Photo, Illustrations, Video, Color, Black&White, PublicDomain, ...
Intratracheal intubation. ... of which resulting from endotracheal intubation. The diagnosis ...
Aspiration; Critical illness; Deglutition disorders; Fluoroscopy; Intratracheal intubation Full Text Links. *. Actions. Cited ... Patients with PED exhibited greater mean duration of intubation (11.85±3.72 days) and length of stay in the intensive care unit ... Duration of endotracheal intubation, LOS-ICU, and oromotor degradation were associated with PED development. Oromotor ... Associations Between Prolonged Intubation and Developing Post-extubation Dysphagia and Aspiration Pneumonia in Non-neurologic ...
Biofilms; Pseudomonas aeruginosa; Intubation, Intratracheal; Methicillin-Resistant Staphylococcus aureus; Respiration, ...
"Intubation, Intratracheal" AND "Burns" OR "Burns, Inhalation". Meta-analyses, systematic reviews, management guidelines, ... with no further intubations; the conclusion was that over 1/3 of those intubations were unnecessary. The limitation of these ... Burns; Intubation; Burns, Inhalation; Airway Management; Laryngoscopy; Quemaduras; Intubación; Quemaduras por inhalación; ... Any findings of severe involvement or progressive edema are an indication for immediate intubation.14,45 Refer to Figs. 1 and 2 ...
After intra-tracheal intubation the lungs were inflated with 10 mmHg positive pressure. The CT-scan showed diffuse ground glass ...
Publications] Ishikawa S et al: Intratracheal stent intubation under extracorporeal lung assist. Surg Today. 25. 995-997 ( ... Publications] Ishikawa, S et al: Intrafracheul steut intubation under extracorporeal lung assist Surg Today. 25. 995-997 ( ... Publications] Ishikawa S et al: Intratracheal steut intabation under extracorporeal lung assist Surgery Today. 25. 995-997 ( ...
For intratracheal administration only.. -Administer under the supervision of clinicians experienced in intubation, ventilator ...
  • Comparison of effects of thoracic epidural and intravenous administration of lidocaine on target-controlled infusion of propofol and tracheal intubation response during induction of anesthesia. (semanticscholar.org)
  • The 20th century saw the transformation of the practices of tracheotomy, endoscopy and non-surgical tracheal intubation from rarely employed procedures to essential components of the practices of anesthesia, critical care medicine, emergency medicine, gastroenterology, pulmonology and surgery. (wikipedia.org)
  • Because it is an invasive and uncomfortable medical procedure , intubation is usually performed after administration of general anesthesia and a neuromuscular-blocking drug . (wikipedia.org)
  • Although it is not the only means to maintain a patent airway during general anesthesia, intubation of the trachea provides the most reliable means of oxygenation and ventilation [1] and the greatest degree of protection against regurgitation and pulmonary aspiration. (wikipedia.org)
  • A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. (harvard.edu)
  • It requires anesthesia and intratracheal intubation, to prevent air circulation through the nasal cavities. (vin.com)
  • We are presenting the first documented case of amisulpride related ventricular arrhythmia during tracheal intubation and extubation under general anesthesia in an 48 year-old female with psychiatric history of chronic schizophrenia who was treated with amisulpride. (cpn.or.kr)
  • 4 , 5) Here, we report a case of ventricular arrhythmia during tracheal intubation and extubation under general anesthesia possibly associated with amisulpride. (cpn.or.kr)
  • Tracheal intubation (usually simply referred to as intubation), an invasive medical procedure, is the placement of a flexible plastic catheter into the trachea. (wikipedia.org)
  • Intratracheal instillation is the introduction of a substance directly into the trachea. (wikipedia.org)
  • Tracheal intubation , usually simply referred to as intubation , is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. (wikipedia.org)
  • Intubation is normally facilitated by using a conventional laryngoscope , flexible fiberoptic bronchoscope , or video laryngoscope to identify the vocal cords and pass the tube between them into the trachea instead of into the esophagus. (wikipedia.org)
  • For centuries, tracheotomy was considered the only reliable method for intubation of the trachea. (wikipedia.org)
  • endotracheal tube an airway catheter inserted in the trachea during endotracheal intubation to assure patency of the upper airway by allowing for removal of secretions and maintenance of an adequate air passage. (thefreedictionary.com)
