Factors influencing time of intubation with a lightwand device in patients without known airway abnormality

Wong, Shu-Yam; Coşkunfırat, Nesil; Hee, H.T.; Li, Jihn-Yih; Chen, Chit; Tseng, Chi-Hao

doi:10.1016/j.jclinane.2003.09.017

Cited by 24 publications

(20 citation statements)

References 32 publications

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“…Although it has been reported that intubation presents a greater difficulty in patients with a high BMI (Voyagis et al 1998;Mansharamani et al 2000;MacIntyre et al 2001;Wong et al 2004), respiratory complications (Asai et al 1998) and obstructive sleep apnea (Tun et al 2003) are observed more frequently, and the mortality rate is higher (Tremblay and Bandi 2003). To the best of our knowledge, the relationship between BMI and the CLT has not been pointed out in previous studies.…”

Section: Discussionmentioning

confidence: 85%

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High Body Mass Index and Long Duration of Intubation Increase Post-Extubation Stridor in Patients with Mechanical Ventilation

Erginel

Uçgun

Yıldırım

et al. 2005

Tohoku J. Exp. Med.

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Approximately 20% of mechanically ventilated patients experience post-extubation stridor (PES) and reintubation, which subsequently may lead to an increased risk of morbidity and mortality. The risk of PES development is significantly higher in obese patients. Low air leakage between the endotracheal tube and the trachea, following cuff deflation, may indicate a higher risk for the development of PES. The aim of this study is to identify the relationship between body mass index (BMI) and PES using the cuff-leak test in patients intubated in the respiratory intensive care unit. A total of 67 consecutive intubations on 56 different ventilated patients were included in this study. The mean age was 63.6 ± 12.1 years and 84% of the patients were male. PES developed in seven patients (10.4%). The mean cuffleak volume was 395 ± 187 ml in non-PES patients and 240 ± 93 ml in PES patients (p = 0.023). The mean BMI was 36 ± 13 kg/m 2 in PES patients and 24 ± 7 kg/m 2 in non-PES patients (p = 0.046). BMI > 26.5 kg/m 2 (OR: 1.2), low cuff-leak volume (< 283 ml) and mechanical ventilation required for more than 5 days (OR: 0.9) were independent variables for PES occurrence. We therefore suggest that non-obese patients, short-term intubated patients and those having a high air leakage around the endotracheal tube could be extubated without much difficulty.intensive care unit; cuff-leak test; body mass index; post-extubation stridor; reintubation

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Section: Discussionmentioning

confidence: 85%

“…To the best of our knowledge, the relationship between BMI and the CLT has not been pointed out in previous studies. In other studies, it has been reported that a higher BMI (27-30 kg/m 2 ) could lead to difficult intubation and PES development (Voyagis et al 1998;Mansharamani et al 2000;MacIntyre et al 2001;Wong et al 2004). …”

Section: Discussionmentioning

confidence: 91%

High Body Mass Index and Long Duration of Intubation Increase Post-Extubation Stridor in Patients with Mechanical Ventilation

Erginel

Uçgun

Yıldırım

et al. 2005

Tohoku J. Exp. Med.

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“…Several measures are suggested as predictors of difficult airway namely short TMD, limited mouth opening, and head extension (15)(16)(17)(18). Expectedly, the current study patients with these predictors got higher Cormack-Lehane scores.…”

Section: Discussionmentioning

confidence: 99%

Effect of Jaw Thrust and BURP Maneuvers on Glottis Visualization During C-MAC® Videolaryngoscopy

Mohseni¹,

Siamdoust²,

Rokhtabnak³

et al. 2017

Ann Anesth Crit Care

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Background: Different techniques are proposed to improve glottis visualization during laryngoscopy, namely backward-upwardrightward pressure (BURP) and jaw trust; however, with controversial results. The current study aimed at comparing the maneuvers to elicit their efficacy for better glottis visualization in videolaryngoscopy (VL). Methods: In the current self-controlled, randomized, clinical trial, 104 patients candidate for elective surgery requiring endotracheal intubation were recruited. All participants underwent airway examination, thyromental distance (TMD), limited mouth opening, and head extension were recorded. Laryngoscopy was performed by a single anesthetist using C-MAC® (KARL STORZ, Germany) and a Macintosh blade, size 4. A second anesthetist applied BURP and jaw thrust maneuvers. For each patient 3 images were provided with and without a maneuver in the optimal view. The images were randomly coded. An anesthesiologist blinded to the codes and assignments scored images based on the Cormack-Lehane scoring system. Results: Both maneuvers significantly improved glottis visualization, but BURP rendered more promising effects. Gender-specific analyses yielded similar results. In subgroups of patients with limited head extension, TMD < 5 cm or limited mouth opening, the findings were significant. Conclusions: Both BURP and jaw thrust maneuvers resulted in better glottis visualization. Nevertheless, BURP may provide better conditions during laryngoscopy irrespective of airway parameters and should be attempted first.

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“…Nevertheless, certain authors also attempted to identify potential problems with other intubation techniques, such as the lighted stylet, 3 the intubating laryngeal mask airway (Fastrach TM ), 4 or the videolaryngoscope. 5 The number of related randomized controlled trials is limited, often leaving the clinician to rely on lower levels of evidence of case reports/case series and personal experience to define or assess the advantages and limitations of these devices.…”

Section: Direct Laryngoscopymentioning

confidence: 99%

“…Néanmoins, certains auteurs ont aussi tenté d'identifier les obstacles à l'utilisation d'autres techniques d'intubation, qu'il s'agisse de la tige lumineuse, 3 du masque laryngé d'intubation Fastrach TM4 ou de la vidéolaryngoscopie. 5 Ces articles sont cependant peu nombreux et il faut plutôt se résigner à recenser les cas rapportés afin de tenter de définir ou d'évaluer les avantages et limites de ces outils.…”

Section: La Laryngoscopie Directeunclassified

Management of the anticipated difficult airway—a systematic approach: Continuing Professional Development

Drolet

2009

Can J Anesth/J Can Anesth

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Factors influencing time of intubation with a lightwand device in patients without known airway abnormality

Cited by 24 publications

References 32 publications

High Body Mass Index and Long Duration of Intubation Increase Post-Extubation Stridor in Patients with Mechanical Ventilation

High Body Mass Index and Long Duration of Intubation Increase Post-Extubation Stridor in Patients with Mechanical Ventilation

Effect of Jaw Thrust and BURP Maneuvers on Glottis Visualization During C-MAC® Videolaryngoscopy

Management of the anticipated difficult airway—a systematic approach: Continuing Professional Development

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