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Blade intubation

Anju Gupta, Geeta Kamal, Aikta Gupta, Nidhi Sehgal, Sapna Bhatla, Rajeev Kumar
BACKGROUND: Videolaryngoscopy has an established role in difficult airway management in adults. However, there is limited literature to support their efficacy in children. The Truview Picture Capture Device has shown promising results for endotracheal intubation in infants in the past. The CMAC videolaryngoscope has launched its novel infant Miller blade, but its performance has not been assessed clinically for routine intubation in infants and neonates. We hypothesized that the CMAC videolaryngoscope would reduce the total time to intubation as compared to the Truview Picture Capture Device in neonates and infants...
December 2018: Paediatric Anaesthesia
Junko Ajimi, Junichi Nishiyama, Ritsuko Masuda, Takeo Shibata, Toshiyasu Suzuki
OBJECTIVE: This prospective randomized study aimed to assess the usefulness of two videolaryngoscopes with a side channel, the Airtraq DLTM and the AWS-200TM , for intubation with a double-lumen tube (DLT). METHODS: In 60 patients with an American Society of Anesthesiologists physical status of 1-3 who were not expected to have difficult airway, the Airtraq DLTM and the AWS-200TM were randomly used for DLT intubation. The primary outcome was intubation time. The secondary outcomes included exposure time, the glottis view with the Macintosh and study videolaryngoscopes, the number of attempts before successful intubation, the intubation difficulty scale (IDS) score, and the subjectively rated ease of blade insertion and DLT advancement...
December 20, 2018: Tokai Journal of Experimental and Clinical Medicine
Kelsey A Miller, Matthew A Eisenberg, Edir S Abid, Joshua Nagler
First-pass success rates during intubation of infants in the emergency department have been shown to be low. Video laryngoscopy is being increasingly used during advanced airway management in the emergency department, but available data have not supported improved outcomes with use in pediatrics. The newly available Macintosh size 0 (curved) blade for the C-MAC video laryngoscope offers a narrower blade for use in infants. We describe the use of the new C-MAC Macintosh 0 blade for intubation of 2 infants with apnea secondary to respiratory syncytial virus bronchiolitis...
November 12, 2018: Pediatric Emergency Care
Sunil Rajan, Dilesh Kadapamannil, Kaushik Barua, Pulak Tosh, Jerry Paul, Lakshmi Kumar
Background and Aims: Nasal intubation with traditional Macintosh laryngoscope usually needs the use of Magill's forceps or external laryngeal manipulation. The primary objective of this study was to assess the ease of intubation during C-MAC videolaryngoscope-assisted nasal intubation using D blade and to compare it with traditional Macintosh laryngoscope-aided nasal intubation. The secondary objectives were comparison of intubation time, attempts, trauma, and hemodynamic stress responses...
July 2018: Journal of Anaesthesiology, Clinical Pharmacology
Abdullah Bakhsh, Michael Ritchie
Tracheal intubation is a critical step in securing the patient's airway in a variety of emergent and non-emergent settings. Difficulties and complications may arise with this procedure, and alternative laryngoscopes that use video technology have been designed to improve visibility when airway difficulty is predicted or encountered. These devices may be flexible or rigid in design for the purpose of assisting in intubations, especially expected difficult intubations. Video laryngoscopes have been advertised as being able to reduce difficulty, failure, trauma and other complications compared with direct laryngoscopy...
October 15, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Daniel Cordovani, Twain Russell, Wallace Wee, Andrew Suen, Richard M Cooper
BACKGROUND: In patients with predictive features associated with easy direct laryngoscopy, videolaryngoscoy with the GlideScope has been shown to require less force when compared with Macintosh direct laryngoscopy. OBJECTIVE: The aim of this study was to compare forces applied with Glidescope vs. Macintosh laryngoscopes in patients with predictive features associated with difficult direct laryngoscopy. DESIGN: A prospective randomised study...
October 10, 2018: European Journal of Anaesthesiology
Zehra İpek Arslan
We herein report two expected difficult intubation cases that failed with an angulated-type video laryngoscope (C-MAC D-blade) and were rescued with a channelled-type Airtraq® device. The common signs and characteristics which indicated difficult ventilation and intubation in these patients were Mallampati 4 (with phonation), mandibular protrusion of B, obstructive sleep apnoea disorder, male gender, and thick neck (>46 cm). We had aids ready in the operating theatre for the anticipated difficult intubation...
