Ultrasound guided tracheal intubation with a styleted tracheal tube in anticipated difficult airway

2020 ◽  
Author(s):  
Pankaj Kundra ◽  
Sri Rama Ananta Nagabhushanam Padala ◽  
Ajay Kumar Jha
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Tracheal Tube ◽  
Ultrasound Guided

scholarly journals Tracheal Tube-Mounted Camera Assisted Intubation vs. Videolaryngoscopy in Expected Difficult Airway: A Prospective, Randomized Trial (VivaOP Trial)

2021 ◽  
Vol 8 ◽  
Author(s):  
Jörn Grensemann ◽  
Emma Möhlenkamp ◽  
Philipp Breitfeld ◽  
Pischtaz A. Tariparast ◽  
Tanja Peters ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Randomized Trial ◽  
Difficult Airway ◽  
Tracheal Tube ◽  
Negative Impact ◽  
Prospective Randomized Trial ◽  
Success Rates ◽  
Blade Shape ◽  
Difficult Airways ◽  
End Tidal

Background: Tracheal intubation in patients with an expected difficult airway may be facilitated by videolaryngoscopy (VL). The VL viewing axis angle is specified by the blade shape and visualization of the larynx may fail if the angle does not meet anatomy of the patient. A tube with an integrated camera at its tip (VST, VivaSight-SL) may be advantageous due to its adjustable viewing axis by means of angulating an included stylet.Methods: With ethics approval, we studied the VST vs. VL in a prospective non-inferiority trial using end-tidal oxygen fractions (etO2) after intubation, first-attempt success rates (FAS), visualization assessed by the percentage of glottis opening (POGO) scale, and time to intubation (TTI) as outcome parameters.Results: In this study, 48 patients with a predicted difficult airway were randomized 1:1 to intubation with VST or VL. Concerning oxygenation, the VST was non-inferior to VL with etO2 of 0.79 ± 0.08 (95% CIs: 0.75–0.82) vs. 0.81 ± 0.06 (0.79–0.84) for the VL group, mean difference 0.02 (−0.07 to 0.02), p = 0.234. FAS was 79% for VST and 88% for VL (p = 0.449). POGO was 89 ± 21% in the VST-group and 60 ± 36% in the VL group, p = 0.002. TTI was 100 ± 57 s in the VST group and 68 ± 65 s in the VL group (p = 0.079). TTI with one attempt was 84 ± 31 s vs. 49 ± 14 s, p < 0.001.Conclusion: In patients with difficult airways, tracheal intubation with the VST is feasible without negative impact on oxygenation, improves visualization but prolongs intubation. The VST deserves further study to identify patients that might benefit from intubation with VST.

scholarly journals Secrets to a successful awake fibreoptic intubation (AFOI) on a patient with odentogenous abscess

2021 ◽  
Vol 14 (2) ◽  
pp. e238600
Author(s):  
Ming Kai Teah ◽  
Esther Huey Ring Liew ◽  
Melvin Teck Fui Wong ◽  
Tat Boon Yeap
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Patient Outcomes ◽  
Fibreoptic Intubation

Awake fibreoptic intubation (AFOI) is an established modality in patients with anticipated difficulty with tracheal intubation. This case demonstrates that with careful and meticulous preparations, AFOI can lead to improved airway management and excellent patient outcomes. A 38-year-old woman presented with severe trismus secondary to odentogenous abscess was identified preoperatively as having a potential difficult airway. AFOI was performed successfully using combined Spray-As-You-Go and dexmedetomidine technique.

scholarly journals Videolaryngoscope‐assisted flexible intubation tracheal tube exchange in a patient with a difficult airway

2019 ◽  
Vol 7 (1) ◽  
pp. 22-25 ◽  
Author(s):  
T. G. Saunders ◽  
M. L. Gibbins ◽  
C. A. Seller ◽  
F. E. Kelly ◽  
T. M. Cook
Keyword(s):  
Difficult Airway ◽  
Tracheal Tube ◽  
Tube Exchange

