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First attempt intubation success rate

Eugene Kim, Byung-Gun Kim, Young-Jin Lim, Young-Tae Jeon, Jung-Won Hwang, Seo-Yun Lee, Hee-Pyoung Park
BACKGROUND: Positioning of a lightwand in the midline of the oral cavity can be challenging in patients with cervical immobilization. Direct laryngoscopy may permit the lightwand tip to more easily access the glottic opening. We tested our hypothesis that a laryngoscope-assisted lightwand technique allows more successful endotracheal intubation than does a conventional lightwand approach. METHODS: A total of 162 patients requiring cervical immobilization during intubation for cervical spine surgery were allocated randomly to 2 groups...
October 11, 2016: Anesthesia and Analgesia
Lucas Van Oeveren, Julie Donner, Andrea Fantegrossi, Nicholas M Mohr, Calvin A Brown
BACKGROUND: Intubation in rural emergency departments (EDs) is a high-risk procedure, often with little or no specialty support. Rural EDs are utilizing real-time telemedicine links, connecting providers to an ED physician who may provide clinical guidance. INTRODUCTION: We endeavored to describe telemedicine-assisted intubation in rural EDs that are served by an ED telemedicine network. MATERIALS AND METHODS: Prospective data were collected on all patients who had an intubation attempt while on the video telemedicine link from May 1, 2014 to April 30, 2015...
September 27, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
M Kleine-Brueggeney, R Greif, N Urwyler, B Wirthmüller, L Theiler
We compared the Bonfils(™) and SensaScope(™) rigid fibreoptic scopes in 200 patients with a simulated difficult airway randomised to one of the two devices. A cervical collar inhibited neck movement and reduced mouth opening to a mean (SD) of 23 (3) mm. The primary outcome parameter was overall success of tracheal intubation; secondary outcomes included first-attempt success, intubation times, difficulty of intubation, fibreoptic view and side-effects. The mean (95% CI) overall success rate was 88 (80-94)% for the Bonfils and 89 (81-94)% for the SensaScope (p = 0...
September 27, 2016: Anaesthesia
Brian E Driver, David Plummer, William Heegaard, Robert F Reardon
BACKGROUND: The King LT airway (King Systems, Noblesville, IN) is a popular extraglottic device that is widely used in the prehospital setting. We report a case of tracheal malplacement of the King airway with a severe kink in the distal tube. CASE REPORT: A 51-year-old unhelmeted motorcyclist collided with a freeway median and was obtunded when paramedics arrived. After bag mask ventilation, a King airway was placed uneventfully and the patient was transported to the emergency department...
September 17, 2016: Journal of Emergency Medicine
Caineng Wu, Jianqi Wei, Qingyun Cen, Xuefan Sha, Qingxiang Cai, Wuhua Ma, Ying Cao
A difficult airway may lead to hypoxia and brain damage. The WEI Nasal Jet Tube (WNJ) is a new nasal pharyngeal tube that applies supraglottic jet oxygenation and ventilation (SJOV) for patients during tracheal intubation without the need for mask ventilation. We evaluated the effectiveness and safety of SJOV-assisted fibre-optic bronchoscopy (FOB) using the WNJ in the management of difficult tracheal intubations. A total of 50 adult patients with Cormack-Lehane grade ≥3 and general anesthesia with tracheal intubation were randomly assigned to either the laryngeal mask airway (LMA) or WNJ groups...
September 14, 2016: Internal and Emergency Medicine
Pitsucha Sanguanwit, Thavinee Trainarongsakul, Noppanan Kaewsawang, Kittisak Sawanyawisuth, Yuwares Sitthichanbuncha
BACKGROUND: Difficult airway intubation is an emergency condition both at the emergency department (ED) and in out-of-hospital situations. Retrograde intubation (RI) is another option for difficult airway management. There are limited data regarding the successful rate of RI compared with direct laryngoscopy (DL) intubation, the commonly used method in the ED. METHODS: This study was a randomized, controlled trial. Participants were randomly assigned to either the RI or the DL technique to attempt intubation on a difficult airway mannequin (Cormack and Lehane grades 3-4)...
