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41.
Recai Dagli Mehmet Canturk Fatma Celik Zeynel Abidin Erbesler Meryem Gurler 《Brazilian Journal of Anesthesiology》2018,68(5):447-454
Background
Macintosh laryngoscopes are widely used for endotracheal intubation training of medical students and paramedics whereas there are studies in the literature that supports videolaryngoscopes are superior in endotracheal intubation training. Our aim is to compare the endotracheal intubation time and success rates of videolaryngoscopes and Macintosh laryngoscopes during endotracheal intubation training and to determine the endotracheal intubation performance of the students when they have to use an endotracheal intubation device other than they have used during their education.Methods
Endotracheal intubation was performed on a human manikin owing a standard respiratory tract by Macintosh laryngoscopes and C-MAC® videolaryngoscope (Karl Storz, Tuttligen, Germany). Eighty paramedic students were randomly allocated to four groups. At the first week of the study 10 endotracheal intubation trials were performed where, Group‐MM and Group‐MV used Macintosh laryngoscopes; Group‐VV and Group‐VM used videolaryngoscopes. Four weeks later all groups performed another 10 endotracheal intubation trial where Macintosh laryngoscopes was used in Group‐MM and Group‐VM and videolaryngoscopes used in Group‐VV and Group‐MV.Results
Success rates increased in the last 10 endotracheal intubation attempt in groups MM, VV and MV (p = 0.011; p = 0.021, p = 0.290 respectively) whereas a decrease was observed in group‐VM (p = 0.008).Conclusions
The success rate of endotracheal intubation decreases in paramedic students who used VL during endotracheal intubation education and had to use Macintosh laryngoscopes later. Therefore we believe that solely videolaryngoscopes is not enough in endotracheal intubation training programs. 相似文献42.
目的 探讨球囊通气和气管插管在院前急救中的应用效果及影响.方法 选取施院前急救的心脏呼吸骤停患者50例,根据选用球囊面罩或者气管插管辅助通气分组,各25例.记录复苏成功率和建立通气时间.结果 球囊面罩组成功5例,死亡20例;气管插管组成功4例,死亡21例,两组成功率差异无统计学意义(P>0.05).球囊面罩组建立通气时间为(9.2±2.4)s,明显少于气管插管组(52.3±14.6)s,差异有统计学意义(P<0.05);两组患者血氧饱和度均大于85%,但是两组差异无统计学意义(P>0.05).结论 两种方法均可有效通气,在院前急救中,应综合分析当时情况,将二者相结合才能提高成功率. 相似文献
43.
目的 探讨用儿童牙刷刷牙配合冲洗法在经口气管插管病人口腔护理的效果.方法 将268例经口气管插管患者随机分为对照组和实验组各134例,对照组采用传统的生理盐水棉球擦洗行口腔护理,实验组采用儿童牙刷刷牙配合冲洗法和负压吸引行口腔护理,比较两组的治疗效果.结果 对照组患者口腔异味、口腔炎、口腔溃疡、肺部感染分别为58、26、18、14、10例,而实验组仅有16、12、7、6、4例;实验组牙菌斑指数也明显低于对照组,经统计学分析,差异均有统计学意义(P< 0.05).结论 采用儿童牙刷刷牙配合冲洗法对经口气管插管患者行口腔护理能有效减少并发症的发生. 相似文献
44.
气管插管致环杓关节脱位10例报告 总被引:1,自引:0,他引:1
目的:探讨气管插管致环杓关节脱位的原因、治疗与预防。方法:总结2000年5月~2010年12月收治的10例环杓关节脱位患者应用喉异物钳复位的临床资料。结果:10例患者中9例行1次治疗,1例行第2次治疗,复位效果满意。结论:了解环杓关节脱位的可能因素,有利于采取预防措施、及时治疗。 相似文献
45.
