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At least 73 records · Page 4Linked to original sources
PubMed1977

[Laryngeal complications in newborns following intratracheal intubation (author's transl)].

Histological and bacteriological findings in comparison to clinical data concerning intubation for 38 dead premature infants and newborns were studied to elucidate conditions complicating intratrachial intubation at the laryngeal level. The larynx was intact in 3 cases. Slight lesions of mucosa (epithelabrasion, hemorrhage) were found in 13, moderately severe lesions (necrosis of epithelium, ulcers, pseudomembranes) in 11, and severe lesions (deep necrosis, perichondritis with sceletisation) in 10 cases. 1 case showed a stage of regeneration. The narrow passage between the two processus vocales is a site of predilection for tubus-induced lesions, the epithelium bein immediately adjacent to the cartilage. Successful bacteriological demonstration of the infectious agent correlated with the rising degree of mucosal lesions, and increasing duration of intubation. 3 cases, however, already had severe lesions after short-time-intubation. Formal and causal pathogenesis are described. Essential causes are: trauma of intubation, irritation by the tubus in situ, duration of intubation, and infection. Regenerative power of the infantile laryngeal mucosa is strong. Permanent lesions may occur as scarred stenosis. Careful indication, accurate and careful technology of intubation, choice of the smallest possible diameter of tubus, good care for the tubus, and generous prophylaxis against infections are to be demanded.

Hemorrhage↗
PubMed1992

[Consequences and prevention methods of hemodynamic changes during laryngoscopy and intratracheal intubation].

In patients ranked ASA 1, laryngoscopy and intubation lead to an average increase in blood pressure of 40 to 50%, and a 20% increase in heart rate. These changes, which are greatest one minute after intubation, last for 5 to 10 min. They are due to sympathetic and adrenal stimulation, which may also result in some arrhythmias. About half the patient with coronary artery disease experience episodes of myocardial ischaemia during intubation when no specific prevention is undertaken. Among the different means available for this, narcotics seem to have a reliable and constant effect, but they may be responsible for postoperative respiratory depression. The protective effect of fentanyl starts at 2 micrograms.kg-1, and is at a maximum at 8 micrograms.kg-1. Lidocaine is the drug used most. Recent studies have questioned its efficacy. In clinical practice, it is particularly effective in preventing the pressor response to tracheal intubation, whatever its route of administration (intravenous or intratracheal), but not the increase in heart rate. Beta blockers with bradycardic, antihypertensive, antiarrhythmic and antiischaemic properties, have been advocated. As opposed to lidocaine, these agents are more effective in preventing the changes in heart rate than the pressor response. Because of their depressor effect on the myocardium, their place still remains to be defined, especially in the cardiac risk patient. Short-acting beta blockers should be preferred. Nitroglycerin is specifically indicated in coronary artery disease. Other agents, such as clonidine or calcium blockers, seem to be less effective or less convenient in preventing the haemodynamic alterations. In clinical practice, prevention will first rely on a sufficient dose of narcotics. In some cases, nitroglycerin or beta blockers may be used so as to decrease the doses of narcotics, without altering their efficacy; however, the risk of hypotension should be constantly borne in mind. If preventing measures have not been taken, short-acting antihypertensive agents (beta blockers, calcium blockers) should be used in patients who develop major hypertension during laryngoscopy and intubation.

Analgesics, Opioid↗
PubMed2005

[Risk factors for postoperative pulmonary complications after gastroduodenal operation].

OBJECTIVE: To investigate the risk factors for postoperative pulmonary complications (PPC) after gastroduodenal operation. METHODS: From December 1999 to December 2003, clinical data of 508 patients undergoing gastroduodenal operation were analyzed retrospectively. Risk factors for PPC were screened. RESULTS: The complication rate of PPC was 25.8% (131/508). Multivariate logistic regression analysis revealed that age (OR=1.052), history of respiratory diseases (OR=2.915), serum albumin level (OR=0.995), length of intratracheal intubation (OR=1.005), length of nasogastric intubation (OR=1.059) and length of postoperative mechanical ventilation (OR=1.367) were risk factors for PPC. CONCLUSION: Patients with old age, lower serum albumin level, intraoperative or postoperative nasogastric intubation, intratracheal intubation or long-term mechanical ventilation were more prone to develop PPC.

Adolescent↗
PubMed1995

Intratracheal stent intubation under extracorporeal lung assist.

An artificial stent was intubated using extracorporeal lung assist (ECLA) in two patients with inoperable tracheal stenosis. In a patient with an endotracheal tumor, an airway obstruction due to a partial stent collapse was overcome by an immediate ECLA perfusion. In another patient with chronic inflammatory tracheal stenosis, a repetitive balloon dilation of the trachea could be safely performed utilizing ECLA perfusion. Preventive femoral cannulation, employing the assistance of an ECLA circuit, is thus considered to be a safe and effective procedure for the treatment of inoperable tracheal stenosis.

Adult↗
PubMed2005

Bluntly traumatic tracheal transection: usefulness of percutaneous cardiopulmonary support for maintenance of gas exchange.

Respiratory management of tracheal injuries is a crucial key to successful treatment. We present herein a patient with a traumatic tracheal transection in whom we confronted difficulty in airway management after false intratracheal intubation. No associated injuries were seen in the patient, then, primary repair of the trachea was carried out under ventilatory support via percutaneous cardiopulmonary support system (PCPS). For a short period in the application of PCPS, the use of a heparin-coated circuit made systemic heparinization unnecessary during and after operation, and the outcome was satisfactory. In a carefully selected patient, ventilatory support via PCPS is useful.

Adolescent↗