• Journal of Yeungnam Medical Science
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• v.21 no.1
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• pp.127-131
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• 2004

A laryngeal mask airway (LMA) has many advantages in the management of airway emergencies or the treatment of patients in whom intubation is difficult, but the use of LMA during positive ventilation may seem inappropriate to protect the airway because of the risk of pulmonary aspiration of regurgitated gastric contents. We experienced aspiration pneumonia after general anesthesia using LMA in patient who suffered from panperitonitis. It is considered that the main reason for aspiration pneumonia was a leakage of gastric content through the space surrounding the nasogastric tube while under high airway inflation pressure. We concluded that when LMA or the Proseal laryngeal mask airway (PLMA) is chosen for the use in difficult intubations, careful patient-suitability selection and the correct knowledge of LMA and PLMA are needed to protect the airway against aspiration.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.57-60
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• 2002

Tracheoinnominate artery fistula is a rare but a catastrophic complication after tracheostomy or tracheal reconstruction. We experienced two cases of tracheoinnominate artery fistula after tracheal reconstruction and tracheostomy. The first patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and reconstruction of trachea. She died of bleeding 3 days after the reoperation. The second patient was a 68 year old man who underwent right upper lobectomy due to lung cancer. After operarion MRSA Pneumonia was developed and tracheostomy was performed 10 days after intubation. Twelve days after tracheostomy, massive bleeding occurred and emergency operation of ligation of innominate artery was performed. He died of sepsis 7 days after reoperation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.135-138
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• 2017

Intraoperative airway obstruction is perplexing to anesthesiologists because the patient may fall into danger rapidly. A 74-year-old woman underwent an emergency incision and drainage for a deep neck infection of dental origin. She was orally intubated with a 6. 0 mm internal diameter reinforced endotracheal tube by video laryngoscope using volatile induction and maintenance anesthesia (VIMA) with sevoflurane, fentanyl ($100{\mu}g$), and succinylcholine (75 mg). During surgery, peak inspiratory pressure increased from 22 to $38cmH_2O$ and plateau pressure increased from 20 to $28cmH_2O$. We maintained anesthesia because we were unable to access the airway, which was covered with surgical drapes, and tidal volume was delivered. At the end of surgery, we found a longitudinal fold inside the tube with a fiberoptic bronchoscope. The patient was reintubated with another tube and ventilation immediately improved. We recognized that the tube was obstructed due to dissection of the inner layer.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5893-5900
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• 2012

It is very critical to promptly maintain airway of cardiac arrest cases or serious traumatic cases. The purpose of this study is to compare intubation rate, successful rate and pre-/post-education self-confidence between laryngeal tube (LTS) and proseal laryngeal mask (PLMA), so that it may contribute to improving the ability of 119 emergency team - a pivotal role in pre-hospitalization process - to carry out advanced airway management. In order to achieve the purpose, total 60 paramedics (Class I) who worked for incumbent 119 emergency team were asked to join a practical experiment and were also divided into two groups (LTS group: 30 people, PLMA group: 30 people). In details, they were all asked to take 3 sessions of practice (5 minutes per session) using dummy model to quantitatively measure the time and success/failure of intubation and the change of their self-confidence. As a result, it was found that there were statistically significant differences in the time of intubation between LTS and PLMA group (p=.000), but there was no significant difference in the rate of successful intubation between these two groups, and self-confidence of two groups tended to significantly increase after experiment (p=.000). Conclusively, if it is necessary to promptly apply intubation to traumatic cases with immobilized cervical vertebral and lingual edema, LTS can be useful as an effective means of intubation. And it is expected that continuing intubation training using LTS will improve the ability of emergency team to perform advanced airway management for traumatic cases.