  • Infants with meconium in the trachea (as determined after intubation) were more likely to develop meconium aspiration syndrome. (aafp.org)
  • From the proximal trachea, mucus eventually moved toward the lungs on the dependent part of the trachea, leading to an "intratracheal route" of colonization of the lungs. (nih.gov)
  • There was difficulty intubating the trachea due to severe subglottic stenosis that developed following the previous episode of endotracheal intubation. (umn.edu)
  • As compared to inhalation, intratracheal instillation allows greater control over the dose and location of the substance, is cheaper and less technically demanding, allows lower amounts of scarce or expensive substances to be used, allows substances to be tested that can be inhaled by humans but not small mammals, and minimizes exposure to laboratory workers and to the skin of laboratory animals. (wikipedia.org)
  • Subglottic stenosis is among the most common causes of airway obstruction in children, 90% of which resulting from endotracheal intubation. (scielo.org.ar)
  • By the mid-20th century, the tracheotomy as well as endoscopy and non-surgical tracheal intubation had evolved from rarely employed procedures to becoming essential components of the practices of anesthesiology , critical care medicine , emergency medicine , and laryngology . (wikipedia.org)
  • All intubations were performed in the intensive care units (56%), the emergency trauma center (35%), or elsewhere (9%) by an anesthesiology attending physician or a resident. (asahq.org)
  • The paralysis of the respiratory function is readily met by intrapharyngeal insufflation, which is easily executed even without training in this procedure, or by the method of intratracheal insufflation, if executed by one trained in its management. (rupress.org)
  • Dr. Armstrong was very much at the forefront in his own field, surgery, as an early adopter of « intratracheal insufflation, » better known today as endotracheal anaesthesia or intubation. (mcgill.ca)
  • Chloride as dose local anesthetic for exposing and inserting cannula in external jugular The intravenous injection of an f solution of magnesium sulphate intubation for intratracheal insufflation was performed with ease, while usually a great deal of ether has to be given to accomplish this and the animal would execute satisfactory voluntary movements. (riseaustin.org)
  • UNRECOGNIZED esophageal intubation can lead to progressive hypoxia, cardiac arrest, neurologic injury, and death. (asahq.org)
  • In critically ill patients, endotracheal intubation is associated with a high risk of complications, including severe hypoxemia and hypotension. (springer.com)
  • Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR (2008) Complications of endotracheal intubation in the critically ill. (springer.com)
  • Tracheal intubation can be associated with complications such as broken teeth or lacerations of the tissues of the upper airway . (wikipedia.org)
  • It can also be associated with potentially fatal complications such as pulmonary aspiration of stomach contents which can result in a severe and sometimes fatal chemical aspiration pneumonitis , or unrecognized intubation of the esophagus which can lead to potentially fatal anoxia . (wikipedia.org)
  • Because of this, the potential for difficulty or complications due to the presence of unusual airway anatomy or other uncontrolled variables is carefully evaluated before undertaking tracheal intubation. (wikipedia.org)
  • REMICrush is a French multicentric non inferiority simple blind randomized clinical trial that will compare the use of Remifentanil to muscle relaxant (reference treatment) for anesthetic rapid sequence intubation in terms of major complications (difficult intubation, gastric liquid aspiration, desaturation, hemodynamics reaction, ventricular arrhythmia, anaphylactic reaction). (centerwatch.com)
  • Use of remifentanil has shown satisfying intubation conditions for adults but its incidence of major complications compared to succinylcholine remains unknown. (centerwatch.com)
  • A total of 30% to 40% of all patients intubated due to a history of airway burn and/or inhalation injury are extubated early, with evidence of unnecessary intubations that increase the risk of complications. (lww.com)
  • Complications of endotracheal intubation include damage to the vocal cords, erosion, and eventual stricture of the larynx. (thefreedictionary.com)
