Delayed obstruction of endotracheal tubes by aspirated foreign bodies: report of two cases.

We present 2 cases of endotracheal tube obstruction as a result of previously aspirated foreign bodies that moved from the bronchial tree into the endotracheal tube. The signs of endotracheal tube obstruction were demonstrated in both cases: (1) activation of the high-pressure alarm; (2) difficulty ventilating by using a bag-valve-mask device; (3) rapid decrease of end-tidal CO2; (4) oxygen desaturation that may have lagged behind the decrease of end-tidal CO2; and (5) the inability to advance a catheter down the endotracheal tube. The differential diagnosis of endotracheal tube obstruction is discussed, as are possible interventions to remove the obstruction and secure an open airway.

In vitro ultrasound augmented clot dissolution--what is the optimal timing of ultrasound application?

The mechanism of ultrasound augmentation of pharmacological thrombolysis is yet unknown. The goal of this study is to find the best timing regimen for in-vitro ultrasound augmented clot dissolution by streptokinase, heparin and their combination. Blood clots from 4 donors were cut into 200-400 mg sections and randomized to no treatment with ultrasound; pre-treatment with ultrasound (before immersion); early treatment with ultrasound; or late treatment with ultrasound.