Airway research: the current status and future directions

Isono, Shiroh; Greif, Robert; Mort, Thomas C.

doi:10.1111/j.1365-2044.2011.06928.x

Cited by 8 publications

(7 citation statements)

References 99 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Airway patency is governed by complex interactions between neuromuscular function and inherent airway structural properties [38, 39]. Upper airway integrity is impaired by minimal levels of neuromuscular blockade due to the susceptibility of the upper airway muscles to the effects of NMBAs [6, 40].…”

Section: Residual Paralysis and Outcomesmentioning

confidence: 99%

“…Repeated airway interventions, upper airway surgery and excessive fluid administration can all result in tissue swelling that may increase airflow resistance [39]. During anesthesia there is also a reduction in the functional residual capacity of the lung, which can increase airway collapsibility, especially in obese patients [45].…”

Section: Residual Paralysis and Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Farhan

Moreno-Duarte

McLean

et al. 2014

Curr Anesthesiol Rep

View full text Add to dashboard Cite

Neuromuscular blocking agents are used to facilitate tracheal intubation in patients undergoing ambulatory surgery. The use of high-dose neuromuscular blocking agents to achieve muscle paralysis throughout the case carries an increased risk of residual post-operative neuromuscular blockade, which is associated with increased respiratory morbidity. Visually monitoring the train-of-four (TOF) fade is not sensitive enough to detect a TOF fade between 0.4 and 0.9. A ratio <0.9 indicates inadequate recovery. Quantitative neuromuscular transmission monitoring (e.g., acceleromyography) should be used to exclude residual neuromuscular blockade at the end of the case. Residual neuromuscular blockade needs to be reversed with neostigmine, but it’s use must be guided by TOF monitoring results since deep block cannot be reversed, and neostigmine administration after complete recovery of the TOF-ratio can induce muscle weakness. The development and use of new selectively binding reversal agents (sugammadex and calabadion) warrants reevaluation of this area of clinical practice.

show abstract

Section: Residual Paralysis and Outcomesmentioning

confidence: 99%

Section: Residual Paralysis and Outcomesmentioning

confidence: 99%

Residual Paralysis: Does it Influence Outcome After Ambulatory Surgery?

Farhan

Moreno-Duarte

McLean

et al. 2014

Curr Anesthesiol Rep

View full text Add to dashboard Cite

show abstract

“…In general, the clinical evaluation of SADs is complicated by a number of practical limitations; the relative infrequency of difficult airways and airway complications often necessitates high-powered, multicentre studies [13], and the subsequent cost and difficulty renders such trials an unattractive option. Lately non-inferiority trials of airways devices have been employed [14]; these found that most popular second-generation SADs (i.e.…”

Section: Context Of This Studymentioning

confidence: 99%

A Cross-Sectional Study Evaluating the GuardianCPVTM Supraglottic Airway Device in a Clinical Setting

Li¹,

Tang²,

Bouniu³

et al. 2017

J Anesth Clin Res

View full text Add to dashboard Cite

Objective: The GuardianCPV TM is a new second-generation supraglottic airway device (SAD), for which there is currently limited information on efficacy or safety. Our aim is to clarify further the efficacy of the Guardian, and to assess any potential predictors for success or failure of insertion. Methods:We conducted a cross-sectional pilot study over a two-month period, recruiting 67 operative cases (33 males; 34 females; weight 81.1 ± 23.0 kg) at the Northern Hospital (TNH), Victoria, Australia, that used the Guardian airway in an elective setting. For each case, the operator of the airway reported, via a voluntary questionnaire, several factors of interest: (1) the overall success rate (primary outcome); (2) ease of insertion; (3) cuff seal pressure (CSP); (4) need for repositioning of the SAD; and (5) patient, airway, operator and technique-related predictors, including past experience with the Guardian (as determined by number of times previously used) and insertion technique. Results:The overall success rate was 78%. There was a positive association between prior experience with the Guardian and subsequent success rates (p=0.049). Successful insertion was associated with greater ease with insertion (p=0.012), and greater CSPs (p<0.0001). The most popular insertion technique was sideways-and-rotate. No other patient, airway or technique-related factors had any significant impact on success rates with the Guardian. Conclusion:The Guardian SAD demonstrated similar efficacy to other SADs as reported in the literature. Prior familiarization with a new airway device is a key determinant in its successful use.

show abstract

“…A third striking aspect is that almost every author echoes the need for evidence as necessary to inform our decision-making processes [11,12]. Perhaps if this supplement had been written 20 or even 10 years ago, we may all have focussed upon the details of emerging technology and speculated (using our own experiences or authority) as to how we might apply it.…”

mentioning

confidence: 99%

“…Careful readers will note that within each chapter, authors have posed some specific questions that they have identified as relevant and fruitful for future research [11]. Similarly NAP4, directly and indirectly through its findings, poses a number of research questions [15][16][17][18][19][20].…”

mentioning

confidence: 99%