By Andrew G. Villanueva M.D. (auth.), John Merritt O’Donnell M.D., Flávio Eduardo Nácul M.D. (eds.)
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Extra info for Surgical Intensive Care Medicine
The tube position (in centimeters at the lips) should be noted. For most adults, proper tube location is between 18 and 24 centimeters for orotracheal intubation (for nasotracheal intubation, add 3 to 4 centimeters). Appropriate tube anchoring prevents endobronchial intubation (tube inserted too far) or accidental extubation (tube cuff proximal to the vocal cords). Changing an Endotracheal Tube with an Airway Exchange Catheter Occasionally, an endotracheal tube needs to be changed. The most common reason is a leaking balloon cuff, which makes it impossible to maintain an airtight seal in the trachea.
22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 21 Peruzzi WT, Shapiro BA. Respiratory care. In: Murray MJ, Coursin DB, Pearl RG, Prough OS, eds. Critical Care Medicine: Perioperative Management. Philadelphia: Lippincott-Raven, 1997. Scacci R. Air entrainment masks: jet mixing is how they work; the Bernoulli and Venturi principles are how they don't. Respir Care 1979;24:928-31. Irwin RS, French CL, Mike RW. Respiratory adjunct therapy. In: Rippe JM, Irwin RS, Alpert JS, Fink MP (eds). Intensive Care Medicine, 2nd ed ..
Using devices that deliver a high Fi02 to patients with COPD and elevated PaC02 can result in a high Pa02, which can lead to further elevations in PaC0 2 and worsening respiratory acidosis. ) Table 2. Air-entrainment ratios and total gas outflows of commercially available Venturi masks (14). 7 105(DF=4) 68 (DF=6) 63 (DF=8) 56 (DF=lO) 50 (DF=12) 33 (DF=12) DF (highest driving flow of oxygen, in liters per minute, recommended by the manufacturer for a given concentration). In general, the highest driving flow should be used to provide the highest total gas outflow.