1991 Volume 13 Issue 3 Pages 325-329
ICU patients frequently have a reduced respiratory and circulatory reserve, and the hypoxemia induced during endoscopic bronchial toilet or associated circulatory changes, such as hypertension and arrythmia, are particularly perilous. In order to enhance safety, an endotracheal tube is generally inserted under general anesthesia and the endoscopic procedure is performed under controlled ventilation. It is, however, difficult to perform endotracheal intubation without affecting the circulation, and furthermore, the endoscopy is not facilitated and the ventilatory resistance increases during the endoscopic procedure. The laryngeal mask airway has recently come into use for general anesthesia, and is a form of new airway that is not directly inserted into the trachea, allowing the effects of insertion on the circulation to be reduced. Also, because of the wide inside diameter and short overall length of the tube, endoscopy becomes smoother and ventilation during the procedure is made easier. Using this laryngeal mask airway, we performed successful endoscopic bronchial toilet for atelectasis in three patients admitted to our ICU.
