• Title/Summary/Keyword: Intubation

Search Result 599, Processing Time 0.025 seconds

Risk factors affecting the difficulty of fiberoptic nasotracheal intubation

  • Rhee, Seung-Hyun;Yun, Hye Joo;Kim, Jieun;Karm, Myong-Hwan;Ryoo, Seung-Hwa;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.20 no.5
    • /
    • pp.293-301
    • /
    • 2020
  • Background: The success rate of intubation under direct laryngoscopy is greatly influenced by laryngoscopic grade using the Cormack-Lehane classification. However, it is not known whether grade under direct laryngoscopy can also affects the success rate of nasotracheal intubation using a fiberoptic bronchoscpe, so this study investigated the same. In addition, we investigated other factors that influence the success rate of fiberoptic nasotracheal intubation (FNI). Methods: FNI was performed by 18 anesthesiology residents under general anesthesia in patients over 15 years of age who underwent elective oral and maxillofacial operations. In all patients, the Mallampati grade was measured. Laryngeal view grade under direct laryngoscopy, and the degree of secretion and bleeding in the oral cavity was measured and divided into 3 grades. The time required for successful FNI was measured. If the intubation time was > 5 minutes, it was evaluated as a failure and the airway was managed by another method. The failure rate was evaluated using appropriate statistical method. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were also measured. Results: A total of 650 patients were included in the study, and the failure rate of FNI was 4.5%. The patient's sex, age, height, weight, Mallampati, and laryngoscopic view grade did not affect the success rate of FNI (P > 0.05). BMI, the number of FNI performed by residents (P = 0.03), secretion (P < 0.001), and bleeding (P < 0.001) grades influenced the success rate. The AUCs of bleeding and secretion were 0.864 and 0.798, respectively, but the AUC of BMI, the number of FNI performed by residents, Mallampati, and laryngoscopic view grade were 0.527, 0.616, 0.614, and 0.544, respectively. Conclusion: Unlike in intubation under direct laryngoscopy, in the case of FNI, oral secretion and nasal bleeding had a significant effect on FNI difficulty than Mallampati grade or Laryngeal view grade.

palliative intubation for advanced esophageal cancer (진행성 식도암의 고식적 식도삽관술)

  • 공현우
    • Journal of Chest Surgery
    • /
    • v.22 no.1
    • /
    • pp.146-150
    • /
    • 1989
  • Dysphagia is common in patients with cancer of the esophagus. The rate of resectability of the lesion is low, and the majority of the patients require palliation to relieve the dysphagia. Celestin tube intubation was performed in patients with unresectable carcinoma of the esophagus, of one with malignant bronchoesophageal fistula. Dysphagia and respiratory symptoms were relieved and the patients became able to eat semi-solid food and fully ambulatory.

  • PDF

THE CASES REPORT OF THE CHRONIC ALVEOLAR ABSCESS TREATED BY APICOCETOMY AND INTUBATION TECHIQUE (치근단절제술후 배농관 삽입에 의한 만성치조농양 치험례)

  • Gwon, Hyeok-Chun
    • The Journal of the Korean dental association
    • /
    • v.14 no.5
    • /
    • pp.461-463
    • /
    • 1976
  • The case of chronic alverolar abscess treated by apicoectomy and intubation technique is reported. The chronic alverolar abscess developed at the apex of the right lower first premolar in the 30-year old Korean female. And the lesion involved the root of the adjacent second premolar.

  • PDF

Pre-hospitalization Advanced Airway Management Using The KING LTS-DTM and the LMA ProSealTM (LTS와 LMA를 이용한 병원 전 전문 기도 관리 연구)

  • Choi, Uk-Jin;Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.13 no.12
    • /
    • pp.5893-5900
    • /
    • 2012
  • It is very critical to promptly maintain airway of cardiac arrest cases or serious traumatic cases. The purpose of this study is to compare intubation rate, successful rate and pre-/post-education self-confidence between laryngeal tube (LTS) and proseal laryngeal mask (PLMA), so that it may contribute to improving the ability of 119 emergency team - a pivotal role in pre-hospitalization process - to carry out advanced airway management. In order to achieve the purpose, total 60 paramedics (Class I) who worked for incumbent 119 emergency team were asked to join a practical experiment and were also divided into two groups (LTS group: 30 people, PLMA group: 30 people). In details, they were all asked to take 3 sessions of practice (5 minutes per session) using dummy model to quantitatively measure the time and success/failure of intubation and the change of their self-confidence. As a result, it was found that there were statistically significant differences in the time of intubation between LTS and PLMA group (p=.000), but there was no significant difference in the rate of successful intubation between these two groups, and self-confidence of two groups tended to significantly increase after experiment (p=.000). Conclusively, if it is necessary to promptly apply intubation to traumatic cases with immobilized cervical vertebral and lingual edema, LTS can be useful as an effective means of intubation. And it is expected that continuing intubation training using LTS will improve the ability of emergency team to perform advanced airway management for traumatic cases.

