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T Staudinger

Publications and source records attributed to T Staudinger.

46 records · Page 3Linked to original sources
PubMed1995

Emergency intubation with the Combitube in two cases of difficult airway management.

The airway was managed successfully in two cases of difficult intubation using the Combitube, a new device for emergency intubation, which combines the functions of an oesophageal obturator airway and a conventional endotracheal airway. One patient could not be intubated due to lockjaw; in the other patient, the vocal cords could not be seen because of continued vomiting. The cases illustrate the benefit of the Combitube during emergency intubation for different problems and its effectiveness as an alternative to traditional intubation techniques.

Aged↗
PubMed1994

[Bronchiolitis obliterans organizing pneumonia with acute respiratory insufficiency].

A 22-year-old woman was hospitalized because of fever of 39 degrees C and increasing dyspnoea. The chest radiograph demonstrated coarse confluent opacities bilaterally. Despite antibiotic treatment the condition deteriorated acutely after 2 days. All efforts to find an infectious agent, including immunological tests, were unsuccessful. Artificial ventilation became necessary because of increasing respiratory failure with an arterial oxygen partial pressure of 56 mm Hg, CO2 of 41 mm Hg and a respiratory rate of 60/min. Histological examination of a transthoracic lung biopsy revealed bronchiolitis obliterans organizing pneumonia, which was treated with prednisolone. The initial dose was 500 mg/d, gradually reduced to 12.5 mg/d over 2 weeks. The clinical and radiological findings improved markedly after 2 days and the patient discharged herself after 3 weeks and there was no follow-up.

Acute Disease↗
PubMed1994

Magnetic resonance imaging of the heart during positive end-expiratory pressure ventilation in normal subjects.

OBJECTIVES: Magnetic resonance imaging was used to assess the effects of ventilation with positive end-expiratory pressure (PEEP) on cardiac volumes, especially on atrial volumes as well as to determine semiquantitative measurements of spatial interactions between heart, lungs and chest. DESIGN: Prospective study with healthy volunteers undergoing mechanical ventilation with different levels of PEEP during magnetic resonance imaging. SETTING: Magnetic resonance unit, Institute of Diagnostic Imaging, Rudolfinerhaus Hospital. SUBJECTS: Twelve healthy volunteers. INTERVENTIONS: Volunteers were imaged, using a multislice-multiphase technique during spontaneous breathing and with PEEP values of 0, 7, and 15 cm H2O. MEASUREMENTS AND MAIN RESULTS: Atrial as well as ventricular volumes, chest diameters, and midventricular contact between the heart and anterior chest wall were determined on transverse-oblique sections. Atrial volumes showed a progressive decline beginning at a PEEP of 7 cm H2O. Diastolic filling of both ventricles was reduced. A PEEP level of 15 cm H2O induced a significant increase in the sagittal-oblique but not in the transverse-oblique chest diameter. PEEP values of 7 and 15 cm H2O shortened the length of the midventricular contact between the heart and anterior chest wall. CONCLUSIONS: Left and right ventricular end-diastolic volumes and stroke volumes decreased significantly during ventilation with PEEP at 15 cm H2O, as did end-systolic atrial volumes. Volume changes in association with changes of chest and heart configuration suggest external cardiac compression by the expanding lungs. Furthermore, this study illustrates the feasibility of magnetic resonance imaging in mechanically ventilated patients.

Adult↗
PubMed1994

[Change in causal attributions and coping caused by inpatient client-centered psychotherapy].

During 3-month client-centered hospital treatment 108 patients with neurotic depression, anxiety disorders and other neuroses (DSM-III-R) recovered from depressivity (Giessen-Test, MES), negative attributional styles and regressive coping (KCF). Gains were maintained over follow-up one and two years after therapy. Not only cognitive, but also rogerian psychotherapy leads to significant increment in cognitive coping efforts, even when grade of depressivity is regarded. Attributional style and coping strategies depended on grade of depressivity and status of patient (admission or follow-up); cognitions did not discriminate dysthymic (depressive) patients from other neurotic disorders.

