Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures
Two cases of difficult ventilation are presented, the first caused by endotracheal tube obstruction with nasal turbinate, and the second caused by tracheobronchial obstruction with blood clots. The clinical presentation in each case was characterized by extreme difficulty in ventilating and severe h...
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| Veröffentlicht in: | Chest 1994-02, Vol.105 (2), p.550-552 |
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| creator | Sprung, Juraj Bourke, Denis L. Harrison, Charles Barnas, George M. |
| description | Two cases of difficult ventilation are presented, the first caused by endotracheal tube obstruction with nasal turbinate, and the second caused by tracheobronchial obstruction with blood clots. The clinical presentation in each case was characterized by extreme difficulty in ventilating and severe hypercapnia despite vigorous ventilatory efforts with either a mechanical ventilator or resuscitator bag. A simple manipulation of the endotracheal tube cuff helped to differentiate between increased impedance caused by endotracheal tube obstruction as opposed to increased respiratory system impedance beyond the tip of tube. In the second patient, in whom even a short interruption of ventilation was poorly tolerated, simultaneous rigid bronchoscopy (for removal of intratracheal masses) and ventilation via endotracheal tube were successfully performed. |
| doi_str_mv | 10.1378/chest.105.2.550 |
| format | Article |
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The clinical presentation in each case was characterized by extreme difficulty in ventilating and severe hypercapnia despite vigorous ventilatory efforts with either a mechanical ventilator or resuscitator bag. A simple manipulation of the endotracheal tube cuff helped to differentiate between increased impedance caused by endotracheal tube obstruction as opposed to increased respiratory system impedance beyond the tip of tube. In the second patient, in whom even a short interruption of ventilation was poorly tolerated, simultaneous rigid bronchoscopy (for removal of intratracheal masses) and ventilation via endotracheal tube were successfully performed.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.105.2.550</identifier><identifier>PMID: 8306761</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: Elsevier Inc</publisher><subject>Adult ; Airway Obstruction - etiology ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bronchial Diseases - complications ; Bronchoscopy ; Emergency and intensive respiratory care ; Humans ; Hypercapnia - etiology ; Hypoventilation - etiology ; Inhalation - physiology ; Intensive care medicine ; Intubation, Intratracheal - adverse effects ; Intubation, Intratracheal - instrumentation ; Male ; Medical sciences ; Middle Aged ; Pressure ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult - etiology ; Thrombosis - complications ; Tracheal Diseases - complications ; Turbinates - pathology</subject><ispartof>Chest, 1994-02, Vol.105 (2), p.550-552</ispartof><rights>1994 The American College of Chest Physicians</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-593291b6803559f49f696c38b392525aab7f9207e703b9453df6571b3ebc58903</citedby><cites>FETCH-LOGICAL-c411t-593291b6803559f49f696c38b392525aab7f9207e703b9453df6571b3ebc58903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3997844$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8306761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sprung, Juraj</creatorcontrib><creatorcontrib>Bourke, Denis L.</creatorcontrib><creatorcontrib>Harrison, Charles</creatorcontrib><creatorcontrib>Barnas, George M.</creatorcontrib><title>Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures</title><title>Chest</title><addtitle>Chest</addtitle><description>Two cases of difficult ventilation are presented, the first caused by endotracheal tube obstruction with nasal turbinate, and the second caused by tracheobronchial obstruction with blood clots. The clinical presentation in each case was characterized by extreme difficulty in ventilating and severe hypercapnia despite vigorous ventilatory efforts with either a mechanical ventilator or resuscitator bag. A simple manipulation of the endotracheal tube cuff helped to differentiate between increased impedance caused by endotracheal tube obstruction as opposed to increased respiratory system impedance beyond the tip of tube. In the second patient, in whom even a short interruption of ventilation was poorly tolerated, simultaneous rigid bronchoscopy (for removal of intratracheal masses) and ventilation via endotracheal tube were successfully performed.