Multivariate Analysis of the Failure Risk of First Tracheal Intubation Attempt in a Population of Patients Scheduled for Bariatric Surgery

2021 ◽  
Author(s):  
Michel Galinski ◽  
Marine Chouteau ◽  
Gessica Lunghi ◽  
Marianne Vinurel ◽  
Béatrice Blazy ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Multivariate Analysis ◽  
Tracheal Intubation ◽  
Intubation Attempt ◽  
Failure Risk

scholarly journals Intubating Conditions with Rocuronium Bromide and Suxamethonium in Elective Surgeries: A Randomized Comparative Study

2019 ◽  
Vol 7 (1) ◽  
pp. 3-8
Author(s):  
Kanchan Prakash Paudyal ◽  
Pawan Puspa Baral ◽  
Laxmi Pathak
Keyword(s):  
Tracheal Intubation ◽  
Comparative Study ◽  
P Value ◽  
Intubation Attempt ◽  
Medical Sciences ◽  
Intubating Conditions ◽  
Airway Trauma ◽  
Group 3 ◽  
American Society ◽  
Lottery System

INTRODUCTION: Adequate  intubating  condition  is  required  to  avoid  airway  trauma  and  adverse  sympathetic  responses. Though, Succinylcholine is considered as ideal drug, it has many contraindications. In search of alternative, rocuronium is found to have similar responses in higher doses. Therefore, our aim was to compare the effect of different dosages of rocuronium with sucinylcholine for tracheal intubation and the haemodynamic variables.  MATERIAL AND METHODS: A prospective randomized comparative study was conducted in Universal College of Medical Sciences (UCMS-TH) in 90 (American Society of Anaesthesiologists Physical Status I and II) patients with age between 18 to 60 years scheduled for elective surgeries under general anesthesia. They were divided into 3 groups of 30 each using lottery system. Groups 1 and 2 received intravenous rocuronium 0.6mg/kg and 1mg/kg respectively whereas patients in group 3 received intravenous succinylcholine 1.5mg/kg. Under continuous monitoring, tracheal intubation attempt was done at 60 seconds after the administration of drug and intubating conditions were assessed according to Cooper et al four point scale.  RESULTS: Only 26.7% of patients in group 1 exhibited excellent intubating condition whereas in groups 2 and 3, excellent intubating condition was exhibited in 100% when muscle relaxant was administered at 60 seconds with highly significant statistical difference between groups 1 and 3 with p value <0.001 without any adverse effects in any of these patients. CONCLUSION: This study concluded that intubating response with inj. succinylcholine 1.5mg/kg is similar to rocuronium 1.0mg/kg and is superior to inj rocuronium 0.6mg/kg, for intubating condition at 60 seconds following the drug administration while using Cooper et al. Score.

scholarly journals A Comparison of Performance of Endotracheal Intubation Using the Levitan FPS Optical Stylet or Lary-Flex Videolaryngoscope in Morbidly Obese Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Tomasz Gaszynski ◽  
Monika Pietrzyk ◽  
Tomasz Szewczyk ◽  
Ewelina Gaszynska
Keyword(s):  
Bariatric Surgery ◽  
Endotracheal Intubation ◽  
Primary Endpoint ◽  
Direct Laryngoscopy ◽  
Cardiovascular Response ◽  
Intubation Attempt ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Monitor Display ◽  
Glottic View

Introduction.The use of videolaryngoscopes is recommended for morbidly obese patients. The aim of the study was to evaluate the Levitan FPS optical stylet (Levitan) vs Lafy-Flex videolaryngoscope (Lary-Flex) in a group of MO patients.Methods.Seventy-nine MO (BMI>40 kg m−2) patients scheduled for bariatric surgery were included in the study and randomly allocated to the Levitan FPS or Lary-Flex group. The primary endpoint was time to intubation and evaluation laryngoscopic of glottic view. Anesthesiologists were asked to evaluate the glottic view first under direct laryngoscopy using the videolaryngoscope as a standard laryngoscope (monitor display was excluded from use) and then using devices. The secondary endpoint was the cardiovascular response to intubation and the participant’s evaluation of such devices.Results.The time to intubation was8.572.66 sec. versus5.790.2 sec. for Levitan and Lary-Flex, respectively (P<0.05). In all cases of CL grade>1under direct laryngoscopy, the study devices improved CL grade to 1. The Levitan FPS produced a greater cardiovascular response than the Lary-Flex videolaryngoscope.Conclusion.The Lary-Flex videolaryngoscope and the Levitan FPS optical stylet improve the laryngeal visualization in morbidly obese patients, allowing for fast endotracheal intubation, but Lary-Flex produces less cardiovascular response to intubation attempt.