  • Drugs commonly used for laryngoscopy and intubation to prevent hemodynamic complications, intravenous lidocaine and sublingual nifedipine, were compared with independent and paired t -tests. (dovepress.com)
  • Wiswell and colleagues conducted a randomized controlled trial to determine whether intratracheal suctioning reduced the incidence of meconium aspiration syndrome in vigorous newborns, and to determine the frequency of complications associated with this procedure. (aafp.org)
  • The use of a readily available rigid stylet as an alternative method for tracheal intubation should be considered only after more conventional techniques and potential complications have been considered. (umn.edu)
  • Efficacy of oropharyngeal lidocaine instillation on hemodynamic responses to orotracheal intubation. (semanticscholar.org)
  • Green R, Hutton B, McIntyre L, Fergusson D (2009) Incidence of post-intubation hemodynamic instability associated with emergent endotracheal intubations: a systematic review. (springer.com)
  • Several study have shown similar intubation conditions in planned surgery with the use of Remifentanil instead of neuromuscular blockade and less hemodynamic reactions. (centerwatch.com)
  • Many surgical procedures require intratracheal intubation, which results in hemodynamic changes. (dovepress.com)
  • According to the results of our study, intravenous lidocaine is more effective than sublingual nifedipine for preventing hemodynamic changes while performing laryngoscopy or intratracheal intubation. (dovepress.com)
  • Clinical Efficacy Of Combination Of Diltiazem And Lidocaine In Attenuating Hemodynamic Changes During Tracheal Intubation And Comparing The Response When They Are Used Alone. (ispub.com)
  • Tracheal intubation produces transient hemodynamic pressor responses which may be unpredictable. (ispub.com)
  • 120 ASA grade I&II patients were randomly divided in to four groups (using a random sequence generator) of 30 each according to the drug given before intubation to attenuate the hemodynamic response to intubation: saline in control group, diltiazem in D group, lidocaine in L group and both diltiazem and lidocaine in DL group. (ispub.com)
  • Nasotracheal intubation was not widely practiced until the early 20th century. (wikipedia.org)
  • This better view could improve the navigation of endotracheal tube in nasotracheal intubation. (bioportfolio.com)
  • Notes: Ovassapian A, Dykes MHM, Golmon M. A training program for fiberoptic nasotracheal intubation. (woodlibrarymuseum.org)
  • Endotracheal intubation may be accomplished through the mouth using an orotracheal tube, or through the nose using a nasotracheal tube. (thefreedictionary.com)
  • Outcomes measured included laryngoscopy view, intubation success, haemodynamic response to laryngoscopy and tracheal intubation, and mortality. (nih.gov)
  • In a comparative, cohort study, pre-hospital RSI using fentanyl, ketamine and rocuronium produced superior intubating conditions and a more favourable haemodynamic response to laryngoscopy and tracheal intubation. (nih.gov)
  • Laryngoscopy and tracheal intubation is invariably associated with certain haemodynamic and cardiovascular changes such as transient hypertension, tachycardia which may result in wide variety of cardiac arrhythmias. (ispub.com)
  • Continuous positive airway pressure (CPAP) is widely used in the belief that it may reduce the need for intubation and mechanical ventilation in patients with acute hypoxemic respiratory insufficiency. (nih.gov)
  • Continuous ventilation during flexible fiberscopic-assisted intubation via supraglottic airways. (harvard.edu)
  • Intratracheal aspiration in a patient on ventilation is generally performed using a catheter. (scirp.org)
  • Difficult airway algorithms are an essential aid when dealing with respiratory failure in clinical situations where ventilation or intubation is unsuccessful. (umn.edu)
  • Hamill JF, Bedford RF, Weaver DC, Colohan AR (1981) Lidocaine before endotracheal intubation: Intravenous or intratracheal? (springer.com)
  • To compare the clinical efficacy and safety of diltiazem-lidocaine combination in attenuating pressor response to tracheal intubation with lidocaine and diltiazem alone. (ispub.com)
  • Lidocaine has been used for attenuation of cardiovascular responses to intubation since a long time. (ispub.com)
  • The 2016 International Society for Burn Injury clinical guidelines for the care of the burn patient recommend intubation or tracheostomy, only as an indication if the airway patency is jeopardized, whereas observation and monitoring are the recommended treatment for secondary upper airway burns due to inhalation. (lww.com)