Adaptation, Psychological↗
PubMed1994

[Emergency intubation with the Combitube in a patient with persistent vomiting].

Prompt establishment of a patient airway and effective ventilation are the major goals during initiation of cardiopulmonary resuscitation in patients with cardiac arrest. Endotracheal intubation is the definitive method to maintain an optimal airway. However, endotracheal intubation is not always possible, even for the skilled physician. The Combitube has been developed to overcome this disadvantage. Studies have proved the effectivity of ventilation with this device. A case is reported where a patient suffered from acute respiratory failure and attempts at endotracheal intubation failed due to continued vomiting rendering fibre-optical visualisation of the vocal cords impossible. Blind insertion of the Combitube led to successful ventilation, and hence replacement by an endotracheal airway could be performed without danger of aspiration.

Adult↗
PubMed1994

[Comparison of the Combitube with the endotracheal tube in cardiopulmonary resuscitation in the prehospital phase].

A prospective controlled study was undertaken to evaluate the efficacy of the Combitube, a combined endotracheal and esophageal obturator airway adjunct, in prehospital cardiac arrest patients. The Combitube and a standard endotracheal tube were utilized on alternate days as the initial airway of choice by paramedics. Of altogether 86 patients treated during the study period, intubation was possible in 80 cases, 38 receiving a Combitube as initial choice of airway. 11 out of 14 patients who could not be intubated with a standard endotracheal tube were then successfully managed with a Combitube. Survival following cardiac arrest after insertion of a Combitube was comparable to conventional endotracheal intubation. Of the 6 patients who survived 2 had received a Combitube, 2 a standard endotracheal tube and 2 an oropharyngeal tube. While visualized endotracheal intubation remains the preferred method of airway control, the Combitube is an effective airway as backup to the endotracheal tube, as well as a primary airway, especially outside hospital. Contraindications are listed.

Allied Health Personnel↗
PubMed1993

Emergency intubation with the Combitube in a grossly obese patient with bull neck.

A grossly obese patient with bull neck required immediate intubation. Endotracheal intubation failed because visualization of the vocal cords was not possible. As an alternative, the Combitube was inserted without difficulty and the patients lungs were ventilated via the Combitube until tracheotomy was performed on the following day. The patient survived and was discharged alive from the hospital 5 weeks later. The Combitube has gained worldwide interest and is now included in the Guidelines of the American Heart Association and the American Society of Anesthesiologists.

Aged↗
PubMed1993

Emergency intubation with the Combitube: comparison with the endotracheal airway.

STUDY OBJECTIVE: To evaluate the safety and effectiveness of the Combitude as used by ICU nurses under medical supervision compared with endotracheal airway established by ICU physicians during CPR. DESIGN: Prospective study of ICU patients over a seven-month period. SETTING: Medical ICU. PARTICIPANTS: Thirty-seven patients suffering from cardiac arrest. INTERVENTIONS: Emergency intubation with either the Combitube by nurses or the endotracheal airway by physicians and subsequent mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Evaluation of blood gases after 20 minutes of mechanical ventilation. Intubation time was shorter for the Combitube (P < .001). Blood gases for each device showed comparable results; PaO2 was slightly higher during ventilation with the Combitube (P < .001). CONCLUSION: The Combitube as used by ICU nurses was as effective as establishment of the endotracheal airway by intensivists during CPR. The Combitube may be used whenever endotracheal intubation cannot be performed immediately.

Aged↗
PubMed1993

[Successful intubation with the Combitube of two patients with bull neck].

Endotracheal intubation is without doubt the optimal method for emergency airway management. Rapid intubation and effective ventilation are the major aims during cardiopulmonary resuscitation. As an alternative, the Combitube can be used whenever endotracheal intubation is not immediately possible. We report the successful use of the Combitube during cardiopulmonary resuscitation in two patients with bull-neck. The patients could be oxygenated and ventilated adequately with the Combitube. This case report shows that the Combitube may be a valuable tool for emergency intubation in difficult situations.

Angioplasty, Balloon, Coronary↗