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At least 487 records · Page 27Linked to original sources
PubMed1977

Enlarging intratracheal tube cuff diameter: a quantitative roentgenographic study of its value in the early prediction of serious tracheal damage.

A prospective study to radiographically document impending tracheal damage in patients on continuous mechanical ventilation was done in 135 intubated adult patients over an eighteen month period. The previously unrecognized enlarging cuff/trachea ratio over 150% was seen in 18 patients. Five of 9 patients who died with C/T ratio over 150% were autopsied; all had severe tracheal damage at the cuff site. Four of 5 patients who were decannulated/extubated developed tracheal stenosis at the cuff site, necessitating tracheal resection in 3 patients. Thus a C/T ratio over 150% is a reliable clinical indicator of tracheal damage. Some thoughts as to prevention of this iatrogenic disease are presented.

Adolescent↗
PubMed1994

Epinephrine absorption following endotracheal administration: effects of hypoxia-induced low pulmonary blood flow.

To investigate the effects of hypoxia-induced decreased pulmonary blood flow on the trans-pulmonary absorption of epinephrine, we measured pulmonary blood flow and arterial plasma tritium counts per minute following endotracheal [3H]epinephrine administration in six chronically instrumented newborn lambs. The lambs were ventilated alternately with room air and with an hypoxic gas mixture sufficient to decrease pulmonary blood flow to approximately 50% of baseline values. Using this model, we found that hypoxia-induced low pulmonary blood flow did not lead to lower concentrations of epinephrine following endotracheal administration, but rather higher concentrations (P < 0.03). In all six lambs, counts per minute of tritium were higher following administration during low pulmonary blood flow. There was a negative correlation between pulmonary blood flow and arterial plasma tritium counts per minute (r = -0.64, P < 0.03). We conclude that trans-pulmonary absorption of epinephrine is not decreased during times of hypoxia-induced low pulmonary blood flow. These data lend support to the clinical practice of intratracheal epinephrine administration during neonatal resuscitation.

Animals↗
PubMed1987

Elastic recoil pressure arising from surface tension in hamster lungs treated with intratracheal bleomycin.

Lung elastic recoil pressure arising from surface tension (Ps) was evaluated in normal and bleomycin-treated lungs. Twenty two male golden hamsters were separated into a control group (group A, n = 10) and a bleomycin group (group B, n = 12). Group B was given a single intratracheal instillation of bleomycin and group A was given normal saline as a control. Thirty days after instillation, three cycles of static air -and saline-filled pressure-volume curves (P-V curve) were measured. Ps was graphically derived from air- and saline-filled P-V curves. The Ps of groups A and B were compared at the same lung volumes. Mean body weight and nose-to-tail length of the two groups did not differ significantly. Total lung capacity, defined as lung air volume at a transpulmonary pressure of 25 cmH2O, was significantly smaller in group B (mean +/- S.E. was 4.08 +/- 0.20 ml) than in group A (mean +/- S.E. was 5.23 +/- 0.12 ml) (p less than 0.01). The Ps of group B was significantly larger than that of group A at all lung volumes studied (p less than 0.01-0.05). These results indicate that the lung elastic recoil pressure component due to the surface tension was increased by intratracheal instillation of bleomycin in hamsters.

Animals↗