• Title/Summary/Keyword: Endotracheal Intubation

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Implementation of Venoarterial Extracorporeal Membrane Oxygenation in Nonintubated Patients

  • Kim, Hyeon A;Kim, Young Su;Cho, Yang Hyun;Kim, Wook Sung;Sung, Kiick;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.17-24
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    • 2021
  • Background: Although extracorporeal membrane oxygenation (ECMO) is generally performed percutaneously, the technology is deployed under sedation and necessitates endotracheal intubation. However, in some patients, the use of venoarterial (VA) ECMO without intubation may be beneficial. Herein, we describe our experiences with VA ECMO performed without prior endotracheal intubation. Methods: A total of 783 patients treated with VA ECMO at a single center between January 2013 and July 2018 were reviewed retrospectively. We included patients who underwent successful VA ECMO implementation without prior endotracheal intubation, and excluded those who were younger than 18 years, had ongoing cardiopulmonary resuscitation status, and had poor quality of the vessels needed for percutaneous cannulation. The primary study outcome was in-hospital survival. Results: In total, 50 patients were included in this study, 94% of whom showed cardiogenic shock. The mean age of the study participants was 56.3±14.5 years. The median VA ECMO support time was 7 days (range, 2-13 days). Twenty-one patients (42%) did not receive ventilator care during the VA ECMO support period, while 29 patients (58%) progressed to intubation after VA ECMO implementation. The rates of survival at discharge and weaning success were 82% (n=41) and 92% (n=46), respectively, and 80% (n=40) of patients presented good Glasgow-Pittsburgh Cerebral Performance Categories scores at discharge. Conclusion: Even in patients with cardiogenic shock, percutaneous VA ECMO can be introduced safely without prior endotracheal intubation by an experienced care team. The application of nonintubated VA ECMO might be a feasible strategy in selected cases.

Design and Implementation Endoscope System for Endotracheal Intubation (기관 내 삽관을 위한 내시경 시스템 설계 및 구현)

  • Kim, H.S.;Kang, S.K.;Kim, G.Y.;Han, Y.H.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.2
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    • pp.153-160
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    • 2015
  • With the development of recent IT fusion technology, IT fusion technology of medical equipment has been dramatically development. The need to most basic preferential implementation of emergency is the respiration of the patient, it is necessary to first aid is maintained in emergency patients airway simultaneously. However, to the endotracheal intubation is a procedure to secure the airway, it requires experience and first aid, Inc. good career, very that may lead to sequelae in patients who otherwise have failed to procedures It is a sensitive and important procedure. For these reasons, the success rate of current endotracheal intubation technique is not at a high level and about 50 percent. In an attempt to complement these problems, in this paper, in the process of endotracheal intubation, intubated by inserting an endoscopic camera to Into Activation tube, the streaming is a real-time monitoring and wireless video transmission method using, there is a purpose of enabling the monitoring in smart devices increase the success rate of endotracheal intubation of first aid purchases.

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Clinical Analysis of the Laryngo-Tracheal Stenosis (후두 및 기관협착증의 임상적 고찰)

  • 김영호;최은창;최재영;홍원표
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.261-269
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    • 1997
  • When performing an endotracheal intubation or tracheotomy to an unconscious patient in emergent situations, one should consider the possibility of later complication of laryngo-tracheal stenosis which can result in difficulties in decannulation. Laryngo-tracheal stenosis is a bothersome problem developing as a complication of treatment by tracheotomy with a cuffed tube and long-term endotracheal intubation with assisted ventilation. One hundred twenty-three cases of laryngo-tracheal stenosis patients during the four yew period from May 1992 to April 1996 were restrospectively reviewed according to several parameters such as the duration of intubation, site of stenosis, treatment modality and, site of tracheostoma. The present report is an analysis of these materials to search for the possible etiologic factors and its proper preventive methods. It was desirable that the endotracheal intubation should be limited within 20 days at most. Tracheotomy performed by non-otolaryngologists has a tendency to be on a higher level of trachea. Technical precautions should be taken into consideration when doing a tracheotomy. The success rate of decannulation of tracheal T-tube was 78.8% and it required average 11 months.

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Effect of Short-Term Endotracheal Intubation on Vocal Function (단기간 기관지 삽관후의 음성의 변화)

  • 장혁기;강무완;최정환;유영삼;우훈영;윤자복
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.64-68
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    • 2000
  • Background and Objectives : To assess the role of altered vocal function in transient voice change after short-term endotracheal intubation, we evaluated acoustic parameters, aerodynamic parameters, and laryngoscopic characteristics preoperatively and postoperatively. Materials and Methods : Vocal function of 10 patients undergoing tympanoplasty and mastoidectomy using general anesthesia and endotracheal intubation were studied preoperatively, at 1day and 7 days after extubation. Acoustic analysis, aerodynamic study, and telescopic examination were used to assess vocal function. Results : In acoustic parameters, there was no significant difference between preoperative and postoperative measures. However, in subglottic pressure, ere was a significant decrease at 1 day after extubation and this change was return to preoperative value at 7 days after extubation. MPT(Maximal Phonation Time), MER(Mean flow Ratio), and VC(Vital Capacity) were decreased 1 day after extubation but did not show statistically significant change. Three of 10 patients manifested a vocal fold edema and injection 1 day after extubation. Conclusions : Subglottic pressure revealed a significant decrease at 1 day after extubation. And this change was correlated with laryngeal morphologic change and decrement in pulmonary function.