A clinical study on the 16 cases of intubation granuloma (후두 삽관육아종 16례에 대한 임상적 고찰)

  • 김용신;김정은;차형근;장백암
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1993.05a
    • /
    • pp.76-76
    • /
    • 1993
  • Endotracheal intubation is common technique for general anesthesia or patency of airway. However, laryngeal intubation granuloma is the most common sequale of endotracheal intubation in otolaryngologic field. From 1982 to 1992, the authors had experienced 16 cases intubation granuloma. The following results were as follows; 1. Age distribution was mostly in the 20 to 49 years old group (84 %).The sex ratio of male to female was 1:7, predominantly in female. 2. Main sx. were hoarse in 12(75%), F.B. sensation in 3(18%), dyspnea in 1 (6%). 3. The side of lesion was bilateral in 6 cases (37%) and unilateral in 10 cases (63%). Unilateral had the 3 cases (30%) in left and the 7 cases (70%) in right. The location of mass was vocal process of arytenoid cartilage in 8 cases(50%), post 1/3 of vocal cord in 6 cases (37 %) and middle 1/3 of vocal cord in 2 cases (12 %). 4. The duration between extubation and onset of symptom in less than a month was most frequent in 7 cases (44 %) out of 16 cases. 5. The most common operation was cesarean section in 6 cases (37 %). 6. Mean duration of intubation time was 2 hour 5 minutes. 7. Composition of used intubation tube was red rubber tube. 8. One case (6 %) was recurred.

  • PDF

Update of minimally invasive surfactant therapy

  • Shim, Gyu-Hong
    • Clinical and Experimental Pediatrics
    • /
    • v.60 no.9
    • /
    • pp.273-281
    • /
    • 2017
  • To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

The Effect of Dietary Zinc on Lipid Metabolism in Cadmium Treated Rats (식이성 아연과 카드뮴이 흰쥐의 체내 지질대사에 미치는 영향)

  • 이미경;조수열;박은미;김명주
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.23 no.5
    • /
    • pp.718-724
    • /
    • 1994
  • The study was conducted to investigated the effect of dietary levels of zinc (Zn) on lipid metabolism in cadmium (Cd) treated rats. Sixty male Sprague-Dawley rats weighing about 110$\pm$10g were divided into 6 groups. The Zn levels were low (0ppm), control (30 ppm) and Cd-treated groups were administrated with Cd chloride (5.0mg/kg of body weight) by oral intubation at the same time once a week. Serum total lipid, triglyceride , total cholesterol and DHL-cholesterol contents decreased significantly in low Zn group. In serum dietary high Zn group, it decreased significantly in the content of triglyceride but total cholesterol and HDL- cholesterol revealed increase slightly . Total lipid and triglyceride contents increased by Cd oral intubation, but triblyceride content of control group decreased significantly in Cd-treated groups. HDL-cholesterol content also decreased by Cd oral intubationl. Cd-treatment increased total cholesterol content in low Zn group. Liver triglyceride content increased as dietary Zn level became more increasing and total lipid was not influenced by dietary Zn levels. Liver cholesterol content was higher in low and high Zn groups than that of control group. Liver phospholipid content decreased in low Zn group . Oral intubation of Cd increased in the contents of triglyceride and total lipid. The content of liver Zn was not influenced by the dietary low Zn but that of serum showed a remarkable increased . Oral Cd intubation increased the Cd contents of liver and serum.

  • PDF

Pharyngeal flap damage caused by nasotracheal intubation in a patient who underwent palatoplasty and pharyngoplasty

  • Oh, Jong-Shik;Choi, Hong-Seok;Kim, Eun-Jung;Kim, Cheul-Hong;Yoon, Ji-Uk;Yoon, Ji-Young
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.16 no.4
    • /
    • pp.309-312
    • /
    • 2016
  • Patients with cleft lip and palate (CLP) must undergo corrective surgeries during infancy and early childhood. Many patients with CLP undergo orthognathic surgery during their childhood for correction of skeletal asymmetries or pharyngoplasty with a pharyngeal flap to improve the quality of speech and velopharyngeal function. During orthognathic surgeries, nasotracheal intubation is performed under general anesthesia. In our case report, the patient had undergone palatoplasty and pharygoplasty previously. During the orthognathic surgery, a flexible fiberoptic bronchoscope-guided nasotracheal tube was inserted through the pharyngeal flap ostium; however, active bleeding occurred in the nasopharynx. Bleeding occurred because the flap was torn. After achieving hemostasis, the surgery was completed successfully. Thus, if a patient may show the potential for velopharyngeal port obstruction, nasotracheal intubation should be performed with utmost care.

USE OF LARYNGEAL MASK AIRWAY (LMA) FOR DENTAL TREATMENT IN MENTALLY RETARD PATIENT WITH DIFFICULT AIRWAY -A CASE REPORT- (기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료)

  • Yi, Young-Eun;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Teo-Jeon
    • The Journal of Korea Assosiation for Disability and Oral Health
    • /
    • v.4 no.2
    • /
    • pp.88-91
    • /
    • 2008
  • A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

  • PDF