Tracheoesophageal fistula formation in intubated patients. Risk factors and treatment with high-frequency jet ventilation

Two ventilator dependent patients developed tracheoesophageal fistulas. Their subsequent treatment using high frequency jet ventilation resulted in transient clinical improvement. Risk factors for the development of tracheoesophageal fistulas in intubated patients are discussed and preventive measures are outlined. High frequency jet ventilation may be useful in managing these patients by preventing death from respiratory failure and allows time for definitive therapy.

Use of respiratory care procedures in the management of hospitalized asthmatics

The current management of the hospitalized asthmatic includes a number of respiratory therapy techniques, both diagnostic and therapeutic. These include measures to increase arterial oxygen content, monitoring of gas exchange, administration of bronchodilator aerosols, chest physiotherapy techniques, breathing exercises, and mechanical ventilation. While many of these are potentially helpful, some are misused or are not of proven benefit. This review is designed to acquaint the clinician with the procedures commonly used, their potential benefits, or lack thereof, and their possible hazards. Recommendations are given for the rational use of these techniques, based upon the experience of the authors.