Mechanical chin support during general anesthesia.
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Biomedical subjects
Publications and source records attributed to E Carden.
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The Carden ventilator is described and assessed when used in adult and paediatric modes against test lungs with varying compliance and airways resistance. The ventilator proved to have limited ability to compensate for changes in test lung compliance and resistance. Repeated confirmation of tidal volume is mandatory, but the Carden combines simplicity with flexibility of design and may prove useful as a theatre ventilator.
Studies were carried out to develop a more successful method of inserting central venous catheters through arm veins without using electrocardiographic or fluoroscopic monitoring. It was found that a running infusion attached to a Sorensen catheter gave a success rate of 48 per cent. The highest success rates (98 per cent) occurred when the basilic vein was used, with the patient positioned so that the upper part of the body was raised at 45-90 degrees to the horizontal and using a Bardic 16 gauge catheter with a special insertion technique, which is described. This represents a great improvement over the usual success rate of 70 to 80 per cent.
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Studies carried out in the laboratory have shown that an S-shaped cannula for trans-laryngeal jet ventilation provides a distinct advantage over conventional straight ones. Tidal volumes are larger and the cannula is more stable in position. The tendency of perforate the posterior wall of the trachea during introduction is also minimal. Blood gas data obtained from patients being operated upon with this technique of anaesthesia show that it provides very adequate ventilation and can be effectively used with balanced anaesthesia if a nitrous oxide-oxygen blender is incorporated into the jetting system. It can be put in position before induction of anaesthesia to enable preoxygenation and assist ventilation and can be left in place at the end of the operation until the patient is breathing adequately. If necessary, a tracheostomy can be done with the cannula in situ. It is not proposed that this should be the standard mode of anaesthesia or ventilation for patients undergoing operations on the larynx, but in stituations where other methods are not adequate and when significant upper airway obstruction is present, this is an excellent alternative.
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