September 2018: Turkish Journal of Anaesthesiology and Reanimation
Yasuhiko Kato, Yasushi Sakuma, Yoshihiro Momota
During laryngoscopy, the laryngoscope blade sometimes comes in contact with the teeth, fracturing or dislocating them. However, no studies have compared the effects of newly marketed video laryngoscopes and the Macintosh laryngoscope (Mac) on teeth. In this study, we measured and compared the force exerted on the teeth of an intubating manikin by the Mac, the Airway Scope (Pentax), and the McGrath MAC (Covidien). The mean force exerted was 141.1 ± 15.7 kg by the Mac, 39.2 ± 10.3 kg by the Airway Scope, and 48...
2018: Anesthesia Progress
Marc Kriege, Nina Pirlich, Thomas Ott, Eva Wittenmeier, Frank Dette
BACKGROUND: In infants, securing the airway is time-critical because of anatomical and physiological differences related to airway management in children less than 1 year old. The aim of this study was to compare the time to ventilation using two different hyperangulated video laryngoscope blades with the time to ventilation via conventional direct laryngoscopy in a normal airway [NA] and in a simulated difficult airway [DA]. METHODS: This study was a comparative, bicentric, open-label, randomized controlled evaluation...
August 31, 2018: BMC Anesthesiology
Ji-Hoon Kim, Sung Wook Kim, Young-Min Kim, Youngsuk Cho, Seung Joon Lee
BACKGROUND: Novice clinicians who have little or no clinical experience in tracheal intubation occasionally need a long time to perform the procedure when using a large curved blade. They also have a lower tracheal intubation success rate, especially in emergency situations, such as cardiac arrest, than experienced practitioners. This study aimed to investigate whether the size of the curved laryngoscope blade affects the outcomes of tracheal intubation performed by incoming interns on a manikin model...
August 2018: Medicine (Baltimore)
Tülay Şahin, Zehra İpek Arslan, Gür Akansel, Onur Balaban, Derya Berk, Mine Solak, Kamil Toker
Objective: Endotracheal intubation should be performed with care when cervical spine (C-spine) injury is suspected. The aim of this study was to evaluate the movement of the C-spine using fluoroscopy during intubation with Laryngeal Mask Airway (LMA) CTrach, C-MAC videolaryngoscope and Macintosh laryngoscope. Methods: This was a single-centre, prospective, observational, controlled trial. In total, 22 surgical patients aged 18-65 years planned to undergo operation under general anaesthesia, were enrolled...
February 2018: Turkish Journal of Anaesthesiology and Reanimation
Yuki Shindo, Shinichi Toda, Kanta Kido, Eiji Masaki
Introduction: Intubation can sometimes be difficult in patients with lesions in the mouth floor. Ameloblastoma is a frequently encountered tumor of the maxillofacial area. An extensive lesion might occupy the floor of the mouth, prevent displacement of the tongue, limiting the space for inserting a laryngoscope blade and resulting in difficult intubation even with fiberoptic bronchoscopy. Case presentation: A 66-year-old man (67 kg; 171 cm) with a mental swelling was diagnosed with ameloblastoma and scheduled for surgical resection...
August 2018: Annals of Medicine and Surgery
Karam Nam, Younsuk Lee, Hee-Pyoung Park, Jaeyeon Chung, Hyun-Kyu Yoon, Tae Kyong Kim
BACKGROUND: In patients with an unstable cervical spine, maintenance of cervical immobilization during tracheal intubation is important. In McGrath videolaryngoscopic intubation, lifting of the blade to raise the epiglottis is needed to visualize the glottis, but in patients with an unstable cervical spine, this can cause cervical spine movement. By contrast, the Optiscope, a rigid video-stylet, does not require raising of the epiglottis during tracheal intubation. We therefore hypothesized that the Optiscope would produce less cervical spine movement than the McGrath videolaryngoscope during tracheal intubation...