• Fire Science and Engineering
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• v.29 no.5
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• pp.104-109
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• 2015

The purpose of this study was to compare the ventilatory volume and airway pressure of a facial mask, endotracheal intubation, King tube, and I-gel devices with an Oxylator EM-100 using a RespiTrainer. The data were obtained from July 20 to 21, 2015. Data were analyzed using SPSS WIN 18.0 software. The ventilatory volume for endotracheal intubation was 537 ml (95% CI 530~545 ml), that for the King tube was 502 ml (95% CI 499~506 ml), that for the I-gel was 88 ml (95% CI 485~491 ml), and that for the facial mask was 499 ml (95% CI 496~503 ml). The airway pressure for endotracheal intubation was $11.34cmH_2O$ (95% CI $11.21{\sim}11.41cmH_2O$), that for the King tube was $10.67cmH_2O$ (95% CI $10.60{\sim}10.75cmH_2O$), that for the I-gel was $10.42cmH_2O$ (95% CI $10.35{\sim}10.67cmH_2O$), and that for the facial mask was $10.61cmH_2O$ (95% CI $10.55{\sim}10.68cmH_2O$). As a result, we were able to identify the appropriate ventilatory volume using the Oxylator EM-100.

• Journal of Veterinary Clinics
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• v.35 no.5
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• pp.184-189
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• 2018

Wild birds rescued for various reasons are injured and admitted to a wild animal rescue center. With the case of collision with cars, buildings and wires on a power pole, most wild birds are severely traumatized or get fractured, which need intensive veterinary treatment. In general, inhalation anesthesia to wild birds is the best choice for the medical and surgical procedure, and intubation is recommended for the stable anesthesia. Although the certain size of an endotracheal tube can be chosen depending on the size and morphology of the bird, there are a few standardized guidelines. Therefore, the optimal endotracheal size of the rescued 162 individual birds of 41 species for four years from March 2014 to December 2017 was investigated and sorted empirically, suggesting possibly the appropriate endotracheal sizes for diverse avian species. It may provide practical information data for wildlife veterinarians to select the size of an endotracheal tube according to the size of the domestic wild bird species, especially during surgery in the emergency cases.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.219-223
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• 2017

In cases of multiple facial trauma and other specific cases, the anesthesiologist may be asked to convert an oral endotracheal tube to a nasal endotracheal tube or vice versa. Conventionally, the patient is simply extubated and the endotracheal tube is re-inserted along either the oral or nasal route. However, the task of airway management can become difficult due to surgical trauma or worsening of the airway condition. Fiberoptic bronchoscopy was considered a novel method of airway conversion but this method is not useful when there are secretions and bleeding in the airway, or if the anesthesiologist is inexperienced in using this device. We report a successful airway conversion under the aid of both, a fiberoptic bronchoscope and a C-MAC video laryngoscope.

• Korean Journal of Adult Nursing
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• v.13 no.1
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• pp.136-147
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• 2001

Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was $2.6{\pm}0.8$(in the midst of stupor or a semicoma),$1.9{\pm}0.5$(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was $9.3{\pm}2.9$, $12.1{\pm}2.2$ respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).

• Journal of Chest Surgery
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• v.23 no.5
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• pp.1021-1026
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• 1990

The patients with tracheal stenosis have become more increasing in recent due to the increased use of tracheostomy and assisted ventilation Anesthetic management during tracheal reconstruction is a concern to the anesthetist and the surgeon, who must share the airway as a operation field and at the same time provide good gas exchange. Multiple technique such as the tube ventilation system or C \ulcornerP bypass method have been recommended to achieve this goals. However, these methods have disadvantages of poor surgical exposure and hemorrhagic complication from using C \ulcornerP bypass The technique for HFJV was first described for bronchoscopy, and it involves positive-pressure breathing with high flow[40 \ulcorner60L/min] of oxygen This flow is directed to a semirigid catheter inserted in the endotracheal tube and the tracheal reconstruction can be done without interruption. From Dec. 1986 to July 1990 we have experienced 6 patients of tracheal stenosis necessitating circumferential resection and end to end anastomosis; 5 patients with tracheal stenosis following cuffed tracheostomy or intubation, a patient with tracheal stenosis due to invasive thyroid cancer. The specific advantages during tracheal reconstruction are unobstructed field during surgical reconstruction and good gas exchange through the procedure.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.31-34
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• 2012

Tension pneumothorax during one-lung ventilation (OLV) is a rare but life-threatening complication. A 79-year-old male patient who was diagnosed with lung cancer underwent $Univent^{(R)}$ Tube (Fuji Systems Corporation, Tokyo) intubation for left upper lobectomy. Two hours after the initiation of OLV, the patient could not tolerate it. Thus, one-and two-lung ventilation were alternatively applied to continue the operation. After the operation, an emergent chest radiograph was taken, and pneumothorax was found at the right (dependent) lung field.