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Difficult intubation prediction

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https://www.readbyqxmd.com/read/28404553/airway-emergencies-presenting-to-the-paediatric-emergency-department-requiring-advanced-management-techniques
#1
Leopold Simma, Domenic Cincotta, Stefan Sabato, Elliot Long
BACKGROUND: Airway emergencies presenting to the emergency department (ED) are usually managed with conventional equipment and techniques. The patient group managed urgently in the operating room (OR) has not been described. AIMS: This study aims to describe a case series of children presenting to the ED with airway emergencies managed urgently in the OR, particularly the anaesthetic equipment and techniques used and airway findings. METHODS: A retrospective cohort study undertaken at The Royal Children's Hospital, Melbourne, Australia...
April 12, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28403413/can-tongue-thickness-measured-by-ultrasonography-predict-difficult-tracheal-intubation
#2
W Yao, Bin Wang
Background.: Increased tongue thickness is likely to be associated with difficult airways. However, no methods to evaluate tongue thickness were available. Currently, tongue thickness can be measured by ultrasonography. The present study investigated the predictive value of tongue thickness to predict difficult tracheal intubation. Methods.: Adult patients undergoing tracheal intubation and general anaesthesia were enrolled in the study. Tongue thickness was assessed using submental ultrasonography in the median sagittal plane before anaesthesia...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28393782/thyromental-height-test-for-prediction-of-difficult-laryngoscopy-in-patients-undergoing-coronary-artery-bypass-graft-surgical-procedure
#3
Nilesh Jain, Sucharita Das, Muralidhar Kanchi
BACKGROUND: Patients undergoing coronary artery bypass graft (CABG) procedures have higher incidence of difficult laryngoscopy and intubation than general surgery population. Accurate prediction of difficult laryngoscopy in CABG patients is desirable to reduce the hemodynamic response and myocardial oxygen requirements. Recently, thyromental height test (TMHT) has been proposed as one of the highly sensitive and specific bedside tests to predict difficult airway. We, in our prospective observational study, evaluated the accuracy of the TMHT in predicting difficult laryngoscopy...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28376741/neck-circumference-to-inter-incisor-gap-ratio-a-new-predictor-of-difficult-laryngoscopy-in-cervical-spondylosis-patients
#4
Yong-Zheng Han, Yang Tian, Mao Xu, Cheng Ni, Min Li, Jun Wang, Xiang-Yang Guo
BACKGROUND: Preoperative airway assessment help anticipate a difficult airway. We hypothesized that a close association existed between difficult laryngoscopy and the neck circumference/inter-incisor gap ratio (RNIIG). Our aim was to determine its utility in predicting difficult laryngoscopy in cervical spondylosis patients. METHODS: Two hundred thirteen consecutive patients, aged 20-70 years, scheduled to undergo cervical spine surgery under general anesthesia, were recruited...
April 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28314604/a-prospective-randomised-study-comparing-double-balloon-colonoscopy-and-conventional-colonoscopy-in-pre-defined-technically-difficult-cases
#5
Edward J Despott, Alberto Murino, Masanao Nakamura, Leonidas Bourikas, Chris Fraser
BACKGROUNDS AND AIM: Technically 'difficult' (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures. Double-balloon colonoscopy (DBC) may facilitate TD colonoscopy. The primary outcome was to compare the time taken to achieve caecal intubation during conventional colonoscopy (CC) and DBC in patient with a TD colon. METHODS: We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy. Patients were screened for parameters predictive of TD colonoscopy using an original scoring system and randomised to DBC or CC...
February 14, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28302228/anaesthetic-management-in-a-child-with-goldenhar-syndrome
#6
Waqas Ahmed Khan, Bushra Salim, Ausaf Ahmed Khan, Shakaib Chughtai
Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain. The boy had various features of Goldenhar syndrome, e.g. cleft palate, absent right eye and ear, right mandibular hypoplasia, micrognathia, and preauricular tags...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28299194/recent-trends-in-airway-management
#7
REVIEW
Joelle Karlik, Michael Aziz
Tracheal intubation remains a life-saving procedure that is typically not difficult for experienced providers in routine conditions. Unfortunately, difficult intubation remains challenging to predict and intubation conditions may make the event life threatening. Recent technological advances aim to further improve the ease, speed, safety, and success of intubation but have not been fully investigated. Video laryngoscopy, though proven effective in the difficult airway, may result in different intubation success rates in various settings and in different providers' hands...
