Respiratory Obstruction in Hæmophilia Recovery After Intubation

Haemophilia with Respiratory Obstruction

“…It is questionable, in fact, whether or not surgical intervention is necessary in this condition.We agree with the recommendation ofBoyd (1950) that an attempt should be made to intubate the trachea before resorting to a tracheotomy or relief incisions. He chose the oral route in his case, and apparently to good effect.…”

Respiratory Obstruction in Haemophilic Patients

“…I can find records of only 21 such patients, of whom 16 suffered from sonme degree of respiratory embarrassment. These were reported by Umbreit (1910), Feliciangeli (1921), Lesne et al (1921), DuLjarier (1930), Troutt (1931), Voit and Paus (1933), Endicott et al (1942), Baird andFox (1943), Fox et al (1946), Davidson et al (1949), Boyd (1950), Herson (1950), Edmonds (1951), MacDonald et al (1953), Tempest (1953), Perrella and Costa (1954), Archer and Zubrow (1954), and Skolnik and Fornatto (1955).…”

“…Orotracheal and Nasotracheal Intubation Boyd (1950) (Macintosh and Pratt, 1940); Case 9, quoted above, is an example of this. In addition, exposure of the glottis and the passage of an endotracheal tube via the nose or mouth may well be extremely difficult in such distorted anatomical conditions whatever method of anaesthesia is employed.…”

Intracranial Haemorrhage in Disorders of Blood Coagulation

“…There need be no reluctance to employ general anaesthesia. Endotracheal intubation has been employed on a number of reported occasions with comparative safety; it is certainly always preferable to tracheotomy (Boyd, 1950;Macdonald et alii, 2953). In the desperate situation met in Case 2, when gross tracheal obstruction was causing cyanosis and cerebral herniation, the tracheotomy was temporarily life-saving ; nevertheless its result9 were ultimately disastrous and endotracheal intubation with an incompressible tube would have been wiser.…”