Comparison of 4 Airway Devices on Cervical Spine Alignment in a Cadaver Model With Global Ligamentous Instability at C5–C6

Prasarn, Mark L.; Conrad, Bryan P.; Rubery, Paul T.; Wendling, Adam; Aydoğ, Tolga; Horodyski, MaryBeth; Rechtine, Glenn R.

doi:10.1097/brs.0b013e31822419fe

Cited by 34 publications

(30 citation statements)

References 26 publications

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“…The extent of movement required to produce a neurological injury in cervical spine instability is unknown, and there is not even robust evidence of laryngoscopy's being a causative factor in cervical cord injury [2,9,16,17]. A recent study from the American …”

Section: Discussionmentioning

confidence: 99%

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Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq^®, Macintosh and McCoy laryngoscopes

et al. 2014

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SummaryConcern that laryngoscopy and intubation might create or exacerbate a spinal cord injury has generated extensive research into cervical spinal movement during laryngoscopy. We performed a randomised trial on six cadavers, using three different laryngoscopes, before and after creating a type-2 odontoid peg fracture. Our primary outcome measure was the change in the space available for the spinal cord at the C1/2 segment measured by cinefluoroscopy. Tracheal intubation was performed using a minimal view of the glottis, a bougie, and manual in-line stabilisation. In a cadaveric model of type-2 odontoid fracture, the space available for the cord was preserved in maximum flexion and extension, and changed little on laryngoscopy and intubation.

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Section: Discussionmentioning

confidence: 99%

“…There are no prospective data on the extent of movement at the unstable C1/2 motion segment that might result in a cervical cord injury during laryngoscopy [9]. Using a = 0.05 and b = 0.…”

mentioning

confidence: 99%

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq^®, Macintosh and McCoy laryngoscopes

et al. 2014

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“…Another major limitation was the use of only a single kinetic therapy bed. The main strengths of the current study include the use of a large number of cadavers and the use of a well-established spinal injury testing methodology [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Is it safe to use a kinetic therapy bed for care of patients with cervical spine injuries?

Prasarn¹,

Horodyski

Behrend

et al. 2015

Injury

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“…In animal models, even 90 min of 'non-injurious' ventilation produces upregulation of pro-inflammatory genes and their products [61,62]. It is of concern that tidal volumes [49,50] Confirmation of tracheal intubation using capnography…”

Section: Management Of Ventilationmentioning

confidence: 99%

The principles and conduct of anaesthesia for emergency surgery

Gray

Morris

2012

Anaesthesia

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SummaryIn this second article we examine the principles underlying delivery of the components of anaesthesia. Topics considered include anaesthetic technique, management of the airway and lung ventilation, induction and maintenance of anaesthesia, patient monitoring including the place of cardiac output devices. We summarise recent research on the management of shock and sepsis syndromes including goal directed therapy and examine some controversies around intravenous fluid therapy. Finally, we discuss intra-operative awareness and challenges during emergence including perioperative cognitive dysfunction. Choice of anaesthetic techniqueOptimal anaesthetic technique is dependent upon an individualised assessment of patient and surgical requirements. Prospective, randomised, controlled trials of rival anaesthetic techniques, e.g. the GALA trial, are rare [1]. Emergency anaesthesia lacks this evidence base and extrapolations from meta-analyses typically fail to reach clear recommendations for clinicians [2]. The nature of surgery, patient co-morbidities, and urgency will frequently decide the anaesthetic choice but clinicians should remain mindful of the options of local or regional anaesthesia and sedation in appropriate patients, especially when a 'lesser' procedure becomes feasible e.g. percutaneous drainage. Management and protection of the airway including pulmonary aspirationThe fourth National Audit Project (NAP4) of the Royal College of Anaesthetists recorded the epidemiology and management of airway complications in UK practice and is essential reading [3]. It is emphasised that 25% of emergency airway management takes place outside operating theatres and since publication, several resources and recommendations have become available [4][5][6]. In the UK, out-of-theatre tracheal intubation frequently occurs in the absence of essential staff and equipment and capnography was not used in nearly a third of cases in a large observational study [7].Both difficult laryngoscopy and difficult tracheal intubation are more common in emergency patients, often outside the theatre setting [8,9]. One American study of non-theatre emergency tracheal intubation by experienced practitioners identified difficulties in over 10%, with over 4% suffering complications [10]. Predictors of complications included multiple attempts and poor views at laryngoscopy and intubation in a ward or emergency department setting. Human factors are increasingly recognised in airway complications and an unfamiliar environment during airway management is likely to be important [3].

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Comparison of 4 Airway Devices on Cervical Spine Alignment in a Cadaver Model With Global Ligamentous Instability at C5–C6

Cited by 34 publications

References 26 publications

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq^®, Macintosh and McCoy laryngoscopes

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq^®, Macintosh and McCoy laryngoscopes

Is it safe to use a kinetic therapy bed for care of patients with cervical spine injuries?

The principles and conduct of anaesthesia for emergency surgery

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Comparison of 4 Airway Devices on Cervical Spine Alignment in a Cadaver Model With Global Ligamentous Instability at C5–C6

Cited by 34 publications

References 26 publications

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq®, Macintosh and McCoy laryngoscopes

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq®, Macintosh and McCoy laryngoscopes

Is it safe to use a kinetic therapy bed for care of patients with cervical spine injuries?

The principles and conduct of anaesthesia for emergency surgery

Contact Info

Product

Resources

About

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq^®, Macintosh and McCoy laryngoscopes

Cadaveric study of movement of an unstable atlanto-axial (C1/C2) cervical segment during laryngoscopy and intubation using the Airtraq^®, Macintosh and McCoy laryngoscopes