An optimal tracheal tube preshaping strategy for endotracheal intubation using video laryngoscopy: a randomized controlled trial

Cao, Yukun; Jiang, Lianxiang; Zhang, Yan; Yao, Wei‐Dong; Chen, Yong Q.; Zhang, Dai

doi:10.1007/s10877-022-00806-4

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…For example, it may not be suitable for patients with spinal cord injuries who are unable to tilt their head back or for obese patients who may have difficulty in exposing the glottis. Previous study showed a correlation between different blade angulation and difficulty in delivering the tube to the glottic opening [ 4 ]. This has led to the development of many new intubation devices based on traditional visualization devices to assist anesthesiologists in both routine and difficult airway management.…”

Section: Introductionmentioning

confidence: 99%

Comparison of video laryngoscope, video stylet, and flexible videoscope for transoral endotracheal intubation in patients with difficult airways: a randomized, parallel-group study

Zhang,

Zhao,

Zhang

et al. 2023

Trials

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Background The 2022 ASA guidelines recommend the video laryngoscope, video stylet, and flexible videoscope as airway management tools. This study aims to compare the efficacy of three airway devices in intubating patients with difficult airways. Methods A total of 177 patients were selected and randomized into the following three groups: the video laryngoscope group (Group VL, n = 59), video stylet group (Group VS, n = 59), and flexible videoscope group (Group FV, n = 59). The success rate of the first-pass intubation, time of tracheal intubation, level of glottic exposure, and occurrence of intubation-related adverse events were recorded and analyzed. Results All patients were successfully intubated with three devices. The first-pass intubation success rate was significantly higher in Groups VS and FV than in Group VL (96.61% vs. 93.22% vs. 83.05%, P < 0.01), but it was similar in the first-pass intubation success rate between Groups VS and FV(P > 0.05). The number of patients categorized as Wilson-Cormack-Lehane grade I-II was fewer in Group VL than in Groups VS and FV (77.97% vs. 98.30% vs. 100%, P = 0.0281). The time to tracheal intubation was significantly longer in Group FV(95.20 ± 4.01) than in Groups VL(44.56 ± 4.42) and VS(26.88 ± 4.51) (P < 0.01). No significant differences were found among the three groups in terms of adverse intubation reactions (P > 0.05). Conclusions In patients with difficult airways requiring intubation, use of the video stylet has the advantage of a relatively shorter intubation time, and the flexible videoscope and video stylet yield a higher first-pass intubation success rate and clearer glottic exposure than the use of the video laryngoscope. Trial registration Chinese Clinical Trial Registry. No: ChiCTR2200061560, June 29, 2022.

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Section: Introductionmentioning

confidence: 99%

Comparison of video laryngoscope, video stylet, and flexible videoscope for transoral endotracheal intubation in patients with difficult airways: a randomized, parallel-group study

Zhang,

Zhao,

Zhang

et al. 2023

Trials

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“…Examples include patients with spinal cord injury who cannot tilt their head back and obese patients who have di culty exposing the vocal tract. There is a study that showed a correlation between different blade angulation and di culty in accessing the vocal tract with a tracheal tube [4]. This has led to the development of many new intubation devices based on traditional visualization devices to assist anesthesiologists in both routine and di cult airway management.…”

Section: Introductionmentioning

confidence: 99%

Comparison of video laryngoscope, video stylet, and flexible videoscope for transoral endotracheal intubation in patients with difficult airways: A randomized, parallel-group study

Zhang

Zhao

Cheng

et al. 2022

Preprint

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BACKGROUND: According to the 2022 American Society of Anesthesiologists (ASA) guidelines on difficult airway management, video laryngoscope, video stylet, and flexible videoscope are recommended for intubation of complex difficult airways. Here we compare the advantages of three airway devices when intubating patients with difficult airways. METHODS: For a comparative study on transoral intubation, 170 patients were selected and randomized into the following three groups: the video laryngoscope group (Group VL, n=59), video stylet group (Group VS, n=59), and flexible videoscope group (Group FV, n=59). The success rate of the first-pass intubation, time of tracheal intubation, level of glottic exposure and occurrence of intubation-related adverse events were recorded and analyzed. RESULTS: A total of 177 patients were enrolled, 59 of whom were randomized to each group. All patients were successfully intubated with three devices. The first-pass intubation success rate was significantly higher in Groups VS and FV than in Group VL (96.61% vs. 93.22% vs. 83.05%, P<0.01), but the difference in the first-pass intubation success rate between Groups VS and FV was not significant(P>0.05). The number of patients categorized as Wilson-Cormack-Lehane(W-C-L) class I-II was lower in Group VL than in Groups VS and FV (77.97% vs. 98.30% vs. 100%, P=0.0281). The mean time to intubation was 44.56 ± 4.42 seconds in Group VL, 26.88 ± 4.51 seconds in the Group VS and 95.20 ± 4.01 seconds in Group FV, and the time to tracheal intubation was significantly longer in Group FV than in Groups VL and VS. Obviously, the Group VS had a significant advantage in intubation time (P < 0.01). No significant differences were found among the three groups in terms of adverse intubation reactions (P > 0.05). CONCLUSIONS: In patients with difficult airways requiring intubation, use of the video stylet has the advantage of a relatively shorter intubation time, and the flexible videoscope and video stylet yield a higher first-pass intubation success rate and clearer glottic exposure than the use of the video laryngoscope. Trial registration: Chinese Clinical Trial Registry. No: ChiCTR2200061560. Prospective registration.

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The mechanical power in neurocritical care patients: is it useful?

Chiumello

Coppola

2022

J Clin Monit Comput

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Patients with acute brain injury have been excluded in the majority of the randomized clinical trials which evaluated a lung protective strategy in patients with acute respiratory failure. It remains unclear if low tidal volume, higher PEEP levels and recruitment maneuvers by increasing both the intracranial and intrathoracic pressure and by leading to a permissible hypercapnia could furthermore deteriorate the acute brain injury and the final outcome. Mechanical power has been associated with the outcome in ARDS patients without brain injury. Jiang et al. demonstrated in neurocritical patients that non-survivors had a higher mechanical power compared to survivors. Mechanical power was associated with an increase in intensive care mortality risk and also to an enhanced risk of hospital mortality, prolonged intensive care length of stay and fewer ventilatory free days; in addition, the mechanical power could better predict mortality compared to the Glasgow Coma Scale.

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An optimal tracheal tube preshaping strategy for endotracheal intubation using video laryngoscopy: a randomized controlled trial

Cited by 4 publications

References 22 publications

Comparison of video laryngoscope, video stylet, and flexible videoscope for transoral endotracheal intubation in patients with difficult airways: a randomized, parallel-group study

Comparison of video laryngoscope, video stylet, and flexible videoscope for transoral endotracheal intubation in patients with difficult airways: a randomized, parallel-group study

Comparison of video laryngoscope, video stylet, and flexible videoscope for transoral endotracheal intubation in patients with difficult airways: A randomized, parallel-group study

The mechanical power in neurocritical care patients: is it useful?

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