endotracheal supraglottic

BACKGROUND: The pediatric sizes of BlockBuster supraglottic airway (SGA) have been introduced recently. Its efficacy as a conduit for endotracheal intubation in children has not been assessed. Newer devices are often compared with Air-Q SGA to assess their intubating capability. AIMS: The primary objective was to compare the time taken for fiber-optic-guided intubation through the BlockBuster and the Air-Q SGAs. METHODS: Sixty children aged 6 months to 12 years with normal airways were randomized into two groups: Air-Q SGA (Group A) and Blockbuster SGA (Group B)...

A 39-year-old man presented for mechanical thrombectomy after receiving systemic tissue plasminogen activator (tPA) for a basilar artery occlusion. The anesthesiology team was initially unable to intubate the patient due to oropharyngeal bleeding and a large epiglottis. Two-handed, 2-provider mask ventilation with an oral airway proved difficult. The team successfully placed a supraglottic airway (SGA) through which an oral endotracheal tube (ETT) was advanced over a fiberoptic bronchoscope into the trachea...

OBJECTIVE: Unlike randomized controlled trials, practical real-world studies can offer important information about implementation of prehospital interventions, particularly in community settings where there may be reluctance to adopt new practices. We present the results of a natural experiment that was driven by mandated COVID-19 pandemic-driven shift from endotracheal intubation (ETI) to the i-gel® supraglottic airway (SGA) as a primary advanced airway management device in the prehospital setting to reduce emergency medical services (EMS) personnel exposure to potentially infectious secretions...

(1) Background: Supraglottic airway devices (SAD) have been used in children and adolescents undergoing adenotonsillectomies under general anesthesia. This systematic review and meta-analysis investigate the safety and efficacy of using SADs when compared to an endotracheal tube (ETT). (2) Methods: After registering with PROSPERO, databases like PubMed, Scopus, OviD, CINAHL, and Cochrane Library were searched using relevant keywords from the year 2000. We used RoB-2 for risk-of-bias assessment, GRADE for assessing the quality of evidence, RevMan 5...

Tracheal and subglottic stenoses are inflammatory conditions that can arise from a variety of potential etiologies, most commonly as a result of iatrogenic airway injury due to endotracheal intubation. Significant stenosis requires management by endoscopy or surgical resection. We describe a case of recurrent subglottic cuff stenosis with an episode of sudden desaturation in a 25-year-old female. The management involved balloon dilatation, laser ablation, and topical mitomycin C application through a flexible fiberoptic bronchoscope...

OBJECTIVE: Intraosseous (IO) access is frequently utilized during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients. Due to proximity to the heart and differential flow rates, the anatomical site of IO access may impact patient outcomes. Using a large dataset, we aimed to compare the outcomes of OHCA patients who received upper or lower extremity IO access during resuscitation. METHODS: The ESO Data Collaborative public use research datasets were used for this retrospective study...

IMPORTANCE: While epinephrine and advanced airway management (AAM) (supraglottic airway insertion and endotracheal intubation) are commonly used for out-of-hospital cardiac arrest (OHCA), the optimal sequence of these interventions remains unclear. OBJECTIVE: To evaluate the association of the sequence of epinephrine administration and AAM with patient outcomes after OHCA. DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed the nationwide, population-based OHCA registry in Japan and included adults (aged ≥18 years) with OHCA for whom emergency medical services personnel administered epinephrine and/or placed an advanced airway between January 1, 2014, and December 31, 2019...

The escalating airway management demands of cancer patients have prompted us to continually curate airway devices, with supraglottic airway devices (SADs) playing a significant role in this regard. SADs serve as instrumental tools for maintaining an open upper airway. Since the inception of the earliest SADs in the early 1980s, an array of advanced and enhanced second-generation devices have been employed in clinical settings. These upgraded SADs integrate specific features designed to enhance positive-pressure ventilation and mitigate the risk of aspiration...

AIM: of the study: This study aimed to compare the survival outcomes of adult patients with out-of-hospital cardiac arrest (OHCA) by drowning who were treated with either endotracheal intubation (ETI) or a supraglottic airway (SGA) device. METHODS: We compared the outcomes of patients with OHCA by drowning according to airway management using a Japanese nationwide population-based registry (All-Japan Utstein Registry). Adult patients with OHCA treated in 2014-2020 with advanced airway management (ETI or SGA) were included...

BACKGROUND: Patients who have had laryngectomy require a thorough preoperative assessment for potential stomal stenosis, and an action plan for possible inadvertent displacement of the voice prosthesis (VP) must be considered. We report the anesthetic management of a post-laryngectomy patient undergoing lung resection surgery. The patient had both a laryngectomy and a VP in situ . CASE DESCRIPTION: A 66-year-old man with Parkinson's disease, who had previously undergone total laryngectomy for supraglottic laryngeal cancer, had a cuffed tracheostomy tube and a VP inserted into the tracheoesophageal fistula below it...

