• 제목/요약/키워드: Endotracheal tube

검색결과 142건 처리시간 0.027초

레이저 조사에 의한 endotracheal tubes의 안정성에 대한 연구

  • 정필상;김영훈;정필섭;이정구
    • 대한기관식도과학회:학술대회논문집
    • /
    • 대한기관식도과학회 1995년도 이비인후과 종합학술대회 초록집
    • /
    • pp.91.2-91
    • /
    • 1995
  • 레이저를 이용한 구강 및 인후두 수술시 endotracheal tubes의 손상은 치명적이라 아니 할 수 없다. 이에 저자들은 여러 가지 endotracheal tube를 실험 재료로 사용하여 보다 안전한 레이저 수술을 위해서 적절한 endotracheal tube를 찾기 위해 본 실험을 시행하였다. 실험에 사용된 tube는 총 5가지 - $Bivona^{TM}$, Xomed Laser Shield $II^{TM}$, Mallinckrodt Laser-$Flex^{TM}$, Rusch tube wrapped with aluminium foil tape(Rusch tube), Polyvinylchloride tube wrapped with aluminium foil tape(PVC tube) - 가 사용되었다. 사용된 레이저는 KTP/532 와 $CO_2$ laser 이며 모든 실험에서 tube를 $FiO_2$ 95%-98% 상태에서 조사하여 각각 5회씩 실시하였다. tube에 이상이 없거나 발화가 되지 않는 한 90초 동안 시행하였다. 실험 결과, KTP/532 조사시 $Bivona^{TM}$, Mallinckrodt 와 PVC tube는 심한 손상을 받거나 발화하였으며 Xomed 와 Rusch tube는 안정된 상태를 유지하였고 $CO_2$ Laser 조사시는 KTP/532 조사시와 유사한 결과를 얻었다. 한편 혈액을 endotracheal tube에 도포한 상황에서는 모든 tube가 더 심한 손상을 보이는 바 KTP/532 조사시 Xomed는 상당히 안정된 상태를 유지하였고 나머지 tube는 심한 손상 또는 발화를 보이고 $CO_2$ Laser 조사시 $Bivona^{TM}$ 와 Mallinckrodt는 발화하였고 Rusch tube는 표면이 녹았으며 Xomed와 PVC tube도 1례에서 발화하였다. 향후 이비인후과 영역에서의 레이저 수술이 증가함을 예상할 때 좀 더 레이저에 대하여 안정적이고 경제적인 endotracheal tube의 개발이 필요할 것으로 사료된다.

  • PDF

기관내삽관 및 후두튜브 삽관의 교육지속효과 -마네킨연구- (Memory retention of education regarding endotracheal and laryngeal tube intubation -A manikin study-)

  • 김정선;최욱진
    • 한국응급구조학회지
    • /
    • 제20권3호
    • /
    • pp.85-93
    • /
    • 2016
  • Purpose: The purpose of this study was to investigate the education retention effect of endotracheal and laryngeal tube intubation using a manikin study. Methods: The study consisted of measuring intubation time, intubation success rate, and confidence of intubation after education. The evaluation of the education was performed 2 weeks, 4 weeks, and 24 weeks after education and skill tests. The study subjects were 48 paramedic students of third and fourth grade. Results: There was no significant difference in endotracheal intubation time but the time spent performing laryngeal tube intubation significantly increased over time (p<.000). The intubation success rate of endotracheal and laryngeal tube intubation was 100% in the $24^{th}$ week, and there was no significant difference in time spent performing the intubation. The students' confidence in endotracheal (p<.023) and laryngeal tube intubation (p<.001) decreased significantly from the second week to the $24^{th}$ week. Conclusion: This study revealed that it is necessary to spend at least 24 weeks to train students endotracheal and laryngeal intubation to improve the students' confidence in performance of intubation.

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

  • 현아름;최명애
    • 중환자간호학회지
    • /
    • 제3권1호
    • /
    • pp.53-65
    • /
    • 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.

  • PDF

Endotracheal tube damage during surgically assisted rapid palatal expansion surgery; a case report

  • Badger, James
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제20권1호
    • /
    • pp.45-47
    • /
    • 2020
  • Endotracheal tube damage is a well-known complication of maxillary surgery. We report a case of failure to ventilate due to superficial damage to the tubing between the cuff and pilot balloon in the nasal portion of a north facing Ring, Adair and Elwyn pre-formed endotracheal tube during Surgically Assisted Rapid Palatal Expansion surgery. The endotracheal tube was replaced uneventfully and surgery completed successfully. On reflection, we feel that that the vulnerable position of the cuff-pilot tubing significantly contributed to this critical incident and suggest that increased recognition of this is vital for the prevention of such cases in the future.

