Pneumoesophagus as a Sign of H Type Tracheoesophageal Fistula

PEDIATRICS ◽  
1976 ◽  
Vol 58 (6) ◽  
pp. 907-909
Author(s):  
Wilbur L. Smith ◽  
E. A. Franken ◽  
John A. Smith
Keyword(s):  
Endotracheal Intubation ◽  
Tracheoesophageal Fistula ◽  
Positive Pressure Ventilation ◽  
Positive Pressure

Two patients with H type tracheoesophageal fistulae demonstrated prominent pneumoesophagus and gaseous distention of the bowel after endotracheal intubation and positive-pressure ventilation. This report discusses the pathophysiology of these events and emphasizes the significance of these findings.

scholarly journals A Controlled Trial of Noninvasive Positive Pressure Ventilation (NIPPV) in Patients of COPD with Respiratory Failure

2013 ◽  
Vol 1 (2) ◽  
pp. 86-92
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Shah Md Saifur Rahman ◽  
Md Ali Hossain ◽  
Md Rashidul Hassan
Keyword(s):  
Respiratory Failure ◽  
Endotracheal Intubation ◽  
Noninvasive Ventilation ◽  
Positive Pressure Ventilation ◽  
Controlled Trial ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Exacerbation Of Copd ◽  
Standard Medical Treatment ◽  
Standard Treatment Group

Objective : To assess the role of noninvasive positive pressure ventilation (NIPPV) in patients of acute exacerbation of COPD with respiratory failure, also to reduce endotracheal intubation (ETI) and the frequency of complications associated with ETI. Materials and Methods : Prospective, single blind, randomized controlled trial study (RCT) comparing the effect of combined standard medical treatment and noninvasive positive pressure ventilation with standard medical treatment alone in patients admitted to National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Bangladesh over a 12-month period. Results : A total number of 60 patients of acute exacerbation of COPD with type II respiratory failure were enrolled from inpatient department of Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Bangladesh. A total of 30 (thirty) were randomly assigned to standard therapy and 30 (thirty) to noninvasive ventilation. The two groups had similar clinical characteristics on admission to the hospital. The use of noninvasive ventilation significantly reduced the need for endotracheal intubation (which was dictated by objective criteria): 12 of 30 patients (40.0%) in the noninvasive- ventilation group were intubated, as compared with 22 of 30 patients (73.3%) in the standard-treatment group (P=0.01). In addition, the frequency of complications was significantly lower in the noninvasive-ventilation group. The mean ( ± SD) hospital stay was significantly shorter for patients receiving noninvasive ventilation. 19.2±5.7days vs. 23.5±8.3 days, (P 0.02). The in-hospital mortality rate was also significantly reduced with noninvasive ventilation, 5 of 30 patients (16.7%) in the noninvasive- ventilation group died in the hospital, as compared with13 of 30 (43.3%) in the standard-treatment group( P 0.04) Conclusions : In selected patients with acute exacerbations of chronic obstructive pulmonary disease, noninvasive ventilation can reduce the need for endotracheal intubation, complications, the length of the hospital stay, and the in-hospital mortality rate. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17201 Bangladesh Crit Care J September 2013; 1 (2): 86-92

scholarly journals Tracheoesophageal Fistula Complicated by Iatrogenic Gastric Perforation in a Low Birth Weight Neonate

2020 ◽  
Vol 18 (2) ◽  
pp. 324-326
Author(s):  
Anju Gupta ◽  
Dimple Pande ◽  
Nishtha Kachru ◽  
Ahtesham Khan
Keyword(s):  
Tracheoesophageal Fistula ◽  
Positive Pressure Ventilation ◽  
Surgical Repair ◽  
Gastric Perforation ◽  
Gastric Distension ◽  
Positive Pressure ◽  
Birth Weight Neonate ◽  
Pulmonary Pathology ◽  
Ventilatory Management ◽  
Common Manifestation

Type-III tracheoesophageal fistula is the commonest type of fistula where upper pouch is blind and distal oesophageal pouch communicates with trachea. In this condition, gastric distension is a common manifestation which can be worsened by positive pressure ventilation. Pulmonary pathology may necessitate ventilation with high peak airway pressures which may rarely lead to gastric perforation with serious consequences. We are reporting such a case of gastric perforation during ventilatory management for fistula repair which needed surgical repair. Keywords: Airway management; esophageal atresia; gastric perforation; tracheo-oesophageal fistula.

Tracheoesophageal Fistula Repair

2013 ◽  
Author(s):  
Lorna Rankin
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Congenital Malformation ◽  
Tracheoesophageal Fistula ◽  
Positive Pressure Ventilation ◽  
Perioperative Period ◽  
Positive Pressure ◽  
Fistula Repair ◽  
Risk Of Aspiration ◽  
Associated Abnormalities

Tracheoesophageal fistula (TEF) and esophageal atresia (EA) is a congenital malformation occurring in 1:3,000 to 4,500 births. The condition presents specific challenges to the anesthesiologist in the perioperative period. The presence of a fistula means that infants born with TEF/EA are at risk of aspiration and positive-pressure ventilation may be hazardous. These babies often have coexistent problems associated with prematurity and low birth weight, and 50% have associated abnormalities, most commonly congenital cardiac malformations.

scholarly journals Time to desaturation in preterm infants undergoing endotracheal intubation

2021 ◽  
pp. fetalneonatal-2020-319509
Author(s):  
Radhika Kothari ◽  
Kate Alison Hodgson ◽  
Peter G Davis ◽  
Marta Thio ◽  
Brett James Manley ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Positive Pressure Ventilation ◽  
Secondary Analysis ◽  
Neonatal Resuscitation ◽  
Physiological Data ◽  
Positive Pressure ◽  
Postmenstrual Age ◽  
Registration Number

BackgroundNeonatal endotracheal intubation is often associated with physiological instability. The Neonatal Resuscitation Program recommends a time-based limit (30 s) for intubation attempts in the delivery room, but there are limited physiological data to support recommendations in the neonatal intensive care unit (NICU). We aimed to determine the time to desaturation after ceasing spontaneous or assisted breathing in preterm infants undergoing elective endotracheal intubation in the NICU.MethodsObservational study at The Royal Women’s Hospital, Melbourne. A secondary analysis was performed of video recordings of neonates ≤32 weeks’ postmenstrual age undergoing elective intubation. Infants received premedication including atropine, a sedative and muscle relaxant. Apnoeic oxygenation time (AOT) was defined as the time from the last positive pressure or spontaneous breath until desaturation (SpO2 <90%).ResultsSeventy-eight infants were included. The median (IQR) gestational age at birth was 27 (26–29) weeks and birth weight 946 (773–1216) g. All but five neonates desaturated to SpO2 <90% (73/78, 94%). The median (IQR) AOT was 22 (14–32) s. The median (IQR) time from ceasing positive pressure ventilation to desaturation <80% was 35 (24–44) s and to desaturation <60% was 56 (42–68) s. No episodes of bradycardia were seen.ConclusionsThis is the first study to report AOT in preterm infants. During intubation of preterm infants in the NICU, desaturation occurs quickly after cessation of positive pressure ventilation. These data are important for the development of clinical guidelines for neonatal intubation.Trial registration numberACTRN12614000709640

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