Evaluation of the accuracy and reliability of the percentage of glottic opening score

2021 ◽  
Vol 38 (2) ◽  
pp. 202-205
Author(s):  
Dilek Unal Yazicioglu ◽  
Sevilay Karahan ◽  
Basak Gulel ◽  
Burak Nalbant ◽  
Melis Sumak ◽  
...  
Keyword(s):  
Glottic Opening

scholarly journals Effects of head positions on awake fiberoptic bronchoscope oral intubation: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhuo Liu ◽  
Li Zhao ◽  
Zhongfeng Ma ◽  
Meiqi Liu ◽  
Xiaohang Qi ◽  
...  
Keyword(s):  
Tracheal Tube ◽  
Orotracheal Intubation ◽  
Neutral Position ◽  
Fiberoptic Bronchoscope ◽  
Glottic Opening ◽  
Vocal Cords ◽  
Oral Intubation ◽  
Vas Scores ◽  
Head Positions ◽  
Position Group

Abstract Background There are many factors affecting the success rate of awake orotracheal intubation via fiberoptic bronchoscope. We performed this study was to investigate the effects of head positions on awake Fiberoptic bronchoscope oral intubation. Methods Seventy-five adult patients, received general anaesthesia were included in this study. After written informed consent, these patients were undergoing awake orotracheal intubation via fiberoptic-bronchoscope and according to the head position, the patients were randomized allocated to neutral position group (NP group), sniffing position group (SP group) or extension position group (EP group). After sedation the patients were intubated by an experienced anesthesiologist. The time to view the vocal cords, the percentage of glottic opening scores (POGO), the time to insert the tracheal tube into trachea and the visual analog scale (VAS) scores for ease experienced of passing the tracheal tube through glottis, the hemodynamic changes and the adverse events after surgery were recorded. Results The time to view the vocal cords was significantly shorter and the POGO scores was significantly higher in the EP group compared with the other two groups (P < 0.05); The SpO2 in the EP group was higher than NP group at before intubation and higher than SP group and NP group at immediate after intubation (P < 0.05); The time to insert the tracheal tube into trachea, the VAS scores for passing the tracheal tube through glottis, the coughing scores had no significant differences among groups (P > 0.05). There were also no significant differences regard to the incidence of postoperative complications, mean arterial pressure and heart rate among the groups (P > 0.05). Conclusions The head at extension position had a best view of glottic opening than neutral position or sniffing position during awake Fiberoptic bronchoscope oral intubation, so extension position was recommended as the starting head position for awake Fiberoptic bronchoscope oral intubation. Trial registration Clinical Trials.gov. no. NCT02792855. Registered at https://register.clinicaltrials.gov on 23 september 2017.

scholarly journals A Prospective Randomized Equivalence Trial of the GlideScope Cobalt® Video Laryngoscope to Traditional Direct Laryngoscopy in Neonates and Infants

2012 ◽  
Vol 116 (3) ◽  
pp. 622-628 ◽  
Author(s):  
John E. Fiadjoe ◽  
Harshad Gurnaney ◽  
Nicholas Dalesio ◽  
Emily Sussman ◽  
Huaqing Zhao ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Elective Surgery ◽  
Passage Time ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Success Rates ◽  
Glottic Opening ◽  
Equivalence Trial ◽  
Neonates And Infants ◽  
Normal Neonates

Background Intubation in children is increasingly performed using video laryngoscopes. Many pediatric studies examine novice laryngoscopists or describe single patient experiences. This prospective randomized nonblinded equivalence trial compares intubation time for the GlideScope Cobalt® video laryngoscope (GCV, Verathon Medical, Bothell, WA) with direct laryngoscopy with a Miller blade (DL, Heine, Dover, NH) in anatomically normal neonates and infants. The primary hypothesis was that intubation times with GCV would be noninferior to DL. Methods Sixty subjects presenting for elective surgery were randomly assigned to intubation using GCV or DL. Intubation time, time to best view, percentage of glottic opening score, and intubation success were documented. We defined an intubation time difference of less than 10 s as clinically insignificant. Results There was no difference in intubation time between the groups (GCV median = 22.6 s; DL median = 21.4 s; P = 0.24). The 95% one-sided CI for mean difference between the groups was less than 8.3 s. GCV yielded faster time to best view (median = 8.1 s; DL 9.9 s; P = 0.03). Endotracheal tube passage time was longer for GCV (median = 14.3 s; DL 8.5 s; P = 0.007). The percentage of glottic opening score was improved with GCV (median 100; DL 80; P &lt; 0.0001). Conclusions Similar intubation times and success rates were achieved in anatomically normal neonates and infants with the GCV as with DL. The GCV yielded faster time to best view and better views but longer tube passage times than DL.