  • In case of suspected airway burn and/or injury by inhalation, the recommendation is to complement the medical evaluation with an examination of the oropharynx via fiberoptic bronchoscopy or laryngoscopy (direct or indirect) to identify airway edema, its evolution, and then decide whether intubation is appropriate. (lww.com)
  • Tumors were induced on day 0 by intratracheal intubation and inhalation (i.t.) of an adenovirus expressing Cre recombinase (AdCre). (nih.gov)
  • Videolaryngoscope is useful to improve the laryngeal view, especially during difficult intubation. (bioportfolio.com)
  • We present a patient with bilateral hypoglossal and unilateral recurrent laryngeal nerves palsy after a complicated intubation and a Legionella infection. (forskningsdatabasen.dk)
  • Intratracheal instillation is often performed with mice, rats, or hamsters, with hamsters often preferred because their mouth can be opened widely to aid viewing the procedure, and because they are more resistant to lung diseases than rats. (wikipedia.org)
  • Tracheal intubation is indicated in a variety of situations when illness or a medical procedure prevents a person from maintaining a clear airway, breathing, and oxygenating the blood. (wikipedia.org)
  • BACKGROUND: Rapid sequence intubation is the reference anaesthetic procedure for patient at risk of pulmonary aspiration of gastric contents (for example emergency procedure, bowel obstruction, obese patients, gastroesophageal reflux ) or difficult airway management. (centerwatch.com)
  • Endotracheal intubation has the advantages of not requiring a surgical procedure as does tracheotomy, of removal of the tube (extubation) being less involved, and of the procedure being able to be repeated as necessary. (thefreedictionary.com)
  • Because the complication rate of intubation and suctioning is low, this procedure should still be performed in a meconium-stained neonate who is not vigorous or who develops respiratory distress. (aafp.org)
  • Orotracheal intubation will be performed 30 to 60 seconds later by a graduated anesthesiologist or a resident with 4 validated semesters. (centerwatch.com)
  • Techniques for administering artificial respiration without the need for INTRATRACHEAL INTUBATION. (bioportfolio.com)
  • In this stage intratracheal intubation for artificial respiration can be easily accomplished. (rupress.org)
  • Acquired tracheal stenosis is a very infrequent lesion in the pediatric age group and may be due to diverse causes, being post-intubation stenosis and stenosis secondary to tracheostomy the most common ones.The management of acquired tracheal stenosis remains controversial. (bvsalud.org)
  • Conversely, good long-term results have been documented with tracheal resection and primary anastomosis.We describe our experience with tracheal resection followed by end-to-end anastomosis for the treatment of post-intubation tracheal stenosis in 8 patients. (bvsalud.org)
  • If a tracheostomy has already been performed, the distinction can be made by the use of intratracheal pressure monitoring while the patient is being sedated. (nih.gov)
  • The mean number of days of oral or nasal endotracheal intubation prior to tracheostomy (96 patients) was 21.5±14.2 days. (elsevier.com)
  • In this study, despite early physiologic improvement, CPAP neither reduced the need for intubation nor improved outcomes in patients with acute hypoxemic, nonhypercapnic respiratory insufficiency primarily due to acute lung injury. (nih.gov)
  • The authors conclude that expectant management of a meconium-stained neonate who appears vigorous is not more likely than intubation and suctioning of such an infant to lead to meconium aspiration syndrome or other respiratory problems. (aafp.org)
  • Data sheets were provided in each intubation tray and were completed by the respiratory care practitioner who assisted in the intubation. (asahq.org)
  • Oct. 4, 2013 -- Discovery Laboratories, Inc. (Nasdaq:DSCO), a specialty biotechnology company dedicated to advancing a new standard in respiratory critical care, today announced the U.S. Food and Drug Administration (FDA) has agreed to the Company's updated product specifications for SURFAXIN® (lucinactant) Intratracheal Suspension which was approved for the prevention of respiratory distress syndrome (RDS) in premature infants at high risk for RDS. (seekingalpha.com)
  • Two patients required intubation for hypoxemic respiratory failure, whereas one required significant supplemental oxygen. (cdc.gov)