Correct placement of supraglottic airway devices (SGDs) is crucial for patient safety and of prime concern of anesthesiologists who want to provide effective and efficient airway management to their patients undergoing surgery or procedures requiring anesthesia care. In the majority of cases, blind insertion of SGDs results in less-than-optimal anatomical and functional positioning of the airway devices. Malpositioning can cause clinical malfunction and result in interference with gas exchange, loss-of-airway, gastric inflation, and aspiration of gastric contents...

Airway management is a cornerstone of emergency medical care. This project aimed to create evidence-based guidelines based on the systematic review recently conducted by the Agency for Healthcare Research and Quality (AHRQ). A technical expert panel was assembled to review the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The panel made specific recommendations on the different PICO (population, intervention, comparison, outcome) questions reviewed in the AHRQ review and created good practice statements that summarize and operationalize these recommendations...

Guidelines for the management of in-hospital cardiac arrest resuscitation are often drawn from evidence generated in out-of-hospital cardiac arrest populations and applied to the in-hospital setting. Approach to airway management during resuscitation is one example of this phenomenon, with the recommendation to place either a supraglottic airway or endotracheal tube when performing advanced airway management during in-hospital cardiac arrest based mainly in clinical trials conducted in the out-of-hospital setting...

Surfactant replacement therapy (SRT) by nebulization to spontaneously breathing patients has been regarded as the Holy Grail since surfactant deficiency was first identified as the cause for neonatal respiratory distress syndrome. It avoids neonatal endotracheal intubation, a procedure that is often difficult and occasionally harmful. Unapproved alternatives to endotracheal tube placement for liquid surfactant instillation, such as LISA (thin catheter intubation) and SALSA (supraglottic airway insertion) have significant merit but are still invasive, leaving nebulized SRT as the only truly non-invasive method...

BACKGROUND AND OBJECTIVES: Although endotracheal intubation is the gold standard in airway management, this procedure requires both technical training and experience. Supraglottic airway devices are an alternative to endotracheal intubation and are simpler, less invazive, and require less time for placement compared with endotrakeal intubation. Aim of the study was to evaluate the success rates, ease of use, duration of application, and maneuver performance of different supraglottic airway devices (SADs) used by term-5 medical students on a manikin...

BACKGROUND: Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea. METHODS: This study included adult medical OHCA patients enrolled prospectively, using data from the citywide OHCA registry for patients registered between 2018 and 2021. The primary outcome was survival to hospital discharge...

In this study, we aimed to compare supraglottic airway devices (Supreme and i-gel laryngeal mask) with tracheal tube with respect to airway control and efficiency in ventilation and oxygenation. The study included 325 patients of ASA I-II who underwent laparoscopic cholecystectomy. In group 1, the airway was secured using endotracheal intubation (115 patients). In group 2 (103 patients), LMA Supreme was applied, whereas i-gel mask was used for airway management in group 3 (107 patients). Monitoring parameters were recorded and compared using t-test, analysis of variance (ANOVA), Tukey's test and χ2-test...

OBJECTIVES: Post-extubation stridor (PES) is difficult to predict before extubation. We therefore evaluated the potential diagnostic performance of pre-extubation laryngeal air column width difference (LACWD) measurement, as assessed by intensivist-performed point-of-care laryngeal ultrasound, in relation to clinically important PES. DESIGN: Prospective observational cohort study. SETTING: Single quaternary care PICU (July 19, 2021, to October 31, 2022)...

PURPOSE: Supraglottic airway devices (SGAs) have been increasingly used as a primary airway in patients undergoing anesthesia as an alternative to endotracheal tubes. Second-generation devices have expanded their applicability to include uses in patients with obesity. Nevertheless, there is limited evidence of SGA suitability for patients with class 3 obesity (body mass index [BMI] ≥ 40 kg·m-2 ). As such, we compared rates of SGA functionality between patients with class 3 obesity and patients without class 3 obesity undergoing general anesthesia...

INTODUCTION: In veterinary medicine, airway management of cats under general anesthesia is performed with an endotracheal tube (ETT) or supraglottic airway device (SGAD). This study aims to describe the use of computational fluid dynamics (CFD) to assess the velocities, pressures, and resistances of cats with ETT or SGAD. METHODS: A geometrical reconstruction model of the device, trachea, and lobar bronchi was carried out from computed tomography (CT) scans that include the head, neck, and thorax...