성문위기도기 인후두튜브(SALT)를 이용한 기관내삽관 신속성과 용이성 비교: 마네킨을 이용한 연구 (Comparison of endotracheal intubation speed and ease by using the supraglottic airway laryngopharyngeal tube: A manikin study)

  • 윤성우
    • 한국응급구조학회지
    • /
    • 제19권2호
    • /
    • pp.29-38
    • /
    • 2015
  • Purpose: The purpose of this study was to improve airway management ability by comparing the speed, angle of the neck, and confidence and ease of supraglottic airway laryngopharyngeal tube (SALT) and endotracheal intubation via direct laryngoscopy. Methods: The subjects of this experimental research study with a randomized crossover design were 44 emergency medicine technician - paramedics working in the fire department of 'J' - do. SPSS version 19.0 was used in the statistical analysis. Results: Speed and angle of the neck (p<.001), as well as confidence and ease (p<.001), showed significant differences between endotracheal intubation with a SALT and endotracheal intubation via direct laryngoscopy. Conclusion: If endotracheal intubation via direct laryngoscopy is difficult to use or in trauma patients, using a SALT is safe and enables fast intubation. Moreover, in order to improve the efficiency of advanced airway management, the application of SALT should be introduced in the domestic scene.

Selection of Appropriate Endotracheal Tube in Wild Birds

  • Jang, Jin-Ho;Park, Young-Seok;Kim, Hee-Jong;Kim, Hye Kwon;Yun, Young-Min
    • 한국임상수의학회지
    • /
    • 제35권5호
    • /
    • pp.184-189
    • /
    • 2018
  • Wild birds rescued for various reasons are injured and admitted to a wild animal rescue center. With the case of collision with cars, buildings and wires on a power pole, most wild birds are severely traumatized or get fractured, which need intensive veterinary treatment. In general, inhalation anesthesia to wild birds is the best choice for the medical and surgical procedure, and intubation is recommended for the stable anesthesia. Although the certain size of an endotracheal tube can be chosen depending on the size and morphology of the bird, there are a few standardized guidelines. Therefore, the optimal endotracheal size of the rescued 162 individual birds of 41 species for four years from March 2014 to December 2017 was investigated and sorted empirically, suggesting possibly the appropriate endotracheal sizes for diverse avian species. It may provide practical information data for wildlife veterinarians to select the size of an endotracheal tube according to the size of the domestic wild bird species, especially during surgery in the emergency cases.

기관 협착에서 Long T-tube의 삽입 방법 (A technique for insertion of a long T-tube in tracheal stenosis)

  • 백만종
    • Journal of Chest Surgery
    • /
    • 제26권8호
    • /
    • pp.664-666
    • /
    • 1993
  • A technique for insertion of a long silicone T-tube in patient with critical stenosis and high-risk resection and primary anastomosis of long segment of the distal trachea is presented. It was not easy to insert a long T-tube by existing methods because of flexibility of a T-tube and tightness of stenosis. So we used a silastic endotracheal tube and guiding wire as stylet of a T-tube. During insertion, ventilation was normally maintained through the lumen of endotracheal tube. This provided rapid relief from airway obstruction and asphyxation and is a easy, safe and effective method to restore patency of the major airways.

  • PDF

Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
    • /
    • 제77권5호
    • /
    • pp.215-218
    • /
    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

Airway obstruction by dissection of the inner layer of a reinforced endotracheal tube in a patient with Ludwig's angina: A case report

  • Shim, Sung-Min;Park, Jae-Ho;Hyun, Dong-Min;Lee, Hwa-Mi
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제17권2호
    • /
    • pp.135-138
    • /
    • 2017
  • Intraoperative airway obstruction is perplexing to anesthesiologists because the patient may fall into danger rapidly. A 74-year-old woman underwent an emergency incision and drainage for a deep neck infection of dental origin. She was orally intubated with a 6. 0 mm internal diameter reinforced endotracheal tube by video laryngoscope using volatile induction and maintenance anesthesia (VIMA) with sevoflurane, fentanyl ($100{\mu}g$), and succinylcholine (75 mg). During surgery, peak inspiratory pressure increased from 22 to $38cmH_2O$ and plateau pressure increased from 20 to $28cmH_2O$. We maintained anesthesia because we were unable to access the airway, which was covered with surgical drapes, and tidal volume was delivered. At the end of surgery, we found a longitudinal fold inside the tube with a fiberoptic bronchoscope. The patient was reintubated with another tube and ventilation immediately improved. We recognized that the tube was obstructed due to dissection of the inner layer.