To the Editor-Recent developments of thoracoscopic surgical instmments and techniques have increased the demand for selective lung ventilation in younger children. Because the use of pediatric doublelumen endotracheal tubes' is limited, this is conventionally accomplished by blocking the required bronchus with a Fogarty embolectomy catheter' or with a pulmonary artery catheter.' In most reporte...

The relative impact of mechanical factors on pharyngeal patency in patients with obstructive sleep apnea is poorly understood. The present study was designed to evaluate parameters of the "tube law" on pharyngeal pressure-flow relationships and collapsibility in patients with obstructive sleep apnea. We developed a mathematical model that considered the collapsible segment of the pharynx to rep...

During cuffed intubation, damage to the trachea is least likely when the lateral wall pressure exerted by the cuff does not exceed the mean capillary perfusion pressure of the mucosa. A study was carried out of eight different types of endotracheal tubes. At the seal point the traditional red rubber tube and the armoured latex and Softway tubes exerted pressures above the mean systemic arterial...

Postintubation tracheal stenosis is a complication of endotracheal intubation. The pathological mechanism and risk factors for endotracheal intubation-induced tracheal stenosis remain not fully understood. We aimed to establish an animal model and to investigate risk factors for postintubation tracheal stenosis. Beagles were intubated with 4 sized tubes (internal diameter 6.5 to 8.0 mm) and cuf...

Communication is a serious problem for patients with ventilator-dependent tetraplegia. A 73-year-old man was presented at the emergency room in cardiopulmonary arrest after falling from a height of 2 m. After successful resuscitation, fractures of the cervical spine and cervical spinal cord injury were found. Due to paralysis of the respiratory muscles, a mechanical ventilator with a tracheosto...

The mammalian heart develops from a primary heart tube, which is formed by fusion of bilateral cardiac territories in which myocardial and endothelial cells have already begun to differentiate from splanchnic mesoderm. A population of myocardial precursors has been identified in pharyngeal mesoderm, anterior to the early heart tube. Cell labeling studies have indicated that this novel territory...

709 March 2013 A 77-YR-OLD woman was admitted to our intensive care unit after uncomplicated on-pump coronary artery bypass grafting. The anesthesiologist reported that direct laryngoscopy was impossible. Use of a videolaryngoscope (GlideScope; Verathon Medical, IJsselstein, Netherlands) improved the laryngeal visibility. After repeated attempts, a standard endotracheal tube with an inner diame...

A 33 month old male with a history of prematurity, developmental delay, intractable epilepsy, chronic lung disease, pulmonary hypertension, tracheotomy, hypotonia, VP shunt, and ECMO in infancy presents for resection of a hepatic mass. He arrives to the operating room with a cuffed tracheostomy tube in place (mechanically ventilated on 30% FiO2), and a tunneled left internal jugular single lume...