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Related Experiment Videos

Physiologic consequences of tracheal intubation.

J D Kaplan1, D P Schuster

  • 1Respiratory and Critical Care Division, Washington University School of Medicine, St. Louis, Missouri.

Clinics in Chest Medicine
|September 1, 1991
PubMed
Summary

Understanding operating room and fluid mechanics principles can enhance endotracheal intubation safety in pulmonary and critical care. Managing airway reflexes with anesthesia and sedatives improves patient outcomes during this vital airway access procedure.

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Area of Science:

  • Pulmonary Medicine and Critical Care
  • Anesthesiology
  • Fluid Mechanics

Background:

  • Endotracheal intubation is a critical airway access procedure in critical care settings.
  • Physiological reflexes during intubation can lead to adverse events.
  • Principles from operating room practices and fluid mechanics are applicable to intubation.

Purpose of the Study:

  • To highlight the relevance of operating room principles and fluid mechanics in endotracheal intubation.
  • To inform pulmonologists and intensivists about factors improving airway access safety.
  • To discuss the modification of physiological reflexes during intubation.

Main Methods:

  • Review of physiological responses to airway stimulation during intubation.
  • Analysis of technical and pharmacologic methods to mitigate airway reflexes.

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  • Consideration of fluid mechanics principles related to airflow within the endotracheal tube.

    • Main Results:

    • Oropharyngeal stimulation triggers reflexes like glottic closure, hypertension, and bronchoconstriction.
    • Anesthetics, vasoactive drugs, and adrenergic blockers can modify these reflex responses.
    • Topical anesthesia and parenteral sedatives are often preferred for risk-benefit balance.
    • Intubation impacts airway caliber, respiratory mechanics, and airflow dynamics.

    Conclusions:

    • Pulmonologists and intensivists should integrate operating room principles for safer intubation.
    • Pharmacologic and technical interventions can effectively manage intubation-related reflexes.
    • Understanding fluid mechanics aids in managing consequences of reduced airway caliber and turbulent airflow.