ABSTRACT
Objective To explore the effects of improved intubation in preventing accidental PICC intubation into internal jugular vein. Methods 180 patients with PICC were randomly divided into two groups:control and trial group.In the control group, the routine intubation with head sided was performed,and in the trial group,the intubation was done with gauze of different size accord-ing to the space between the neck and shoulder pressed downward and inward at the spot of internal jugular vein to the bottom and meanwhile having the patient turn the head aside and press the gauze with their draw when the tube head was inserted 15 cm deep.The two groups were compared in terms of the rate of PICC intubation into internal jugular vein.Result The incidence of catheterization by accident into the internal jugular veinin the trial group was significantly lower than that of the control group (P＜0.05). Conclusion The intubation with gauze pressed at the internal jugular vein can obviously reduce the incidence of catheterization by accident into the internal jugular vein.This method is worthy of clinical popularization and application.
ABSTRACT
Objective To observe the displacement of endotracheal tube during laparoscopic surgery,explore whether pneumoperitoneum and body position are associate with the displacement. Methods A total of 120 female patients were included in this study,60 cases underwent gynecological lapa-roseopic operation as group A,and 60 cases had laparoscopic cholecystectomy as group B.Intrabdominal pressure was maintained in 13 mm Hg during the operation.The length of trachea(Lac),the length from carina to the tip of an endotracheal tube(Lab),the length from glottis to the tip of an endotracheal tube (Lbc)and the cuff pressure (Pc)were measured after endotracheal intubation (T1 ),insufflation in the su-pine position (T2 ),insufflation in the Trendelenburg or reverse Trendelenburg position (T3 ),30 minutes after insufflation in the Trendelenburg or reverse Trendelenburg position (T4 ),deflation in the Trendelen-burg or reverse Trendelenburg position (T5 ),deflation in the supine position (T6 ).Results In both groups,Lac and Lab at T2-T4 were significantly shorter than those at T1 (P<0.05),but they were back to the original level at T5 ,T6 .Pc were higher at T2-T4 (P<0.05).Lac,Lab and Lbc didn’t show significant difference between the two groups at T1-T6 .At T2 and T3 ,in group B endotracheal tube distorting occurred in 2 patients and tube into right bronchus occurred in 3 patients,while tube into right bronchus occurred in 3 patients in group A.Conclusion Pneumoperitoneum can cause endotracheal tube displacement to-ward to carina.Body position unlikely to change endotracheal tube position.The displacement was blocking by cuff could cause distorting of the tube.
ABSTRACT
PURPOSE: Tube displacement, consisting of protrusion, spontaneous loss, and intrusion, is the most common cause of failure in conjunctivodacryocystorhinostomy with Jones tube. Recently, MEDPOR(R) Coated Tear Drain was designed to minimize these complications. We evaluate the surgical outcome of conjunctivodacryocystorhinostomy with MEDPOR(R) Coated Tear Drain. METHODS: Primary conjunctivodacryocystorhinostomy or revision surgery using MEDPOR(R) Coated Tear Drain was done on 23 eyes of 23 patients and the development of displacement was monitored. Thirteen patients suffered from habitual displacement of Jones tube and underwent revision surgery, while the remaining 10 underwent primary conjunctivodacryocystorhinostomy. RESULTS: During 12-month follow-up after surgery, tube intrusion was noted in one among the 23 patients. Protrusion or spontaneous loss of tube did not develop. CONCLUSIONS: The use of MEDPOR(R) Coated Tear Drain may be very effective not only for revision surgery in patients who have suffered from habitual displacement of Jones tube but also on primary conjunctivodacryocystorhinostomy.