scholarly journals Assessment of Airway Visualization: Validation of the Percentage of Glottic Opening (POGO) Scale

1998 ◽  
Vol 5 (9) ◽  
pp. 919-923 ◽  
Author(s):  
Richard M. Levitan ◽  
E. Andrew Ochroch ◽  
Scott Rush ◽  
Frances S. Shofer ◽  
Judd E. Hollander
Keyword(s):  
Glottic Opening

scholarly journals A Randomised Control Trial Comparing the Efficacy of LMA-Supreme and I-Gel as Rescue Ventilatory Device in Patients with Simulated Difficult Airway Undergoing Anaesthesia with Controlled Ventilation

2021 ◽  
Author(s):  
Sadia Rahman ◽  
Nidhi Agarwal ◽  
Sushil Guria ◽  
Swati Jain ◽  
Mona Swain
Keyword(s):  
Difficult Airway ◽  
Randomised Control Trial ◽  
P Value ◽  
Leak Pressure ◽  
Glottic Opening ◽  
Controlled Ventilation ◽  
Oropharyngeal Leak Pressure ◽  
Group I ◽  
Lma Supreme ◽  
Ventilatory Device

Introduction: In an unanticipated difficult airway or in an emergency situation of cannot-intubate-cannot-ventilate scenario, Supraglottic Airway Devices (SGD) are recommended as rescue devices for establishing airway quickly to prevent hypoxia. Aim: To compare efficacy of i-gel airway and Laryngeal Mask Airway supreme (LMA supreme) as ventilatory devices and the time taken for their insertion in anaesthetised and paralysed patients with simulated difficult airway. Materials and Methods: One hundred and eighty adult patients with simulated difficult airway were randomly allocated to two groups of 90 patients each. In group I: i-gel and in group S: LMA supreme was inserted. Primary outcome studied was time taken for insertion of SGD. Secondary outcomes were the number of attempts taken for insertion of device, oropharyngeal leak pressure, ease of gastric catheter insertion, fibreoptic bronchoscopic view of anatomical alignment of device with glottic opening. Quantitative variables were compared using unpaired t-test/Mann-Whitney Test, between the two groups. Qualitative variable were compared using Chi-Square test/Fisher’s-exact test. Results: Total time taken for successful insertion was significantly shorter with group i-gel as compared to group LMA supreme {median (IQR) {19 (18.25-21)} versus {24 (23-24)} with p-value ≤0.0001. Overall success rate of insertion (96.67% vs 97.78%, p=1.000) and oropharyngeal leak pressure (p-value=0.555) of i-gel and LMA-S were comparable. i-gel has better anatomic alignment with glottic opening as compared to LMA-S (p-value ≤0.0001). Gastric tube insertion was easy in all patients in both the groups. Conclusion: Shorter time for the insertion of i-gel was observed due to absence of inflatable cuff, although both LMA-S and i-gel are equally efficacious as ventilatory devices in patients with simulated difficult airway under general anaesthesia with controlled ventilation.