Critical Airway Team: A Retrospective Study of an Airway Response System in a Pediatric Hospital

2017 ◽  
Vol 157 (6) ◽  
pp. 1060-1067 ◽  
Author(s):  
Emily C. Sterrett ◽  
Charles M. Myer ◽  
Jennifer Oehler ◽  
Bobby Das ◽  
Benjamin T. Kerrey
Keyword(s):  
Tracheal Intubation ◽  
Difficult Intubation ◽  
Direct Laryngoscopy ◽  
Case Series ◽  
Intubation Attempt ◽  
Response Team ◽  
Airway Response ◽  
History Of ◽  
Surgical Airway ◽  
Team Characteristics

Objective Study the performance of a pediatric critical airway response team. Study Design Case series with chart review. Setting Freestanding academic children’s hospital. Subjects and Methods A structured review of the electronic medical record was conducted for all activations of the critical airway team. Characteristics of the activations and patients are reported using descriptive statistics. Activation of the critical airway team occurred 196 times in 46 months (March 2012 to December 2015); complete data were available for 162 activations (83%). For 49 activations (30%), patients had diagnoses associated with difficult intubation; 45 (28%) had a history of difficult laryngoscopy. Results Activation occurred at least 4 times per month on average (vs 3 per month for hospital-wide codes). The most common reasons for team activation were anticipated difficult intubation (45%) or failed intubation attempt (20%). For 79% of activations, the team performed an airway procedure, most commonly direct laryngoscopy and tracheal intubation. Bronchoscopy was performed in 47% of activations. Surgical airway rescue was attempted 4 times. Cardiopulmonary resuscitation occurred in 41 activations (25%). Twenty-nine patients died during or following team activation (18%), including 10 deaths associated with the critical airway event. Conclusion Critical airway team activation occurred at least once per week on average. Direct laryngoscopy, tracheal intubation, and bronchoscopic procedures were performed frequently; surgical airway rescue was rare. Most patients had existing risk factors for difficult intubation. Given our rate of serious morbidity and mortality, primary prevention of critical airway events will be a focus of future efforts.

scholarly journals Comparison of the Laryngeal View during Tracheal Intubation Using Airtraq and Macintosh Laryngoscopes by Unskillful Anesthesiology Residents: A Clinical Study

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Carlos Ferrando ◽  
Gerardo Aguilar ◽  
F. Javier Belda
Keyword(s):  
Clinical Study ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
The Other ◽  
Intubation Attempt ◽  
Laryngeal View ◽  
Other Hand

Background and Objective. The Airtraq laryngoscope (Prodol Meditec, Vizcaya, Spain) is a novel tracheal intubation device. Studies, performed until now, have compared the Airtraq with the Macintosh laryngoscope, concluding that it reduces the intubation times and increase the success rate at first intubation attempt, decreasing the Cormack-Lehane score. The aim of the study was to evaluate if, in unskillful anesthesiology residents during the laryngoscopy, the Airtraq compared with the Macintosh laryngoscope improves the laryngeal view, decreasing the Cormack-Lehane score.Methods. A prospective, randomized, crossed-over trial was carried out on 60 patients. Each one of the patients were intubated using both devices by unskillful (less than two hundred intubations with the Macintosh laryngoscope and 10 intubations using the Airtraq) anesthesiology residents. The Cormack-Lehane score, the success rate at first intubation attempt, and the laryngoscopy and intubation times were compared.Results. The Airtraq significantly decreased the Cormack-Lehane score (). On the other hand, there were no differences in times of laryngoscopy (; IC 95% 3.1, +4.8) and intubation (; C95%  −6.1, +10.0) between the two devices. No relevant complications were found during the maneuvers of intubation using both devices.Conclusions. The Airtraq is a useful laryngoscope in unskillful anesthesiology residents improving the laryngeal view and, therefore, facilitating the tracheal intubation.

