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Difficult intubation prediction

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https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#1
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29109635/correlation-between-preoperative-ultrasonographic-airway-assessment-and-laryngoscopic-view-in-adult-patients-a-prospective-study
#2
Aruna Parameswari, Mithila Govind, Mahesh Vakamudi
Background and Aims: Difficult tracheal intubation is associated with serious morbidity and mortality and cannot be always predicted based on preoperative airway assessment using conventional clinical predictors. Ultrasonographic airway assessment could be a useful adjunct, but at present, there are no well-defined sonographic criteria that can predict the possibility of encountering a difficult airway. The present study was conducted with the aim of finding some correlation between preoperative sonographic airway assessment parameters and the Cormack-Lehane (CL) grade at laryngoscopic view in adult patients...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28987399/review-of-difficult-airway-management-in-thoracic-surgery
#3
M Granell, M J Parra, M J Jiménez, L Gallart, A Villalonga, O Valencia, M C Unzueta, A Planas, J M Calvo
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers...
October 4, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28984098/role-of-flexible-fiberoptic-laryngoscopy-in-predicting-difficult-intubation
#4
Ying Guo, Yufang Feng, Hui Liang, Rubo Zhang, Xiaolan Cai, Xinliang Pan
BACKGROUND: The ability to precisely predict which intubations will be difficult during administration of anesthesia is an importantpart of preoperative preparation. This study's goal is to accurately identify patients who will be difficult to intubate using the number of tracheal rings observed preoperatively by fiberoptic laryngoscopy. METHODS: We enrolled 994 adult patients in our study who required general anesthesia and orotracheal intubation for their elective surgeries...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28975073/usefulness-of-ultrasound-view-of-larynx-in-pre-anesthetic-airway-assessment-a-comparison-with-cormack-lehane-classification-during-direct-laryngoscopy
#5
Sussan Soltani Mohammadi, Alireza Saliminia, Nasim Nejatifard, Roxana Azma
BACKGROUND: One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28930848/nociceptive-stimulation-during-macintosh-direct-laryngoscopy-compared-with-mcgrath-mac-videolaryngoscopy-a-randomized-trial-using-indirect-evaluation-using-an-automated-administration-of-propofol-and-remifentanil
#6
RANDOMIZED CONTROLLED TRIAL
Rathvirak Ing, Ngai Liu, Thierry Chazot, Julien Fessler, Jean François Dreyfus, Marc Fischler, Morgan Le Guen
BACKGROUND: Decrease of the nociceptive stimulation induced by laryngoscopy could be an advantage for patients without risk of difficult intubation. The present study aimed to compare the difference in nociceptive stimulation between the use of a conventional laryngoscope or of a videolaryngoscope. Amount of nociception was assessed indirectly using the peak remifentanil concentration determined by a closed-loop administration of propofol and remifentanil with bispectral index (BIS) as the input signal (target 50)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28918615/predicting-difficult-laryngoscopy-and-intubation-with-laryngoscopic-exam-test-a-new-method
#7
Mahmood Akhlaghi, Mohammadreza Abedinzadeh, Ali Ahmadi, Zohre Heidari
Airway assessment is fundamental skill for anesthesiologists and failure to maintain a patient's airway is the tremendous cause of anesthesia-related morbidity and mortality. None of the tests which have recommended for predicting difficult intubation stands out to be the best clinical test or have high diagnostic accuracy. Our study aimed to determine the utility of a new test as "laryngoscopic exam test (LET)" in predicting difficult intubation. Three hundred and eleven patients aged 16-60 years participated and completed the study...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28913492/incorporating-airway-examination-photography-into-the-electronic-record
#8
Joshua W Sappenfield, Nik Gravenstein, Judith M Wishin, Chukwudi Obiora Chiaghana, David Smyth, Brenda G Fahy, Terrie Vasilopoulos, Laurie Davies, F Kayser Enneking
BACKGROUND: Photography of the airway has been used in research to validate preoperative airway assessment and the likelihood of identifying the difficult-to-mask ventilate and/or intubate patient. Up till now, no study has demonstrated the perceived utility of incorporation of airway photographs into the anesthesia preassessment. METHODS: The University of Florida Health Presurgical Clinic routinely incorporates three photographs of all adult patients during their preanesthesia visit...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28890556/ethnicity-and-upper-airway-measurements-a-study-in-south-indian-population
#9
Kalpana P Balakrishnan, Punitha A Chockalingam