ZHI-QING LIN ZHU-GE XI DAN-FENG YANG Fu-HUAN CHAO HUA-SHAN ZHANG WEI ZHANG HUANG-LIANG LIU ZAI-MING YANG RU-BAO SUN 《Biomedical and environmental sciences : BES》2009,22(3):223-228
Objective To investigate the oxidative damage to lung tissue and peripherial blood in PM2.5-treated rats. Methods PM2.5 samples were collected using an auto-sampling instrument in summer and winter. Treated samples were endotracheally instilled into rats. Activity of reduced glutathione peroxidase (GSH-Px) and concentration of malondialdehyde (MDA) were used as oxidative damage biomarkers of lung tissue and peripheral blood detected with the biochemical method. DNA migration length (μm) and rate of tail were used as DNA damage biomarkers of lung tissue and peripheral blood detected with the biochemical method. Results The activity of GSH-Px and the concentration of MDA in lung tissue significantly decreased after exposure to PM2.5 for 7-14 days. In peripheral blood, the concentration of MDA decreased, but the activity of GSH-Px increased 7 and 14 days after experiments. The two indicators had a dose-effect relation and similar changing tendency in lung tissue and peripheral blood. The DNA migration length (μm) and rate of tail in lung tissue and peripheral blood significantly increased 7 and 14 days after exposure to PM2.5. The two indicators had a dose-effect relation and similar changing tendency in lung tissue and peripheral blood. Conclusion PM2.5 has a definite oxidative effect on lung tissue and peripheral blood. The activity of GSH-Px and the concentration of MDA are valuable biomarkers of oxidative lung tissue damage induced by PM2.5. The DNA migration length (μm) and rate of tail are simple and valuable biomarkers of PM2 5-induced DNA damage in lung tissues and peripheral blood. The degree of DNA damage in peripheral blood can predict the degree of DNA damage in lung tissue. 相似文献
46.
47.
Variceal hemorrhage (VH) is a lethal complication of portal hypertension. Aspiration occurring during endoscopic intervention
for acute VH is a concern; however, few data exist regarding the efficacy of prophylactic intubation to prevent aspiration
pneumonia. We reviewed all endoscopic procedures for acute VH from January 1995 to December 2002; only patients with the absence
of hepatic encephalopathy greater than stage II and normal chest x-ray at admission were included. The use of prophylactic
intubation, postprocedure chest x-ray, and mortality were recorded. Sixty-two patients (69 bleeding episodes) were identified.
Elective intubation was performed in 42 patients (47 episodes); pulmonary infiltrates developed in 7 of 42 (17%), with an
overall mortality rate of 9 of 42 (21%). Twenty patients (22 episodes) were not intubated. None developed pulmonary infiltrates,
and the overall mortality rate was 1 in 20 (5%). We conclude that in patients with suspected variceal bleeding, elective intubation
is associated with a substantial risk of aspiration pneumonia. 相似文献
48.
Roudsari BS Nathens AB Arreola-Risa C Cameron P Civil I Grigoriou G Gruen RL Koepsell TD Lecky FE Lefering RL Liberman M Mock CN Oestern HJ Petridou E Schildhauer TA Waydhas C Zargar M Rivara FP 《Injury》2007,38(9):1001-1013
OBJECTIVES: To compare patient- and injury-related characteristics of trauma victims and pre-hospital trauma care systems among different developed and developing countries. METHOD: We collated de-identified patient-level data from national or local trauma registries in Australia, Austria, Canada, Greece, Germany, Iran, Mexico, New Zealand, the Netherlands, the United Kingdom and the United States. Patient and injury-related characteristics of trauma victims with injury severity score (ISS) >15 and the pre-hospital trauma care provided to these patients were compared among different countries. RESULTS: A total of 30,339 subjects from one or several regions in 11 countries were included in this analysis. Austria (51%), Germany (41%) and Australia (30%) reported the highest proportion of air ambulance use. Monterrey, Mexico (median 10.1min) and Montreal, Canada (median 16.1min) reported the shortest and Germany (median: 30min) and Austria (median: 26min) reported the longest scene time. Use of intravenous fluid therapy among advanced EMS systems without physicians as pre-hospital care providers, varied from 30% (in the Netherlands) to 55% (in the US). The corresponding percentages in advanced EMS systems with physicians actively involved in pre-hospital trauma care, excluding Montreal in Canada, ranged from 63% (in London, in the UK) to 75% in Germany and Austria. Austria and Germany also reported the highest percentage of pre-hospital intubation (61% and 56%, respectively). CONCLUSION: This study provides an early look at international variability in patient mix, process of care, and performance of different pre-hospital trauma care systems worldwide. International efforts should be devoted to developing a minimum standard data set for trauma patients. 相似文献
49.