Determination of Predictive Variables Associated to Difficult Tracheal Intubation in a Cohort of Obese Patients who Underwent Bariatric Surgery

2015 ◽  
Vol 11 (6) ◽  
pp. S146-S147
Author(s):  
Marissa Minutti ◽  
Eduardo Herrera ◽  
David Velàzquez-Fernàndez ◽  
Guillermo Dominguez-Cherit ◽  
Miguel Herrera ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Tracheal Intubation ◽  
Difficult Tracheal Intubation ◽  
Obese Patients ◽  
Predictive Variables

scholarly journals Incident heart failure risk after bariatric surgery: the role of epicardial fat

2020 ◽  
Vol 41 (18) ◽  
pp. 1775-1775 ◽  
Author(s):  
Gijs van Woerden ◽  
Sophie L van Veldhuisen ◽  
Michiel Rienstra
Keyword(s):  
Heart Failure ◽  
Bariatric Surgery ◽  
Epicardial Fat ◽  
Failure Risk ◽  
Incident Heart Failure

scholarly journals Difficult tracheal intubation in bariatric surgery patients, a myth or reality?

2016 ◽  
Vol 116 (4) ◽  
pp. 557-558 ◽  
Author(s):  
M.M. Hashim ◽  
M.A. Ismail ◽  
A.M. Esmat ◽  
S Adeel
Keyword(s):  
Bariatric Surgery ◽  
Tracheal Intubation ◽  
Difficult Tracheal Intubation

scholarly journals Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy

2009 ◽  
Vol 23 (7) ◽  
pp. 1645-1645 ◽  
Author(s):  
Vicky Ka Ming Li ◽  
Nestor Pulido ◽  
Patricio Fajnwaks ◽  
Samuel Szomstein ◽  
Raul Rosenthal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Multivariate Analysis ◽  
Sleeve Gastrectomy ◽  
Gastric Banding ◽  
Gallstone Formation

scholarly journals Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study

2020 ◽  
Author(s):  
Yuanyuan Ma ◽  
Yan Wang ◽  
Ping Shi ◽  
Xue Cao ◽  
Shengjin Ge
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Sore Throat ◽  
Elective Surgery ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Intubation Attempt ◽  
Successful Intubation ◽  
Ultrasound Guided ◽  
Normal Airway

Abstract Background To compare ultrasound-guided tracheal intubation (UGTI) versus Shikani optical stylet (SOS)-aided tracheal intubation in patients with anticipated normal airway.Methods Sixty patients aged 18–65 years old who presented for elective surgery under general anesthesia were recruited in this prospective randomized study. They were assigned into two equal groups, either an ultrasound-guided group (Group UG, n = 30) or an SOS-aided group (Group SOS, n = 30). After the induction of anesthesia, the tracheal intubation was performed by a specified skilled anesthesiologist. The number of tracheal intubation attempt and the duration of successful intubation on the first attempt were recorded. Complications relative to tracheal intubation including desaturation, hoarseness and sore throat were also recorded.Results The first-attempt success rate is 93.3% (28/30) in Group UG and 90% (27/30) in Group SOS (P = 0.64). The second-attempt was all successful for the 2 and 3 patients left in the two groups, and the overall success rate of both groups was 100%. The duration of successful intubation on the first attempt of Group UG was not significantly different from that of Group SOS (34.0 ± 20.8 s vs 35.5 ± 23.2 s, P = 0.784). One patient in Group SOS had desaturation (P = 0.313), and there was none hoarseness in the two groups. Sore throat was detected in both group (4 in Group UG, 5 in Group SOS, P = 0.718).Conclusion Ultrasound-guided tracheal intubation was as effective as Shikani optical stylet-aided tracheal intubation in adult patients with anticipated normal airway.Trial registration: Chinese Clinical Trial Registry, ChiCTR-IIC-17010875. Date of Registration: 15 March 2017.

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