2017: F1000Research
https://www.readbyqxmd.com/read/28262247/use-of-the-totaltrack-vlm-for-emergent-endotracheal-intubation-in-predicted-difficult-airway-with-obstruction-by-expanding-space-occupying-lesions-and-reduced-interincisor-opening
#8
B Izquierdo-González, M Á Gómez-Ríos, E Freire-Vila
Acute cervical pathology may lead to serious airway compromise resulting from anatomical distortion secondary to obstruction or deviation of the upper airway, scenarios where any airway device can be fallible. Passage of a fiberoptic bronchoscopy to expose the glottis may be very difficult and tracheostomy may be impractical or risky in advanced cases. We present the use of the TotalTrack VLM to secure the airway for emergent surgery in 2 uncooperative patients with difficult airway due to Ludwig's angina and neck hematoma, respectively, both accompanied by trismus...
March 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28258945/the-performance-of-neck-circumference-and-other-airway-assessment-tests-for-the-prediction-of-difficult-intubation-in-obese-parturients-undergoing-cesarean-delivery
#9
J Eiamcharoenwit, N Itthisompaiboon, P Limpawattana, A Suwanpratheep, A Siriussawakul
BACKGROUND: Pregnancy and obesity each increase the chance of difficult tracheal intubation. This study assessed the performance of the neck circumference and other bedside tests for predicting difficult intubation, and aimed to identify the optimal cutoff point of the test(s) with the highest performance. METHODS: Parturients with a body mass index ≥30kg/m(2), undergoing a cesarean delivery employing conventional tracheal intubation, were enrolled. Preoperative neck circumference, sternomental distance and modified Mallampati test were examined...
February 5, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28244630/implementation-of-nap4-emergency-airway-management-recommendations-in-a-quaternary-level-pediatric-hospital
#10
Elliot Long, Domenic Cincotta, Joanne Grindlay, Anastasia Pellicano, Michael Clifford, Stefan Sabato
Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28235540/determination-of-the-diagnostic-value-of-the-modified-mallampati-score-upper-lip-bite-test-and-facial-angle-in-predicting-difficult-intubation-a-prospective-descriptive-study
#11
Ata Mahmoodpoor, Hassan Soleimanpour, Samad Ej Golzari, Arezoo Nejabatian, Tannaz Pourlak, Masoumeh Amani, Saeed Hajmohammadi, Hamzeh Hosseinzadeh, Robab Mehdizadeh Esfanjani
BACKGROUND: Difficult intubation is a significant cause of mortality and morbidity related to anesthesia. We decided to evaluate the value of Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in the prediction of difficult intubation. METHODS: In a prospective descriptive study, data from 132 patients who were candidates for elective maxillofacial surgeries under general anesthesia were gathered. Facial Angles were measured by a maxillofacial surgeon according to cephalometry...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235504/usefulness-and-diagnostic-value-of-the-nema-parameter-combined-with-other-selected-bedside-tests-for-prediction-of-difficult-intubation
#12
Kamil Torres, Marcin Błoński, Łukasz Pietrzyk, Małgorzata Piasecka-Twaróg, Ryszard Maciejewski, Anna Torres
STUDY OBJECTIVE: To assess the usefulness of the new NEMA (Neck Circumference Minus Acromion-Acromion Distance) parameter, in preoperative identification of patients' difficult intubation and compare it with other commonly used scales and tests. DESIGN: Prospective study. SETTING: District Specialist Hospital of Lublin, Poland. PATIENTS: Six hundreds twenty-nine patients underwent nonemergency surgical interventions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28219331/a-comparison-of-videolaryngoscopes-for-tracheal-intubation-in-predicted-difficult-airway-a-feasibility-study
#13
Maria Vargas, Antonio Pastore, Fulvio Aloj, John G Laffey, Giuseppe Servillo
BACKGROUND: Videolaryngoscopy has become increasingly attractive for the routine management of the difficult airway. Glidescope® is well studied in the literature while imago V-Blade® is a recent videolaryngoscope. This is a feasibility study with 1:1 case-control sequential allocation comparing Imago V-Blade ® and Glidescope® in predicted difficult airway settings. METHODS: Two senior anesthesiologists with no clinical experience in video assisted intubation but previously trained in a simulated scenario, performed the endotracheal intubations with Imago V-Blade® and Glidescope®...