Abstract 186: Patient Positioning Improves Direct Laryngoscopy First-Attempt Success in Patients with Cardiac Arrest

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mark Escott ◽  
Guy Gleisberg ◽  
Kevin Traynor ◽  
Shane Jenks ◽  
Levon Vartanian ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Patient Outcomes ◽  
Direct Laryngoscopy ◽  
Patient Positioning ◽  
Study Patient ◽  
Glottic Opening ◽  
Institutional Review ◽  
Advanced Airway ◽  
Rural Settings ◽  
Difficult Airways

Introduction: Multiple endotracheal intubation (ETI) attempts can facilitate complications and adversely affect patient outcomes. According to the AHA, in out-of-hospital urban and rural settings, patients intubated during resuscitation had a better survival rate than patients who were not intubated. Published literature on cardiac arrest (CA) patient positioning during ETI and its significance on first attempt success rate (FASR) are scarce. Objective: To compare direct laryngoscopy (DL) intubation FASR and glottic exposure with patient position during CA. Methods: An institutional review board approved, multi-agency prospective analysis was conducted comparing video laryngoscopy to DL from March 18, 2013 through March 17, 2014 performed by consented paramedics. Subsequently, a subgroup analysis was performed on CA patients, examining the effect of provider positioning on FASR during DL. Throughout this study, patient airways were managed in the following optional positions: (1) supine - floor (Floor), (2) supine stretcher - ambulance (Ambulance), and (3) supine stretcher - elevated (Elevated). We recorded the FASR, Cormack- Lehane and Percentage of Glottic Opening views within each intubation position. Results: A total of 190 first attempt DL intubations were recorded, of these 120 (63%) were successful. The DL intubation FASR by positions was: (1) Floor 37 (55%) compared to Ambulance 19 (58%) (95% CI: -0.179 - 0.216), (2) Ambulance 19 (58%) compared to Elevated 64 (71%) (95% CI: -0.047 - 0.323), (3) Floor 37 (55%) compared to Elevated 64 (71%)(95%: CI: 0.008 - 0.304). The Cormack- Lehane view grade mean was: Floor 2.6, Ambulance 2.4, and Elevated 2.0. The Percentage of Glottic Opening mean was: Floor 52%, Ambulance 53%, and Elevated 66%. Conclusions: This analysis demonstrated a 16% increase and superiority in DL intubation FASR from the Floor to the Elevated position on CA patients. The Elevated position offers an enhanced view of the airway anatomy and improved Cormack- Lehane and Percentage of Glottic Opening scores. The position of intubation should be considered when evaluating the appropriate stage in cardiac arrest to provide advanced airway management, particularly with anticipated difficult airways.

Magnetic Control of the Glottic Opening in an Ex Vivo Sheep Larynx Model: A Preliminary Study

2016 ◽  
Vol 30 (5) ◽  
pp. 621-625 ◽  
Author(s):  
Zafer Ciftci ◽  
Mahmut Deniz ◽  
Halide Gunes Ciftci ◽  
Damla Nihan Ozdemir ◽  
Aklime Isik ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Magnetic Control ◽  
Glottic Opening ◽  
Preliminary Study

Endoscopic Surgical Management for Laryngomalacia

1987 ◽  
Vol 96 (6) ◽  
pp. 650-653 ◽  
Author(s):  
Kevin T. Kavanagh ◽  
Richard W. Babin
Keyword(s):  
Airway Obstruction ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Surgical Intervention ◽  
Preoperative Evaluation ◽  
Supraglottic Airway ◽  
Direct Visualization ◽  
Glottic Opening ◽  
The Many ◽  
Severe Airway Obstruction

Laryngomalacia is the most common of the many causes of respiratory stridor in the newborn. It may be identified by fiberoptic nasopharyngoscopy in the nursery or office. Several anatomic mechanisms of supraglottic collapse have been reported in the literature. The most common is a narrowing of the supraglottic airway with blockage of the glottic opening by the redundant tissue of the aryepiglottic folds. Although surgery rarely is indicated, severe airway obstruction, necessitating surgical intervention, can occur. Resection of supraglottic tissue should be performed only as an alternative to tracheotomy. Surgical procedures ranging from tracheotomy to epiglottidectomy have been advocated. Direct visualization of the obstructing tissue by nasopharyngoscopy allows the planning of an appropriate surgical procedure. In a patient with lateral supraglottic collapse, deep resection of the epiglottis would be expected to weaken the support of the aryepiglottic folds and aggravate the airway condition. Similarly, resection of tissue along the aryepiglottic folds will be useful only if preoperative evaluation demonstrates the obstruction to be at this location.

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