Comparison of the Intubating Laryngeal Mask Airway with the Fiberoptic Intubation in Anticipated Difficult Airway Management

2001 ◽  
Vol 94 (6) ◽  
pp. 968-972 ◽  
Author(s):  
Olivier Langeron ◽  
François Semjen ◽  
Jean-Louis Bourgain ◽  
Alain Marsac ◽  
Anne-Marie Cros
Keyword(s):  
Laryngeal Mask Airway ◽  
Tracheal Intubation ◽  
Adverse Events ◽  
Oxygen Saturation ◽  
Difficult Airway ◽  
Difficult Intubation ◽  
Laryngeal Mask ◽  
Fiberoptic Intubation ◽  
Alternative Technique ◽  
Intubating Laryngeal Mask Airway

Background The intubating laryngeal mask airway (ILMA; Fastrach; Laryngeal Mask Company, Henley-on-Thames, UK) may provide an alternative technique to fiberoptic intubation (FIB) to facilitate the management of the anticipated difficult airway. The authors therefore compared the effectiveness of the ILMA with FIB in patients with anticipated difficult intubation. Methods One hundred patients, with at least one difficult intubation criteria (Mallampati class III or IV, thyromental distance < 65 mm, interincisor distance < 35 mm) were enrolled (FIB group, n = 49; ILMA group, n = 51) in this prospective randomized study. Anesthesia was induced with propofol and maintained with alfentanil and propofol after an efficient mask ventilation has been demonstrated. The success of the technique (within three attempts), the number of attempts, duration of the successful attempt, and adverse events (oxygen saturation < 90%, bleeding) were recorded. Results The rate of successful tracheal intubation with ILMA was 94% and comparable with FIB (92%). The number of attempts and the time to succeed were not significantly different between groups. In case of failure of the first technique, the alternative technique always succeeded. Failures in FIB group were related to oxygen desaturation (oxygen saturation < 90%) and bleeding, and to previous cervical radiotherapy in the ILMA group. Adverse events occurred significantly more frequently in FIB group than in ILMA group (18 vs. 0%, P < 0.05). Conclusion The authors obtained a high success rate and comparable duration of tracheal intubation with ILMA and FIB techniques. In patients with previous cervical radiotherapy, the use of ILMA cannot be recommended. Nevertheless, the use of the ILMA was associated with fewer adverse events.

scholarly journals The AirView Study: Comparison of Intubation Conditions and Ease between the Airtraq-AirView and the King Vision

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Patrick Schoettker ◽  
Jocelyn Corniche
Keyword(s):  
Difficult Airway ◽  
Median Time ◽  
Tracheal Tube ◽  
Primary Endpoint ◽  
Clinical Relevance ◽  
Lung Ventilation ◽  
Professional Experience ◽  
Tube Insertion ◽  
Secondary Endpoints

We conducted a study assessing the quality and speed of intubation between the Airtraq with its new iPhone AirView app and the King Vision in a manikin. The primary endpoint was reduction of time needed for intubation. Secondary endpoints included times necessary for intubation. 30 anaesthetists randomly performed 3 intubations with each device on a difficult airway manikin. Participants had a professional experience of 12 years: 60.0% possessed the Airtraq in their hospital, 46.7% the King Vision, and 20.0% both. Median time difference [IQR] to identify glottis (1.1 [−1.3; 3.9]P=0.019), for tube insertion (2.1 [−2.6; 9.4]P=0.002) and lung ventilation (2.8 [−2.4; 11.5]P=0.001), was shorter with the Airtraq-AirView. Median time for glottis visualization was significantly shorter with the Airtraq-AirView (5.3 [4.0; 8.4] versus 6.4 [4.6; 9.1]). Cormack Lehane before intubation was better with the King Vision (P=0.03); no difference was noted during intubation, for subjective device insertion or quality of epiglottis visualisation. Assessment of tracheal tube insertion was better with the Airtraq-AirView. The Airtraq-AirView allows faster identification of the landmarks and intubation in a difficult airway manikin, while clinical relevance remains to be studied. Anaesthetists assessed the intubation better with the Airtraq-AirView.

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