  • Background: Subglottic stenosis is a frequent complication of endotracheal intubation in children and can create a difficult airway situation for subsequent respiratory illnesses. (umn.edu)
  • Case Report: A 4-month-old infant with a history of previous endotracheal intubation required endotracheal intubation for stridor and respiratory failure due to croup. (umn.edu)
  • McGrath videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis. (bioportfolio.com)
  • There are several anecdotal reports that the McGrath is superior to the Macintosh laryngoscope for tracheal intubation. (bioportfolio.com)
  • AND [exp intubation intratracheal OR exp laryngoscopy OR "laryngoscope".mp]. (bestbets.org)
  • To remove tracheal secretions through the intratracheal tube, catheter suction is used, and the suction catheter may be of the closed- or open-type. (scirp.org)
  • This phenomenon is caused by some factors: influence of flow, clogging of the suction tube, problem of manipulation of flushing and angle between the intubation tube and the connection port. (scirp.org)
  • Some studies have advocated intratracheal suctioning to prevent meconium aspiration syndrome, and this technique was widely adopted in the 1980s. (aafp.org)
  • More recent studies suggest that intratracheal suctioning may not be necessary in all cases of meconium aspiration. (aafp.org)
  • Improvement in PaO(2)/FIO(2) ratio, rate of endotracheal intubation at any time during the study, adverse events, length of hospital stay, mortality, and duration of ventilatory assistance, compared between the CPAP and standard treatment groups. (nih.gov)
  • Improvements in gas exchange were seen in approximately 71% of these patients, endotracheal intubation was not needed for 82%, and the standardised mortality ratio was 0.86. (hkmj.org)
  • A systematic literature search was conducted to identify interventional and observational studies where the mortality rates of adult trauma patients undergoing pre-hospital endotracheal intubation were compared to those undergoing emergency department intubation. (biomedcentral.com)
  • The median mortality rate in patients undergoing pre-hospital intubation was 48% (range 8-94%), compared to 29% (range 6-67%) in patients undergoing intubation in the emergency department. (biomedcentral.com)
  • Odds ratios were in favour of emergency department intubation both in crude and adjusted mortality, with 2.56 (95% CI: 2.06, 3.18) and 2.59 (95% CI: 1.97, 3.39), respectively. (biomedcentral.com)
  • Twelve of the twenty-one studies found a significantly higher mortality rate after pre-hospital intubation, seven found no significant differences, one found a positive effect, and for one study an analysis of the mortality rate was beyond the scope of the article. (biomedcentral.com)
  • The association between pre-hospital intubation and a higher mortality rate does not necessarily contradict the importance of the intervention, but it does call for a thorough investigation by clinicians and researchers into possible causes for this finding. (biomedcentral.com)
  • Studies that assessed in-hospital mortality (the primary review outcome), endotracheal intubation, or length of hospital stay were eligible for inclusion. (york.ac.uk)
  • For each study, the intubation rates and mortality for each treatment group were extracted. (york.ac.uk)
  • Pooled RDs and 95% CIs were calculated for in-hospital mortality and endotracheal intubation. (york.ac.uk)
  • Heffner AC, Huang DT, Al-Khafaji A (2007) Post-intubation hypotension during emergency airway management. (springer.com)
  • Rapid Sequence Induction of anaesthesia (RSI) is the recommended method to facilitate emergency tracheal intubation in trauma patients. (nih.gov)
  • Mort TC (2005) Preoxygenation in critically ill patients requiring emergency tracheal intubation. (springer.com)
  • Shiga T, Wajima Z, Inoue T, Sakamoto A (2005) Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. (springer.com)
  • In patients with an unstable cervical spine, maintenance of cervical immobilization during tracheal intubation is important. (bioportfolio.com)
  • This cross-sectional study included non-neurologic critically ill adult patients who required endotracheal intubation and underwent videofluoroscopic swallowing study (VFSS) between October and December 2016. (koreamed.org)
  • Pre-hospital endotracheal intubation is frequently used for trauma patients in many emergency medical systems. (biomedcentral.com)
  • The rationale for wide and unspecific indications for pre-hospital intubation seems to lack support in the literature, despite several publications involving a relatively large number of patients. (biomedcentral.com)
