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Biomedical subjects

Imad Swaiss

Publications and source records attributed to Imad Swaiss.

2 recordsLinked to original sources

Bedside percutanous forceps dilatational tracheostomy.

ICU patients, mainly those who need prolonged ventilatory support, may require tracheostomy, which once was done in the operating room, nowadays is performed in the ICU, as percutaneous dilatational tracheostomy (PDT). Forty two patients 18-72 yrs of age (mean 44 yrs), with varying indications for tracheostomy, had undergone PDT in the ICU under the standard protocol for this procedure. The mean time for completion of the procedure was 10 min. Advantages and complications are reviewed. The difficulties encountered were mainly the anatomical landmarks (10%), difficulties in dilatation (5%) and peristomal oozing (1%). It is concluded that percutaneous dilatational tracheostomy is an easy, cost effective, practical when done at bedside in the ICU, and spares transferring the patient to the operating theater.

Adolescent↗

Anesthesia apparatus: Cuff Mate-2, endotracheal cuff inflator and pressure monitor.

OBJECTIVE: A digital endotracheal cuff inflator and pressure monitor were tested under clinical conditions on 150 patients in the intensive care. METHODS: Patients were either intubated with endotracheal tubes or had tracheostomies, and were spontaneously breathing or artificially ventilated. Patients were divided into three groups. Group A had the endotracheal tube or tracheostomy cuff inflated randomly by a syringe and tested later by the Cuff Mate. Group B had the cuffs inflated by a syringe till air leak just disappeared on a hand-bagged positive pressure inspiration. Group C had the cuff inflated by the Cuff Mate till air leak just disappeared on a hand bagged positive pressure inspiration. In all three groups, cuff pressure measurement and inflation were done using the Cuff Mate. RESULTS: Higher mean tracheal cuff pressures were recorded in Group A, in comparison with the other two groups, while smaller differences were observed between Group B and C. CONCLUSION: Using the Cuff Mate to inflate cuffs till no air leak, in addition to simultaneous monitoring of the cuff pressure to prevent excessive cuff pressure, decreases the ischemic damage that is caused by overinflated cuffs. Cuff pressures should be kept below that causing obstruction to the tracheal mucosal blood flow so as to avoid prolonged overinflated cuffs in intensive care patients.

Critical Care↗