Successful intubation of a child with Goldenhar syndrome, who previously failed intubation, using an Airtraq

Objectives. To assess the advantages and disadvantages of videolaryngoscopy as one of methods of tracheal intubation which is being widely used as an alternative to direct laryngoscopy in anesthesiologist’s practice.Material and methods. Over 100 of tracheal intubations were conducted with the use of videolaryngoscope, along with a routine use of the direct laryngoscopy. The results of 48 intubations are discussed. 4 clinical cases are presented in this article.Results. Cormack-Lehane grade I view was obtained in 39 cases (81,3%), Cormack-Lehane grade II - in 9 patients (18,8%). First attempt intubation was performed in 43 cases (89,6%), in 4 cases intubation was successful after second attempt (8,3%), failed intubation was in 1 case (2,1%). The mean duration of successful intubation was 36,9 sec. Certain difficulties occured during intubation related with the advancement of the endotracheal tube. Technical solutions are given for some of intraprocedural conditions.Conclusions. Videolaryngoscopy is a safe and effective method of tracheal intubation. Although this method is not lacking in disadvantages it has a number of advantages, main of which is the improved larynx visualization. In our opinion, this method can not completely replace direct laryngoscopy in anesthesiolodist’s practice, but may serve as an adjuvant in case of difficult intubation.

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Modified Infant Feeding Tube as an Indigenous Endotracheal Tube in Unanticipated Congenital Subglottic Stenosis

Indonesian Journal of Anesthesiology and Reanimation ◽

10.20473/ijar.v3i12021.1-9 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Rahul Gupta ◽

Rama Chatterjee ◽

Neelam Dogra ◽

Dinesh Kumar Barolia ◽

Pratibha Rathore ◽

...

Keyword(s):

Endotracheal Tube ◽

Infant Feeding ◽

Feeding Tube ◽

Subglottic Stenosis ◽

Surgical Patients ◽

Successful Intubation ◽

Failed Intubation ◽

Shunt System ◽

Emergency Airway ◽

Infant Feeding Tube

Introduction: In neonates with an unanticipated difficult airway, there is an increased probability of failed intubation even with highly trained hands while performing direct laryngoscopy. Aims: We describe our experience of using a modified infant feeding tube (IFT) as an indigenous endotracheal tube (ETT) in a series of paediatric surgical patients with congenital subglottic stenosis (SGS). Material and Methods: A retrospective study was performed in our institute from January 2018 to December 2019. ETT with modified 6 and 8 French (Fr) sized IFT’s were used. A stylet obtained from the VP shunt system was used to aid in intubation. Results: Out of 12,500 admissions in our department, there were 5 pediatric cases with SGS which were managed using modified IFT. Four were neonates and 1 infant (M:F = 2:3). Modified IFT(s) were used after failed intubation with ETT of size 2.5 mm in 4 patients (non-availability of ETT of size 2 mm), while in one neonate, even 2 mm ETT could not be negotiated due to SGS. In all the 5 children, successful intubation was finally performed with modified 8 French (Fr) IFT in 3, and with modified 6 Fr IFT in two cases. The surgical procedure was completed in 4 neonates out of 5 cases, while in one infant it was deferred due to the clinical condition of the patient and significant SGS. Conclusion: All 5 patients with SGS were managed without performing a tracheostomy. Modified IFT(s) is an effective alternative if smaller sized ETT(s) cannot be negotiated or unavailable in difficult neonatal and paediatric airway. This modified IFT as ETT has to be an important part of the emergency airway tray. It should not be considered as a replacement for routine use of standard ETT.

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Successful intubation with Macintosh laryngoscope after failed intubation with McGrath videolaryngoscope in post burn contracture of the neck

Sri Lankan Journal of Anaesthesiology ◽

10.4038/slja.v22i2.6833 ◽

2014 ◽

Vol 22 (2) ◽

pp. 69

Author(s):

Rashmi Salhotra ◽

Varun Arora ◽

Chhavi Sarabpreet Sharma ◽

Ashok Kumar Sethi

Keyword(s):

Macintosh Laryngoscope ◽

Successful Intubation ◽

Failed Intubation

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Infant with Goldenhar syndrome: failed intubation and rescue using fiberoptic and i-gel laryngeal mask.

Trends in Anaesthesia and Critical Care ◽

10.1016/j.tacc.2019.12.077 ◽

2020 ◽

Vol 30 ◽

pp. e30

Author(s):

Sebastián Tamayo Orozco ◽

Juan Luis Ramírez Latorre ◽

Ms Carolina Alzate Saldarriaga

Keyword(s):

Laryngeal Mask ◽

Goldenhar Syndrome ◽

Failed Intubation

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Fifteen-minute consultation: Intubation of the critically ill child presenting to the emergency department

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2021-322520 ◽

2021 ◽

pp. edpract-2021-322520

Author(s):

Constantinos Kanaris ◽

Peter Croston Murphy

Keyword(s):

Emergency Department ◽

Critically Ill ◽

Critically Ill Children ◽

Successful Intubation ◽

Patient Harm ◽

Failed Intubation ◽

Drug Choice ◽

Critically Ill Child ◽

Adequate Oxygenation ◽

Selection Of

Intubation of critically ill children presenting to the emergency department is a high-risk procedure. Our article aims to offer a step-by-step guide as to how to plan and execute a rapid, successful intubation in a way that minimises risk of adverse events and patient harm. We address considerations such as the need for adequate resuscitation before intubation and selection of equipment and personnel. We also discuss drug choice for induction and peri-intubation instability, difficult airway considerations as well as postintubation care. Focus is also given on the value of preintubation checklists, both in terms of equipment selection and in the context of staff role designation and intubation plan clarity. Finally, in cases of failed intubation, we recommend the application of the Vortex approach, highlighting, thus, the importance of avoiding task fixation and maintaining our focus on what matters most: adequate oxygenation.

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