June 28, 2018: Anesthesia and Analgesia
Randolph H Hastings, Suraj Kedarisetty, Jennifer Moitoza Johnson, Dale Glaser, Nathan Delson
Background: The goal of this study was to determine whether motion parameters during laryngoscopy in a manikin differed with experienced operators versus novice trainees and whether motion measurements would predict trainee outcomes when intubating patients. Methods: Motion, force, and duration of laryngoscopy on a manikin were compared in two separate experiments between beginning anesthesiology residents (CA1) and anesthesiologists with more than 24 months of anesthesiology training (CA3 or attendings)...
January 2018: Journal of Education in Perioperative Medicine: JEPM
Hiroyuki Oshika, Yukihide Koyama, Masataka Taguri, Koichi Maruyama, Go Hirabayashi, Shoko Merrit Yamada, Masashi Kohno, Tomio Andoh
BACKGROUND: It is very rare but challenging to perform emergency airway management for accidental extubation in a patient whose head and neck are fixed in the prone position when urgently turning the patient to the supine position would be unsafe. The authors hypothesized that tracheal intubation with a videolaryngoscope would allow effective airway rescue in this situation compared with a supraglottic airway device and designed a randomized crossover manikin study to test this hypothesis...
June 2018: Medicine (Baltimore)
Hiroshi Hoshijima, Takahiro Mihara, Koichi Maruyama, Yohei Denawa, Kentaro Mizuta, Toshiya Shiga, Hiroshi Nagasaka
STUDY OBJECTIVE: The C-MAC laryngoscope (C-MAC) is a videolaryngoscope that uses a modified Macintosh blade. Although several anecdotal reports exist, it remains unclear whether the C-MAC is superior to the Macintosh laryngoscope for tracheal intubation in the adult population. DESIGN: Systematic review, meta-analysis. SETTING: Operating room, intensive care unit. MEASUREMENTS: For inclusion in our analysis, studies had to be prospective randomised trials which compared the C-MAC with the Macintosh laryngoscope for tracheal intubation in the adult population...
September 2018: Journal of Clinical Anesthesia
Brian E Driver, Matthew E Prekker, Lauren R Klein, Robert F Reardon, James R Miner, Erik T Fagerstrom, Mitchell R Cleghorn, John W McGill, Jon B Cole
Importance: The tracheal tube introducer, known as the bougie, is typically used to aid tracheal intubation in poor laryngoscopic views or after intubation attempts fail. The effect of routine bougie use on first-attempt intubation success is unclear. Objective: To compare first attempt intubation success facilitated by the bougie vs the endotracheal tube + stylet. Design, Setting, and Patients: The Bougie Use in Emergency Airway Management (BEAM) trial was a randomized clinical trial conducted from September 2016 through August 2017 in the emergency department at Hennepin County Medical Center, an urban, academic department in Minneapolis, Minnesota, where emergency physicians perform all endotracheal intubations...
June 5, 2018: JAMA: the Journal of the American Medical Association
Han Joon Kim, Su In Park, Sang Yun Cho, Min Jae Cho
Objective Insertion of a nasogastric tube (NGT) in patients who have been intubated with an endotracheal tube while under general anesthesia can cause difficulties and lead to complications, including hemorrhage. A visualization-aided modality was recently used to facilitate NGT insertion. Some studies have focused on the role of modified Magill forceps, which have angles similar to those of the GlideScope blade (Verathon, Bothell, WA, USA). Methods Seventy patients were divided into a control group (Group C) and an experimental group (GlideScope and modified Magill forceps, Group M)...
August 2018: Journal of International Medical Research
Tiberiu Ezri, Ronen Waintrob, Yuri Avelansky, Alexander Izakson, Katia Dayan, Mordechai Shimonov
Background: The incidence of difficult intubation (DI) in obese patients may reach a two-digit figure. No studies have assessed the effect of primary use of special intubation devices on lowering the incidence of DI. We assessed the effect of primary selection of special intubation techniques on the incidence of DI in patients with a BMI of 35 kg/m2 or higher. Patients and methods: Data from 546 patients with a BMI of 35 kg/m2 or higher who underwent bariatric surgery at Wolfson Medical Center from 2010 through 2014 was retrospectively extracted and analyzed for demographics, predictors of DI and intubation techniques employed...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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