February 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28183567/evaluation-of-the-reliability-of-preoperative-descriptive-airway-assessment-tests-in-prediction-of-the-cormack-lehane-score-a-prospective-randomized-clinical-study
#14
Onur Selvi, Tugce Kahraman, Ozgur Senturk, Serkan Tulgar, Ercan Serifsoy, Zeliha Ozer
STUDY OBJECTIVE: In this study we investigated and compared the predictive values of different airway assessments tests including thyromental height measurement test, which has been recently suggested, in difficult laryngoscopy (Cormack and Lehane [C-L] scores 3 and 4). In addition, we compared the effectiveness of methods and C-L scores, by IDS, in terms of predicting difficult intubation. DESIGN: Prospective, blinded study. SETTING: Maltepe University...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28098589/can-mandibular-condylar-mobility-sonography-measurements-predict-difficult-laryngoscopy
#15
Weidong Yao, Yumei Zhou, Bin Wang, Tao Yu, Zhongbing Shen, Hao Wu, Xiaoju Jin, Yuanhai Li
BACKGROUND: Limited mandibular condylar mobility plays an important role in difficult laryngoscopy. Indirect assessment methods, such as mouth opening, have been proven to be useful predictors of difficult laryngoscopy. Sonography is a new direct assessment method for the limited mandibular condylar mobility. However, whether this method could be used in predicting difficult laryngoscopy still remains unknown. This study aimed to observe its ability to predict difficult laryngoscopy. METHODS: Adult patients who were administered tracheal intubations for elective surgery under general anesthesia were enrolled in the study...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28007521/children-with-challenging-airways-what-about-glidescope-%C3%A2-video-laryngoscopy
#16
Chrystelle Sola, Anne-Charlotte Saour, Christine Macq, Sophie Bringuier, Olivier Raux, Christophe Dadure
BACKGROUND: GlideScope(®) video-laryngoscopy is becoming increasingly used, including in paediatrics. However, to date, very few data are available on efficiency during situations involving difficult intubation. Our objective was to describe the usefulness of the GlideScope(®) in children with presumed challenging airway criteria. METHODS: In this observational study, all children with predicted criteria of potential difficult intubation and requiring general anaesthesia with tracheal intubation were prospectively enrolled over a 12-month period...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27942053/ultrasonography-a-viable-tool-for-airway-assessment
#17
Preethi B Reddy, Pankaj Punetha, Kolli S Chalam
BACKGROUND AND AIMS: Accurate prediction of the Cormack-Lehane (CL) grade preoperatively can help in better airway management of the patient during induction of anaesthesia. Our aim was to determine the utility of ultrasonography in predicting CL grade. METHODS: We studied 100 patients undergoing general endotracheal anaesthesia. Mallampati (MP) class, thyromental distance (TMD) and sternomental distance (SMD) were noted. Ultrasound measurements of the anterior neck soft tissue thickness at the level of the hyoid (ANS-Hyoid), anterior neck soft tissue thickness at the level of the vocal cords (ANS-VC) and ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point of the distance between the vocal cords (E-VC) were obtained...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27935771/preparing-anesthetists-to-manage-cannot-intubate-cannot-ventilate-situations
#18
Kenneth A Wofford
Cannot intubate/cannot ventilate (CICV) situations during anesthesia are rare, potentially catastrophic to the patient, and difficult to predict. Widely adopted practice guidelines advocate an algorithmic approach to CICV situations in which the anesthetist: (a) recognizes the CICV situation, (b) calls for help, (c) steadily progresses through a variety of methods to ventilate the patient and secure the airway, (d) restores ventilation via an infraglottic airway if the patient cannot be safely awakened prior to becoming moribund...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27930894/the-i-gel-supraglottic-airway-as-a-conduit-for-fibreoptic-tracheal-intubation-a-randomized-comparison-with-the-single-use-intubating-laryngeal-mask-airway-and-ctrach-laryngeal-mask-in-patients-with-predicted-difficult-laryngoscopy
#19
Pavel Michálek, Will Donaldson, Francis McAleavey, Alexander Abraham, Rachel J Mathers, Claire Telford
Fibreoptic intubation through a supraglottic airway is an alternative plan for airway management in difficult or failed laryngoscopy. The aim of this study was to compare three supraglottic airways as conduits in patients with at least one predictor for difficult laryngoscopy. The i-gel was compared with the single-use intubating laryngeal mask airway (sILMA) and CTrach laryngeal mask in 120 adult patients scheduled for elective surgeries under general anaesthesia using a prospective, randomized and single-blinded design...
2016: Prague Medical Report
https://www.readbyqxmd.com/read/27900760/choice-of-anaesthesia-for-category-1-caesarean-section-in-women-with-anticipated-difficult-tracheal-intubation-the-use-of-decision-analysis
#20
A J Krom, Y Cohen, J P Miller, T Ezri, S H Halpern, Y Ginosar
A predicted difficult airway is sometimes considered a contra-indication to rapid sequence induction of general anaesthesia, even in an urgent case such as a category-1 caesarean section for fetal distress. However, formally assessing the risk is difficult because of the rarity and urgency of such cases. We have used decision analysis to quantify the time taken to establish anaesthesia, and probability of failure, of three possible anaesthetic methods, based on a systematic review of the literature. We considered rapid sequence induction of general anaesthesia with videolaryngoscopy, awake fibreoptic intubation and rapid spinal anaesthesia...
February 2017: Anaesthesia
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