BACKGROUND AND AIMS: Most studies on upper airway are conducted based on airway measurements in the western population. We set out to find the normal values of upper airway measurements in South Indian population. The aim of this study was to perform various upper airway examinations and to set standards for normal measurements in the South Indian population as well as to analyse the data for predictors of difficult intubation. METHODS: This prospective observational study was conducted in a tertiary cancer hospital in Southern India...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28879322/difficult-airway-management-in-a-patient-with-a-thin-mandible
#10
Hong-Seok Choi, Jong-Shik Oh, Eun-Jung Kim, Ji-Young Yoon, Ji-Uk Yoon, Cheul-Hong Kim
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28879321/perioperative-airway-management-of-a-patient-with-beckwith-wiedemann-syndrome
#11
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Airway obstruction in pediatric patients always poses a challenge for anesthesiologists. Beckwith-Wiedemann syndrome causes various abnormalities such as macroglossia and omphalocele. Patients with these abnormalities often need corrective surgeries. Management of difficult airway caused by conditions such as macroglossia in patients with this syndrome could be challenging. We encountered a case of difficult airway in an infant with Beckwith-Wiedemann syndrome. It was predicted that macroglossia might cause difficult ventilation, intubation, and extubation...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28855237/predict-prioritisation-study-establishing-the-research-priorities-of-paediatric-emergency-medicine-physicians-in-australia-and-new-zealand
#12
Heather Carol Deane, Catherine L Wilson, Franz E Babl, Stuart R Dalziel, John Alexander Cheek, Simon S Craig, Ed Oakley, Meredith Borland, Nicholas G Cheng, Michael Zhang, Elizabeth Cotterell, Tibor Schuster, David Krieser
BACKGROUND: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work. OBJECTIVE: To identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand. METHODS: Online surveys were administered in a two-stage, modified Delphi study...
August 30, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#13
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#14
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28757825/sternomental-distance-and-sternomental-displacement-as-predictors-of-difficult-laryngoscopy-and-intubation-in-adult-patients
#15
Smita Prakash, Parul Mullick, Shyam Bhandari, Amitabh Kumar, Anoop Raj Gogia, Rajvir Singh
BACKGROUND: Several morphometric airway measurements have been used to predict difficult laryngoscopy (DL). This study evaluated sternomental distance (SMD) and sternomental displacement (SMDD, difference between SMD measured in neutral and extended head position), as predictors of DL and difficult intubation (DI). MATERIALS AND METHODS: We studied 610 adult patients scheduled to receive general anesthesia with tracheal intubation. SMD, SMDD, physical, and airway characteristics were measured...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#16
REVIEW
Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu, Gui-Zhen Yang
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28739243/heaven-criteria-derivation-of-a-new-difficult-airway-prediction-tool
#17
Daniel P Davis, David J Olvera
OBJECTIVE: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. METHODS: A retrospective descriptive analysis was performed in a population of air medical rapid sequence intubation patients requiring more than 1 attempt...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28720096/clinical-and-radiographic-predictors-of-acute-compartment-syndrome-in-the-treatment-of-tibial-plateau-fractures-a-retrospective-cohort-study
#18
Axel Gamulin, Anne Lübbeke, Patrick Belinga, Pierre Hoffmeyer, Thomas V Perneger, Matthieu Zingg, Gregory Cunningham
BACKGROUND: The aim of the study was to evaluate the relation between demographic, injury-related, clinical and radiological factors of patients with tibial plateau fractures and the development of acute compartment syndrome. METHODS: All consecutive adult patients with intra-articular tibial plateau fractures admitted in our urban academic medical centre between January 2005 and December 2009 were included in this retrospective cohort study. The main outcome measurement was the development of acute compartment syndrome...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28701849/blunt-trauma-neck-with-complete-tracheal-transection-a-diagnostic-and-therapeutic-challenge-to-the-trauma-team
#19
K N J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict "difficult airway" and recognize "failed airway" very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28701595/cardiovascular-operation-a-significant-risk-factor-of-arytenoid-cartilage-dislocation-subluxation-after-anesthesia
#20
Seri Tsuru, Mayuko Wakimoto, Takeshi Iritakenishi, Makoto Ogawa, Yukio Hayashi
BACKGROUND: Arytenoid cartilage dislocation/subluxation is one of the rare complications following tracheal intubation, and there have been no reports about risk factors leading this complication. From our clinical experience, we have an impression that patients undergoing cardiovascular operations tend to be associated with this complication. AIMS: We designed a large retrospective study to reveal the incidence and risk factors predicting the occurrence and to examine whether our impression is true...
July 2017: Annals of Cardiac Anaesthesia
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