Endotracheal Intubation and Tracheostomy: Indications, Techniques, and Complications

Abstract

This section contains descriptions of machinery and procedures related to the respiratory care of surgical patients. Positive-pressure devices and ventilators come in a variety of types, each with its own bedazzling set of knobs, gauges, alarms, and blinking lights. Drinker and Berryman’s description of ventilators is written from the viewpoint of the bioengineer. The principles they outline will help the surgeon to feel at home with any mechanical ventilator in current or future use. Gallagher and coauthors divide monitoring methods into pulmonary mechanics, gas exchange, and systemic oxygen delivery. In addition to these specific techniques, they present the practical pitfalls that are commonly encountered. The next four articles could be subtitled Surgical Care of the Respiratory Patient. The articles by Orringer, Gazzaniga, and Connolly form a mini-atlas of techniques and procedures. All surgeons will benefit from a review of these often neglected details. Bronchoscopy should be as routine to general and thoracic surgeons as cystoscopy is to the urologist, yet this important technique is often neglected in residency training. Ratliff leaves description of bronchoscopic techniques to existing atlases and on-site training and devotes his discussion to when, why, and how bronchoscopy should be used in respiratory care. Eric Milne is noted for his studies of chest radiography in acute lung disease. His clear descriptions and examples provide a useful bridge between dynamic physiology and the static shadows on the celluloid.