Role of Trachway versus Conventional Modes of Intubation in Difficult Airway Management in COVID-19 Setups

Difficult airway management in critically ill patients remains a difficult task associated with high morbidity and mortality rates. In difficult airway populations, prompt effective intubation is more important to prevent hypoxia and neurological injury. During the ongoing COVID-19 pandemic, prolonged intubation time and repeated intubation can lead to an increase in the risk of infection. Therefore, digital devices can shorten intubation times and decrease the risk of infection among clinical staff. The advantages of the Trachway videolight intubating stylet suit these conditions. Trachway stylet intubation is an effective method for video laryngoscopy to enhance patient safety and improve the intubation success rate. However, a few studies have focused on the effect of stylet intubation by reducing repeated intubation and oxygen desaturation. In this study, we reviewed current data of Trachway intubation and shared our four major training scenarios in Taipei Tzu Chi Hospital via the Trachway videolight intubating stylet system for emergency intubation, comparing them with other modes of intubation.

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Emergency Surgical Airways Following Activation of a Difficult Airway Management Team in Hospitalized Critically Ill Patients: A Case Series

Journal of Intensive Care Medicine ◽

10.1177/0885066616680594 ◽

2016 ◽

Vol 33 (9) ◽

pp. 517-526 ◽

Cited By ~ 4

Author(s):

Joseph M. Darby ◽

Gregory Halenda ◽

Courtney Chou ◽

Joseph J. Quinlan ◽

Louis H. Alarcon ◽

...

Keyword(s):

Airway Management ◽

Difficult Airway ◽

Critically Ill ◽

Critically Ill Patients ◽

Case Series ◽

Management Team ◽

Team Approach ◽

High Morbidity ◽

Difficult Airway Management ◽

Surgical Airway

Introduction: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. Methods: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT). Results: Of 207 DAMT activations for native airway events, 22 (10.6%) events culminated in an ESA, with 59% of these events occurring in ICUs with the remainder outside the ICU in the context of rapid response team activations. Of patients undergoing ESA, 77% were male, 63% were obese, and 41% had a history of a difficult airway (DA). Failed planned or unplanned extubations preceded 61% of all ESA events in the ICUs, while bleeding from the upper or lower respiratory tract led to ESA in 44% of events occurring outside the ICU. Emergency surgical airway was the primary method of airway control in 3 (14%) patients, with the remainder of ESAs performed following failed attempts to intubate. Complications occurred in 68% of all ESAs and included bleeding (50%), multiple cannulation attempts (36%), and cardiopulmonary arrest (27%). Overall hospital mortality for patients undergoing ESA was 59%, with 38% of deaths occurring at the time of the airway event. Conclusion: An ESA is required in approximately 10% of DA events in critically ill patients and is associated with high morbidity and mortality. Efforts directed at early identification of patients with a difficult or challenging airway combined with a multidisciplinary team approach to management may reduce the overall frequency of ESA and associated complications.

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Manejo anestésico de resección de quiste de vallécula en neonato. A propósito de un caso

Revista Chilena de Anestesia ◽

10.25237/revchilanestv49n04-16 ◽

2020 ◽

Vol 49 (4) ◽

pp. 576-580

Author(s):

Neus Fuertes S. ◽

José Cortell B. ◽

Juan Camilo Jaramillo G. ◽

Pilar Argente N.

Keyword(s):

Airway Management ◽

Respiratory Distress ◽

Difficult Airway ◽

Gold Standard ◽

Orotracheal Intubation ◽

Spontaneous Ventilation ◽

Morbidity And Mortality ◽

High Morbidity ◽

Difficult Airway Management ◽

Alternative Management

Difficult airway management is one of the most important challenges an anesthesiologist faces. It is due to the high morbidity and mortality that it entails. The challenge is even greater if the patient is a newborn. For this reason, we should have different strategies that allow us to anticipate and treat possible complications derived from the procedure. In this case, we present a newborn with vallecular cyst and respiratory distress who is admitted for cyst resection. The gold-standard in anticipated difficult airway management is the fibrobronchoscope. We decided to perform an alternative management by means of orotracheal intubation with videolaryngoscope (Glydescope) in spontaneous ventilation.

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