</description><subject>Adult</subject><subject>Airway Obstruction - etiology</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bronchial Diseases - complications</subject><subject>Bronchoscopy</subject><subject>Emergency and intensive respiratory care</subject><subject>Humans</subject><subject>Hypercapnia - etiology</subject><subject>Hypoventilation - etiology</subject><subject>Inhalation - physiology</subject><subject>Intensive care medicine</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>Intubation, Intratracheal - instrumentation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pressure</subject><subject>Respiration, Artificial</subject><subject>Respiratory Distress Syndrome, Adult - etiology</subject><subject>Thrombosis - complications</subject><subject>Tracheal Diseases - complications</subject><subject>Turbinates - pathology</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFv2yAYxdG0qUu7nXuaxGHqzSkYg81xirqmUqXukGlHBBjXVAQyPrtV_vvRJOp22QX08d73HvohdEnJkrK2u7ajg2lJCV_WS87JO7SgktGK8Ya9RwtCaF0xIeuP6BzgiZSZSnGGzjpGRCvoAqWb2Kcp65KjA97MxmEde7w5vCSTU7SjL8qDgSnPdvIpYg14pWdwgNOA1_tdenZx8kEfxF9-GvHaP474LsLOZz2lvMc_sgOYy_EJfRh0APf5dF-gn99vNqt1df9we7f6dl_ZhtKp4pLVkhrREca5HBo5CCks6wyTNa-51qYdZE1a1xJmZMNZPwjeUsOcsbyThF2gq2PuLqffc2Gkth6sC0FHl2ZQrWBNx1lbjNdHo80JILtB7bLf6rxXlKhXxOqAuExc1aogLhtfTtGz2br-zX9iWvSvJ12D1WHIOloPbzYmZds1zd_iscB68dkp2OoQSig7Vj6lOUcd_i2Wxw1XwD17lxVY76J1fdm2k-qT_--n_wCd9qpO</recordid><startdate>19940201</startdate><enddate>19940201</enddate><creator>Sprung, Juraj</creator><creator>Bourke, Denis L.</creator><creator>Harrison, Charles</creator><creator>Barnas, George M.</creator><general>Elsevier Inc</general><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19940201</creationdate><title>Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures</title><author>Sprung, Juraj ; Bourke, Denis L. ; Harrison, Charles ; Barnas, George M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-593291b6803559f49f696c38b392525aab7f9207e703b9453df6571b3ebc58903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Airway Obstruction - etiology</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Bronchial Diseases - complications</topic><topic>Bronchoscopy</topic><topic>Emergency and intensive respiratory care</topic><topic>Humans</topic><topic>Hypercapnia - etiology</topic><topic>Hypoventilation - etiology</topic><topic>Inhalation - physiology</topic><topic>Intensive care medicine</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>Intubation, Intratracheal - instrumentation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pressure</topic><topic>Respiration, Artificial</topic><topic>Respiratory Distress Syndrome, Adult - etiology</topic><topic>Thrombosis - complications</topic><topic>Tracheal Diseases - complications</topic><topic>Turbinates - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sprung, Juraj</creatorcontrib><creatorcontrib>Bourke, Denis L.</creatorcontrib><creatorcontrib>Harrison, Charles</creatorcontrib><creatorcontrib>Barnas, George M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sprung, Juraj</au><au>Bourke, Denis L.</au><au>Harrison, Charles</au><au>Barnas, George M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>1994-02-01</date><risdate>1994</risdate><volume>105</volume><issue>2</issue><spage>550</spage><epage>552</epage><pages>550-552</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Two cases of difficult ventilation are presented, the first caused by endotracheal tube obstruction with nasal turbinate, and the second caused by tracheobronchial obstruction with blood clots. The clinical presentation in each case was characterized by extreme difficulty in ventilating and severe hypercapnia despite vigorous ventilatory efforts with either a mechanical ventilator or resuscitator bag. A simple manipulation of the endotracheal tube cuff helped to differentiate between increased impedance caused by endotracheal tube obstruction as opposed to increased respiratory system impedance beyond the tip of tube. In the second patient, in whom even a short interruption of ventilation was poorly tolerated, simultaneous rigid bronchoscopy (for removal of intratracheal masses) and ventilation via endotracheal tube were successfully performed.</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>8306761</pmid><doi>10.1378/chest.105.2.550</doi><tpages>3</tpages></addata></record> |
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| ispartof | Chest, 1994-02, Vol.105 (2), p.550-552 |
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| subjects | Adult Airway Obstruction - etiology Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bronchial Diseases - complications Bronchoscopy Emergency and intensive respiratory care Humans Hypercapnia - etiology Hypoventilation - etiology Inhalation - physiology Intensive care medicine Intubation, Intratracheal - adverse effects Intubation, Intratracheal - instrumentation Male Medical sciences Middle Aged Pressure Respiration, Artificial Respiratory Distress Syndrome, Adult - etiology Thrombosis - complications Tracheal Diseases - complications Turbinates - pathology |
| title | Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures |
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