BACKGROUND Pre-hospital paediatric airway management is complex. A variety of pitfalls need prompt response to establish and maintain adequate ventilation and oxygenation. Anatomical disparity render laryngoscopy different compared to the adult. The correct choice of endotracheal tube size and depth of insertion is not trivial and often challenged due to the initially unknown age of child. ME...

We evaluated the use of pressure support to compensate for the added inspiratory work of breathing due to the resistances of endotracheal tubes and a ventilator demand-valve system for continuous positive airway pressure (CPAP). A mechanical model was used to simulate spontaneous breathing at five respiratory rates through 7-mm, 8-mm, and 9-mm endotracheal tubes with and without a ventilator de...

Performing emergency endotracheal intubation necessarily means doing so under less than ideal conditions. Rates of first-time success will be lower than endotracheal intubation performed under controlled conditions in the operating room. Some factors associated with improved success are predictable and can be modified to improve outcome. Factors to be discussed include the initial decision to p...

Unusual case of endotracheal tube obstruction by caseous necrotic material Sir, Tuberculosis is a social disease with medical implications. In spinal tuberculosis, surgery is performed for either deformities and neurologic deficits and/or drainage of cold abscess. Endotracheal intubation is the cornerstone in the anesthesia practice; however, the tube itself may become a source of airway obstru...

Tracheal rupture is a rare complication of endotracheal intubation. We present a case of tracheal rupture that was diagnosed intraoperatively after the use of an NIM EMG endotracheal tube. A 66-year-old female with a recurrent multinodular goiter was scheduled for total thyroidectomy. Induction of anesthesia was uncomplicated. Intubation was atraumatic using a 6 mm NIM EMG endotracheal tube (ET...

Obstructive fibrinous tracheal pseudomembrane is a rare, but potentially fatal complication associated with endotracheal intubation. It has been known that the formation of tracheal pseudomembrane is related with intracuff pressure during endotracheal intubation or infectious cause. But in the patient described in this case, pseudomembrane formation in the trachea was associated with subglottic...

The introduction into clinical practice of new tools for intubation as videolaringoscopia has dramatically improved the success rate of intubation and the work of anesthesiologists in what is considered the most delicate maneuver. Nevertheless intubation difficulties may also be encountered with good anatomical visualization of glottic structures in videolaringoscopia. To overcome the obstacles...

AIM identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS Evidence...

Two cases are reported of recurrent laryngeal nerve paralysis that followed thoracic manipulations in paediatric patients. Possible aetiological factors in relation to anaesthesia and operation in paediatric and adult patients are reviewed. These include: forceful endotracheal intubation; direct surgical trauma; compression of the nerve in the neck by a tracheal cuff, or a large endotracheal tu...

A case of successful endotracheal intubation using an image intensifier in a 9-year-old boy with tracheal stenosis was reported. After the induction of anesthesia, the trachea was observed by use of mobile surgical X-ray apparatus under artificial ventilation using a face mask. Because the tracheal wall of the stenotic part was smooth and seemed soft, we selected a plain 5.5 mm diameter endotra...