Background Tracheobronchial foreign body (TFB) removal in adult patients using the combined technique of flexible bronchoscopy (FBSC)
through the endotracheal tube as well as using the simple FBSC has not often been described. This study reports our experience
with FBSC for removal of TFBs and describes diagnosis, techniques of removal, and types of TFBs.
Methods We retrospectively examined bronchoscopic records of adult patients performed between 1995 and 2006 and collection of foreign
bodies in Clinical Department for Respiratory Diseases, University Hospital Split, Croatia.
Results TFBs were found in 86 (0.33%) out of 26,124 patients who were submitted to bronchoscopy. The majority of the patients (90%)
had some risk factor for aspiration, among which stroke (30%) was the most frequent. Patients with different neurologic and
neuromuscular diseases together accounted for 58% of all patients with TFB aspiration. Medical history was suggestive of foreign
body aspiration in 38.4% of the patients, while chest X-ray was indicative in 7% of the patients. TFBs were most often found
in the right bronchial tree (75.6%). The most common TFBs were animal and fish bones (39.5%). In 90.7% of the patients they
were successfully removed under FBSC, whereas in 8.1% of the patients a TFB was extracted with flexible bronchoscope through
endotracheal tube. Surgery was needed in only one case.
Conclusions Although foreign bodies in the tracheobronchial tree are rare in adults, the clinician must be aware of their likelihood.
Foreign body aspiration should be considered especially in the etiology of recurrent lung diseases and in the presence of
risk factors for aspiration, in particular with different neurologic and neuromuscular diseases. They can be successfully
and safely removed in the majority of patients under local anesthesia by using FBSC. In cases when repeated procedure is needed,
endotracheal tube is recommended. 相似文献
50.
Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: a clinical trial 总被引:2,自引:1,他引:1
Berra L Kolobow T Laquerriere P Pitts B Bramati S Pohlmann J Marelli C Panzeri M Brambillasca P Villa F Baccarelli A Bouthors S Stelfox HT Bigatello LM Moss J Pesenti A 《Intensive care medicine》2008,34(6):1030-1037
OBJECTIVE: Coated medical devices have been shown to reduce catheter-related infections. We coated endotracheal tubes (ETT) with silver sulfadiazine (SSD), and tested them in a clinical study to assess the feasibility, safety, and efficacy of preventing bacterial colonization. DESIGN: A prospective, randomized clinical trial, phase I-II. SETTING: Academic intensive care unit (ICU). PARTICIPANTS: Forty-six adult patients expected to need 12-24 h of intubation were randomized into two groups. INTERVENTIONS: Patients were randomized to be intubated with a standard non-coated ETT (St-ETT, n=23; control group), or with a SSD-coated ETT (SSD-ETT, n=23). MEASUREMENTS AND RESULTS: Coating with SSD prevented bacterial colonization of the ETT (frequency of colonization: SSD-ETT 0/23, St-ETT 8/23; p<0.01). No organized bacterial biofilm could be identified on the lumen of any ETT; however, SSD was associated with a thinner mucus layer (in the SSD-ETT secretion deposits ranged from 0 to 200 microm; in the St-ETT deposits ranged between 50 and 700 microm). No difference was observed between the two groups in the tracheobronchial brush samples (frequency of colonization: SSD-ETT 0/23, St-ETT 2/23; p=0.48). No adverse reactions were observed with the implementation of the novel device. CONCLUSION: SSD-ETT can be safely used in preventing bacterial colonization and narrowing of the ETT in patients intubated for up to 24 h (mean intubation time 16 h). 相似文献