Appendix D 417

7. Bring cephalic end of feeding tube out of the nose or

mouth, leaving other end well outside skin insertion.

8. While feeding tube is in place, remove the cannula

from the tracheal insertion site.

9. Clamp the feeding tube at its tracheal insertion so

it will not be pulled into the trachea farther than

desired.

10. At the upper end, slip the ET tube over the feeding

tube and along its course until it has passed the proper

distance into the trachea. Stabilize the ET tube.

11. Cut the feeding tube at its tracheal insertion.

12. While keeping the ET tube in place, pull the feeding

tube through the ET tube.

13. Secure ET tube after verifying correct intratracheal

position.

References

1. Georgeson K, Vain N. Intubation of the left main bronchus in the

newborn infant: a new technique. J Pediatr. 1980;96:920.

2. Mathew O, Thach B. Selective bronchial obstruction for treatment

of bullous interstitial emphysema. J Pediatr. 1980;96:475.

3. Weintraub Z, Oliven A, Weissman D, et al. A new method for

selective left main bronchus intubation in premature infants. J

Pediatr Surg. 1990;25:604.

4. Sivasubramanian K. Technique of selective intubation of the left

bronchus in newborn infants. J Pediatr. 1979;94:479.

5. Williamson R. Blind nasal intubation of an apneic neonate.

Anesthesiology. 1988;69(4):633.

6. Zawistowska J, Menzel M, Wytyczak M. Difficulties and modifications of intubation technique in infants with labial, alveolar and

palatal clefts. Anaesth Resusc Intens Ther. 1973;1:211.

7. Stool SE. Intubation techniques of the difficult airway. Pediatr

Infect Dis J. 1988;7:154.

8. Cooper CM, Murray-Wilson A. Retrograde intubation. Management

of a 4.8 kg, 5 month infant. Anaesthesia. 1987;42:1197.

418

Table E.1 Drugs Requiring Adjustment in Severe Renal Failure

Drug Method Adjustment Elimination by PD

Acetaminophen i q8 h No

Acyclovir i q48 h No

Allopurinol i q12–24 h

d 50%

Amikacin i q24 h Yes

d 20%–30%

Amlodipine Unchanged

Amoxicillin i q12–16 h No

Amphotericin B i q24–36 h No

Amphotericin B cholesteryl sulfate Unchanged

Amoxicillin-clavulanic acid i q12–24 h No

Ampicillin i q12–24 h No

Bumetanide Unchanged

Caffeine

Calcitonin

Unchanged

Unchanged

Yes

Captopril d 50%

Carbamazepine d 75%

Carbenicillin i q24–48 h No

Cefaclor d 33% Yes

Cefamandole i q8–12 h No

Cefazolin i q24–48 h No

Cefotaxime i q12–24 h No

Cefoxitin i q24–48 h No

Ceftazidime i q24–48 h No

Ceftriaxone Unchanged No

Cefuroxime i q48–72 h Yes

Cephalexin i q12–24 h No

Cephalothin i q8–12 h Yes

Chloral hydrate Avoid

Chloramphenicol Unchanged No

Cimetidine d 50% No

Clavulanic acid d 50%–75% No

Clindamycin Unchanged No

Dexamethasone Unchanged

Diazepam Unchanged

Diazoxide Unchanged Yes

Dicloxacillin Unchanged No

Digitoxin d 50%–75% No

Digoxin i q48 h No

d 10%–25% No

Diphenhydramine i q9–12 h

Enoxaparin Not approved

Erythromycin Unchanged No

Ethambutol i q48 h Yes

Fentanyl 30%–50%

Flucytosine i q24–48 h Yes

d 20%–30%

Fluconazole d 25% Yes

Furosemide Unchanged

Appendix E

Chapter 53