August 30, 2016: American Journal of Emergency Medicine
Xiaojun Du, Songsong Mao, Jianxiu Cui, Jue Ma, Guangyan Zhang, Yong Zheng, Haiyu Zhou, Liang Xie, Dongkun Zhang, Ruiqing Shi, Gang Chen
BACKGROUND: The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure. METHODS: Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital...
August 2016: Journal of Thoracic Disease
Hui Li, Wu Wang, Ya-Ping Lu, Yan Wang, Li-Hua Chen, Li-Pei Lei, Xiang-Ming Fang
BACKGROUND: There is an unmet need for a reliable method of airway management for patients in the lateral position. This prospective randomized controlled two-center study was designed to evaluate the feasibility of intubation using a flexible fiberoptic bronchoscope in the lateral position during surgery. METHODS: Seventy-two patients scheduled for elective nonobstetric surgery in the lateral decubitus position requiring tracheal intubation under general anesthesia at Lishui Central Hospital of Zhejiang Province and Jiaxing First Hospital of Zhejiang Province from April 1, 2015, to September 30, 2015, were enrolled in this study...
2016: Chinese Medical Journal
Suhail Sarwar Siddiqui, S Janarthanan, M M Harish, Harish Chaudhari, R Natesh Prabu, Jigeeshu V Divatia, Atul Prabhakar Kulkarni
BACKGROUND AND AIMS: The oncologists are treating cancer more aggressively, leading to increase in number of pediatric admissions to the ICU. Due to anatomical and physiological differences, pediatric patients are at high risk of complications during intubation. We evaluated the incidence of complications during intubations in pediatric patients in our ICU. SUBJECTS AND METHODS: We performed retrospective analysis of complications occurring during intubation in 42 pediatric patients...
July 2016: Indian Journal of Critical Care Medicine
Ayten Saracoglu, Kemal T Saracoglu
STUDY OBJECTIVE: To evaluate the available data describing the use of single and double lumen VivaSight tubes. DESIGN: Systematic review. SETTING: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications. PATIENTS: Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials...
September 2016: Journal of Clinical Anesthesia
Carlos A Artime, Alfonso Altamirano, Katherine C Normand, Lara Ferrario, Hassan Aijazi, Davide Cattano, Carin A Hagberg
STUDY OBJECTIVE: This study was designed to compare the Ambu Aura-i to the single-use LMA Fastrach regarding time to intubation, success rate, and airway morbidity in patients undergoing elective surgery requiring general anesthesia. DESIGN: Prospective, randomized controlled trial. SETTING: Academic medical center. PATIENTS: Sixty-five adult patients scheduled for elective surgery requiring general anesthesia. INTERVENTIONS: Patients were randomized into 2 groups...
September 2016: Journal of Clinical Anesthesia
Sun Kyung Park, Geum Ko, Geun Joo Choi, Eun Jin Ahn, Hyun Kang
BACKGROUND: Comparisons between the efficacies of supraglottic airway devices (SGAs) and endotracheal tubes (ETTs) in patients undergoing laparoscopic surgeries have yielded conflicting results. Therefore, in this meta-analysis, we compared the clinical performance and incidence of complications between SGAs and ETT intubation in laparoscopic surgery. METHODS: A comprehensive search was conducted using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Google Scholar to identify randomized controlled trials that compared SGAs with ETTs in laparoscopic surgery...
August 2016: Medicine (Baltimore)
Simon Sulser, Dirk Ubmann, Martin Schlaepfer, Martin Brueesch, Georg Goliasch, Burkhardt Seifert, Donat R Spahn, Kurt Ruetzler
BACKGROUND: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE: The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting...
August 16, 2016: European Journal of Anaesthesiology
Jason J Bischof, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
UNLABELLED: Introduction Endotracheal intubation (ETI) is a complex clinical skill complicated by the inherent challenge of providing care in the prehospital setting. Literature reports a low success rate of prehospital ETI attempts, partly due to the care environment and partly to the lack of consistent standardized training opportunities of prehospital providers in ETI. Hypothesis/Problem The availability of a mobile simulation laboratory (MSL) to study clinically critical interventions is needed in the prehospital setting to enhance instruction and maintain proficiency...