  • Pre-hospital intubation (PHI) of trauma patients is performed in many advanced emergency medical systems (EMS). (biomedcentral.com)
  • We describe our technique of awake intubation and prone patient self-positioning before percutaneous nephrolithotomy (PCNL), and review the literature regarding prone positioning in obese patients and the impact of obesity on PCNL. (northwestern.edu)
  • Conclusions: The technique of awake intubation with prone patient self-positioning can be helpful for positioning morbidly obese patients before PCNL and has been safe and effective in properly selected patients. (northwestern.edu)
  • See Rapid Sequence Intubation regarding peri-intubation precautions (e.g. (fpnotebook.com)
  • The peri-intubation period is one of the moments of most stress during general anaesthesia. (ispub.com)
  • Unfortunately, clinical signs are insufficiently sensitive to detect esophageal intubation, [1,2] and thus other techniques to confirm correct placement of an endotracheal tube (ETT) are necessary. (asahq.org)
  • [3-6] In the emergency setting involving out-of-hospital, emergency department, and intensive care unit intubations, however, where esophageal intubation is perhaps more likely to occur, [7] capnometry is not always available. (asahq.org)
  • Esophageal intubation was diagnosed if there was no detection of carbon dioxide at the fifth manual breath, in conjunction with a consistent clinical examination. (asahq.org)
  • Immediate reintubation was performed when esophageal intubation was diagnosed. (asahq.org)
  • Intratracheal instillation was reported as early as 1923 in studies of the carcinogenicity of coal tar. (wikipedia.org)
  • Intubation-mediated Intratracheal (IMIT) Instillation: A Noninvasive, Lung-specific Delivery System. (louisville.edu)
  • Publications] Ishikawa, S et al: 'Intrafracheul steut intubation under extracorporeal lung assist' Surg Today. (nii.ac.jp)
  • First, we expressed whole palivizumab (secreted, termed sPali) in the lung via synthetic mRNA delivery by intratracheal aerosol. (nature.com)
  • Comparison of two bolus doses of esmolol for attenuation of haemodynamic response to tracheal intubation. (semanticscholar.org)
  • Many methods have been devised to reduce the extent of such haemodynamic events during intubation. (ispub.com)
  • In this study, participants aimed to compare the effects of direct laryngoscopic endotracheal intubation and videolaryngoscopic intubation with C-MAC videolaryngoscope and McGrath videolar. (bioportfolio.com)
  • Most intubations were performed using direct laryngoscopy after administration of a hypnotic agent and a muscle relaxant, with cricoid pressure applied until correct placement of the ETT was verified. (asahq.org)
  • mean age, 49.7 yr) who were undergoing emergency endotracheal intubation at Harborview Medical Center between September 1, 1995 and March 31, 1996. (asahq.org)
  • Either that person or someone else who is immediately available should have the skills required to perform a complete resuscitation, including endotracheal intubation and administration of medications. (ahajournals.org)
  • Perhaps the most common indication for tracheal intubation is for the placement of a conduit through which nitrous oxide or volatile anesthetics may be administered. (wikipedia.org)
  • La evidencia internacional recomienda diferente presión de 'cuff' a utilizar en usuarios con vía aérea artificial. (bvsalud.org)
  • El objetivo de este trabajo fue crear un cuestionario válido y confiable sobre el uso de técnicas y manejo de la presión del 'cuff' en usuarios adultos con vía aérea artificial por parte de profesionales de salud en Chile. (bvsalud.org)
  • En la fase B diez expertos chilenos en el manejo de usuarios con vía aérea artificial analizaron la herramienta y recomendaron modificaciones de algunos componentes del cuestionario. (bvsalud.org)
  • Lo anterior permite concluir que este cuestionario cumple con su objetivo y servirá para conocer las técnicas y presiones del 'cuff' que profesionales de la salud en Chile utilizan para el manejo de usuarios adultos con vía aérea artificial. (bvsalud.org)
  • Reid C, Chan L, Tweeddale M (2004) The who, where, and what of rapid sequence intubation: prospective observational study of emergency RSI outside the operating theatre. (springer.com)
  • Radical evolution: the 2015 Difficult Airway Society guidelines for managing unanticipated difficult or failed tracheal intubation. (ox.ac.uk)
  • A 80% incidence of intubation without major complication was hypothesized. (centerwatch.com)