Abstract:
OBJECTIVES:Prolonged excessive endotracheal cuff pressure greater than 30 cmH2O is thought to cause ischemic airway injury. Excessive cuff pressure with altitude gain during air medical transport has been previously described in adult patients. It is poorly understood how pediatric-sized endotracheal tube (ETT) cuffs behave with atmospheric pressure change during flight. METHODS:In ex vivo models 4.0, 6.0, and 8.0, ETTs restricted within scaled syringe tubing were inflated to 20 cmH2O. Pressure was measured against 1500 ft elevation gain in ground and flight models. In an in vivo observation of pediatric patient transport, change in cuff pressure was measured between takeoff and helicopter peak flight altitudes. RESULTS:In the ex vivo ground model, endotracheal cuff pressure increased linearly with altitude and exceeded 40 cmH2O in all tube sizes. Comparable pressure change was demonstrated in the flight model. No difference was demonstrated in the degree of pressure change between ETT sizes. In the in vivo observations during patient transport, pressure increase was consistent with that seen in the ex vivo models. CONCLUSIONS:Children who are intubated with cuffed ETTs for air medical transport are subject to excessive endotracheal cuff pressure at even low flight altitudes. Endotracheal tube size did not affect the degree of cuff pressure change, contrary to previous study. These findings need to be validated and correlated to patient clinical outcomes. The implications of these data need to be considered clinically particularly for prolonged transport of intubated pediatric patients at elevation.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Long MT,Cvijanovich NZ,McCalla GP,Flori HRdoi
10.1097/PEC.0000000000000755subject
Has Abstractpub_date
2018-08-01 00:00:00pages
570-573issue
8eissn
0749-5161issn
1535-1815journal_volume
34pub_type
杂志文章abstract::We present a case of a 4-month-old girl referred to the emergency department with a provisional diagnosis of acute life-threatening event with a recent episode of heart block and a history of long-lasting fever. Soon after admission, the child suddenly deteriorated rapidly; she became pulseless with complete heart blo...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000195757.74328.68
更新日期:2006-01-01 00:00:00
abstract::Visual disturbances resulting from acute nerve paralysis of the muscles controlling eye movements can be challenging to evaluate in the pediatric population. Children may not be capable of describing symptoms or providing an adequate history. Therefore, it is important to have an understanding of the anatomical course...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000391
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the patterns of ceftriaxone use in an urban pediatric emergency department (PED) and to determine if overuse exists based on published guidelines for management of febrile infants. METHODS:We conducted a retrospective study of 229 young febrile patients who received ceftriaxone between January 1 ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200208000-00007
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:Venipuncture is a frequent source of painful procedures for infants. It has been well documented that infants react to pain with a combination of physiologic and behavioral responses. Infants are unable to describe pain and at particularly high risk for inadequate pain management. The Vibration Anesthesia Dev...
journal_title:Pediatric emergency care
pub_type: 杂志文章,随机对照试验
doi:10.1097/PEC.0000000000000228
更新日期:2014-10-01 00:00:00
abstract::Hereditary angioedema is a disorder characterized by decreased levels or function of complement C1 esterase inhibitor. Symptoms in children generally consist of recurrent episodes of soft tissue swelling. On rare occasion, it can cause airway edema which may lead to airway obstruction. A case is presented of a child p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000150985.81109.0d
更新日期:2005-01-01 00:00:00
abstract::Subcutaneous granuloma annulare is an inflammatory lesion occurring in otherwise healthy children. We present 3 pediatric patients with different diagnostic-therapeutic paths depending on the ward they were referred to. The lesions regress spontaneously, and medical or surgical treatments are generally not necessary. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000591
更新日期:2017-08-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000485
更新日期:2015-07-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31817de2e6
更新日期:2008-07-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31819dac6
更新日期:2009-01-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31826d1e9a
更新日期:2012-10-01 00:00:00
abstract::Neonatal seizures are a potentially life-threatening pediatric problem with a variety of causes, such as birth trauma, asphyxia, congenital anomalies, metabolic disturbances, infections, and drug withdrawal or intoxication. Thorough and timely evaluations of such patients are necessary to identify and treat the underl...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182a62fd6
更新日期:2013-10-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001697
更新日期:2018-12-27 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000092576.40174.28
更新日期:2003-10-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002324
更新日期:2020-12-21 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/01.pec.0000215651.50008.1b
更新日期:2006-05-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181f39d84
更新日期:2010-10-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31816b7a92
更新日期:2008-04-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002011
更新日期:2020-01-10 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000454
更新日期:2015-06-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199712000-00001
更新日期:1997-12-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
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更新日期:2016-11-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318196fa9b
更新日期:2009-02-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
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更新日期:2016-10-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199210000-00008
更新日期:1992-10-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
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更新日期:2020-01-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 临床试验,杂志文章
doi:10.1097/PEC.0b013e318128f85d
更新日期:2007-08-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
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更新日期:1996-06-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
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更新日期:1999-12-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31827b54db
更新日期:2013-01-01 00:00:00