October 2016: Prehospital and Disaster Medicine
Nilgun Kavrut Ozturk, Ali Sait Kavakli
OBJECTIVES: Transesophageal echocardiography (TEE) probe insertion with the conventional blind insertion technique may be difficult in anesthetized and intubated patients. The use of a videolaryngoscope may facilitate the insertion of the TEE probe. The aim of this study was to compare the conventional technique with the use of the McGrath MAC videolaryngoscope for TEE probe insertion in terms of success rate, duration of insertion, and complications in patients undergoing cardiovascular surgery...
March 31, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Ai H Lee, Nadia M Nor, Azarinah Izaham, Nurlia Yahya, Shereen S P Tang, Norsidah A Manap
BACKGROUND: This prospective, randomized, single blind, single operator study was conducted to compare hemodynamic responses when endotracheal intubation was performed using the Bonfils intubation fibrescope versus the C-MAC videolaryngoscope. METHOD: Forty-four ASA I patients aged between 18 and 60 years, scheduled for elective surgery requiring endotracheal intubation were recruited. They were randomized into the Bonfils group or C-MAC group. Hemodynamic changes, laryngeal view, duration of intubation and post intubation complications were evaluated...
June 2016: Middle East Journal of Anesthesiology
Ting Xu, Min Li, Cheng Ni, Xiang-Yang Guo
BACKGROUND: The purpose of this study was to compare the efficacy and safety of dexmedetomidine versus remifentanil for sedation during awake intubation using a Shikani optical stylet (SOS). METHODS: Sixty-eight patients with cervical trauma or severe cervical spondylosis undergoing cervical spinal surgery were enrolled in this prospective study. They were randomly assigned to receive dexmedetomidine (Group D) or remifentanil (Group R). In Group D, the patients received an intravenous loading dose of dexmedetomidine 1 μg · kg(-1) over 10 min followed by a continuous infusion of 0...
2016: BMC Anesthesiology
Latha Naik, Neerja Bhardwaj, Indu Mohini Sen, Rakesh V Sondekoppam
Introduction. The study aims to test whether flexible silicone tubes (FST) improve performance and provide similar intubation success through I-Gel as compared to ILMA. Our trial is registered in CTRI and the registration number is "CTRI/2016/06/006997." Methods. One hundred and twenty ASA status I-II patients scheduled for elective surgical procedures needing tracheal intubation were randomised to endotracheal intubation using FST through either I-Gel or ILMA. In the ILMA group (n = 60), intubation was attempted through ILMA using FST and, in the I-Gel group (n = 60), FST was inserted through I-Gel airway...
2016: Anesthesiology Research and Practice
L Chrisman, W King, K Wimble, S Cartwright, K B Mohammed, B Patel
BACKGROUND: 'Can't Intubate, Can't Oxygenate' is a rare but life threatening event. Anaesthetists must be trained and have appropriate equipment available for this. The ideal equipment is a topic of ongoing debate. To date cricothyroidotomy training for anaesthetists has concentrated on cannula techniques. However cases reported to the NAP4 audit illustrated that they were associated with a high failure rate. A recent editorial by Kristensen and colleagues suggested all anaesthetists must master a surgical technique...
August 2016: British Journal of Anaesthesia
Swati Chhatrapati, Anjana Sahu, Subhhash Sadashiv Auti, Swapnil Ganesh Aswar
INTRODUCTION: Polyvinyl Chloride Endotracheal Tube (PVC ETT) can be used as an alternative to Fastrach Silicone Wire-Reinforced Tube (FTST) for intubation through Intubating Laryngeal Mask Airway (ILMA) as the latter is expensive and has low volume high pressure cuff. AIM: To evaluate the effects of orientation of PVC ETT (normal curve and reverse curve) on the success of intubation through ILMA, haemodynamic response and postoperative sore throat. MATERIALS AND METHODS: Sixty healthy adult patients of ASA physical status I & II scheduled for elective surgery under general anaesthesia requiring endotracheal intubation were randomly divided into two groups...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
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