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A Case of Bacterial Tracheitis Associated with Endotracheal Intubation and Corticosteroid (기관내삽관과 스테로이드 사용 후 발생한 세균성 기관염 1예)

  • Lim, Jae-Min;Kim, Jung-Ho;Jung, Heon-Nyoung;Kim, Eun-Kyung;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.332-336
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    • 2002
  • Bacterical tracheitis is a very rare complication in adults after endotracheal intubation. We report a case of bacterial tracheitis associated with endotracheal intubation and corticosteroids. The patient was discharged with a permanent tracheostomy, and a resection and an end-to-end anastomosis of the trachea is planned.

Efficiency of modified ramped position during the endotracheal intubation (기관내삽관 시 수정된 경사면자세의 효율성)

  • Jung, Sooyeon;Jung, Jun-Ho;Yun, Seong-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.306-308
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    • 2022
  • The purpose of this study is to compare and analyze the sniffing position and the modified ramped position, which was created by using a specially designed instrument, to improve the performance of advanced airway management during endotracheal intubation. The study included 30 students from the Department of Emergency technology, N University, who had completed advanced cardiac life support and advanced airway management. The randomized crossover study was conducted with the students who were randomly assigned into two groups; Sniffing position and Modified ramped position. As a result of the study, the modified ramped position showed better glottal vision than the sniffing posture, and there was a significant difference in speed time. In the subject's subjective ease, confidence, and preference, the modified ramped position showed better results than the sniffing posture. Therefore, it is considered that modified ramped position during endotracheal intubation will help improve the performance of advanced airway management.

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A Comparison of Cardiovascular Effects between Orotracheal Intubation and Nasotracheal Intubation (경구기관삽관법과 경비기관삽관법의 심혈관계 영향에 대한 비교)

  • Kim, Dong-Ok;Choi, Young-Kyoo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.10-15
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    • 2001
  • Background: This prospective study was designed to compare the cardiovascular response to endotracheal insertion of either an orotracheal tube or a nasotracheal tube Methods: 120 ASA physical status I and II surgical patients requiring general anesthesia and tracheal intubation were studied and assigned to two groups: orotracheal intubation group (n = 60) and nasotracheal intubation group (n = 60). Patients were premedicated with midazolam 0.05 mg/kg and glycopyrrolate 0.005 mg/kg intramuscularly and anesthesia was induced with thiopental sodium 5 mg/kg and succinylcholine 0.1 mg/kg intravenously. Systolic blood pressure (SBP), diastolic blood pressure (DBP). mean arterial pressure (MAP) and heart rate (HR) were assessed noninvasively before induction of anesthesia and immediately after intubation, 1 min, 2 min, 3 min, and 5 min after intubation. Results: Cardiovascular responses such as SBP, DBP, MAP and HR were similar for both techniques and no significant differences between two groups were observed until 5 min after intubation. Conclusions: In healthy ASA I and II patients with normal blood pressure, induction doses of thiopental sodium 5 mg/kg and succinylcholine 0.1 mg/kg didn't attenuated the cardiovascular response to laryngoscopy and tracheal intubation. Insertion of an endotracheal tube may be the most invasive stimulus during intubation procedures. (JKDSA 2001; 1: 10-15)

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Patient Discomfort Caused by an Endotracheal Tube during Ventilator Therapy after Cardiac Surgery (심장 수술 후 인공호흡기 치료를 받는 환자의 기관내관으로 인한 불편감에 관한 연구)

  • Hyun, A-Reum;Choe, Myoung-Ae
    • Journal of Korean Critical Care Nursing
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    • v.3 no.1
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    • pp.53-65
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    • 2010
  • Purpose: The purpose of this study was to identify the intensity and types of discomfort caused by an endotracheal tube in patients during ventilator therapy after cardiac surgery, and to analyze the differences in the intensity and types of discomfort by sociodemographic and clinical characteristics and characteristics related to endotracheal tubes. Methods: The intensity of discomfort was measured using an 11-point numeric rating scale and the types of discomfort were measured using a 4-point numeric rating scale. Sociodemographic and clinical characteristics and characteristics related to endotracheal tube were collected by observation and the electronic medical chart using a structured questionnaire. Results: The mean intensity of discomfort in patients due to endotracheal tubes was 6,91 points, 84% of patients reported discomfort over 5 points, The most severe discomfort was pain during endotracheal suctioning, and dry mouth and breathing difficulties were also found to induce discomfort. Patients who had more severe surgical site pain, longer duration of intubation and higher cuff pressure demonstrated more severe discomfort due to the endotracheal tube. Conclusion: These results can be used as basic data for developing nursing intervention to relieve the discomfort caused by endotracheal tubes in patients during ventilator therapy.

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Left Bronchial Rupture Following Endobronchial Intubation - One case report - (기관 삽관후 발생한 좌측 주기관지 파열 - 1례 보고 -)

  • 김건일;지현근;김형수;이희성;이원용
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.1014-1016
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    • 1998
  • Rupture of the bronchus following endotracheal intubation with a double-lumen tube is extremely rare in all complications of endotracheal intubation. We experienced a case of left main bronchial rupture following endotracheal intubation. This 58-year old female patient was diagnosed of well-differentiated adenocarcinoma of right lower lobe, stage IIB, preoperatively. She was intubated with Robertshaw double-lumen tube(35 Fr.) for Rt. lower lobectomy. Intraoperatively, Lt. main bronchial rupture was suspected because of pneumomediastinum and ventilation insufficiency and immediately repaired with monofilament absorbable sutures(PDS) through left thoracotomy. Postoperative course was uneventful.

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Two cases of femorofemoral cardiopulmonary bypass prior to induction of anaesthesia in the management of tracheal obstruction by thyroid cancer (기도 폐쇄로 인한 삽관불능이 갑상선 암환자엣 심장폐우회 마취에 의한 치험 2예)

  • 왕수건;김기태;이병주;권재영;김영대;이강대
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.101-104
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    • 2003
  • One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

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