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

Drolet, Pierre

doi:10.1007/s12630-009-9144-4

Cited by 29 publications

(10 citation statements)

References 33 publications

(30 reference statements)

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“…Aucun e´chec d'intubation n'a e´te´note´dans le groupe VL contre deux e´checs dans le groupe LS (diffe´rence non significative). 8 Les patients ayant une DID \ 35 mm, une DTM \ 60 mm ou une classe Mallampati III ou IV étaient considérés comme pouvant avoir une intubation difficile et étaient exclus de l'étude. Les patients inclus étaient randomisés en deux groupes selon la technique utilisée pour l'intubation : un groupe vidéolaryngoscopie (le X-Lite TM Vidéolaryngoscope Rusch, Tuttlingen, Allemagne) (groupe VL) et un groupe laryngoscopie standard avec une lame de MacIntosh (groupe LS).…”

Section: Résuméunclassified

Le vidéolaryngoscope permet une intubation avec un tube à double lumière plus rapide que le laryngoscope standard

Bensghir

Alaoui

Azendour³

et al. 2010

Can J Anesth/J Can Anesth

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Purpose This study was designed to compare videolaryngoscopy with direct laryngoscopy with respect to ease of intubation when inserting a double lumen tube (DLT). Methods In this prospective randomized study 68 patients American Society of Anesthesiologists (ASA) physical status I and II were included. Patients with criteria indicating possible difficult intubation were excluded. The patients were randomized into two groups, depending on the tool used to facilitate intubation: videolaryngoscope (VL group) or direct laryngoscopy (DL group). The time required for intubation was the primary endpoint. Cormack and Lehane glottic visualization (CL) scores, the need for external laryngeal maneuvers and the number of attempts were measured. Results Glottic visualization was better in the VL group than in the DL group. The CL scores were I, II and III in 24, eight and two patients, respectively, in the VL group compared with 13, 11 and eight in the DL group (P = 0.025). Patients in the VL group required fewer attempts than the DL group (P = 0.019). Intubation time was 39.9 ± 4.4 sec in the VL group and 47.9 ± 5.4 sec in the DL group (P \ 0.001). No intubation failure was noted in group VL compared with two in the DL group (not significant). Conclusion The use of a videolaryngoscope reduces the time required for intubation with a DLT compared with the direct laryngoscopy in elective thoracic surgery.

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Section: Résuméunclassified

Le vidéolaryngoscope permet une intubation avec un tube à double lumière plus rapide que le laryngoscope standard

Bensghir

Alaoui

Azendour³

et al. 2010

Can J Anesth/J Can Anesth

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“…2 Currently, fiberoptic intubation (FOI) with a flexible fiberoptic bronchoscope has become a mainstay of difficult airway management in awake, sedated, and anesthetized patients; its use is taught at the annual meeting of the American Society of Anesthesiologists (ASA), 3 and its role is recognized in guidelines for management of both anticipated and unanticipated difficult airways. [4][5][6][7] …”

Section: Introductionmentioning

confidence: 99%

Fiberoptic Intubation: An Overview and UpdateDiscussion

2014

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SummaryFiberoptic intubation (FOI) is an effective technique for establishing airway access in patients with both anticipated and unanticipated difficult airways. First described in the late 1960s, this approach can facilitate airway management in a variety of clinical scenarios given proper patient preparation and technique. This paper seeks to review the pertinent technology, clinical techniques, and indications for and complications of its use. The role of FOI in airway management algorithms is discussed. Evidence is presented comparing FOI to other techniques with regard to difficult airway management. In addition, we have reviewed the literature on training processes and skill development in FOI.

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“…[6] Thus, unexpected difficult intubation is an intermittent and often challenging problem for clinically practicing anesthesiologists, maxillofacial surgeons, eye, ear, and nose (ENT), emergency, and critical care physicians. [67] An increasing number of airway management devices have been introduced into clinical practice. [38] One such device is the tracheal tube introducer (bougie), which has been widely used to facilitate endotracheal intubation.…”

Section: Introductionmentioning

confidence: 99%

“…[38] One such device is the tracheal tube introducer (bougie), which has been widely used to facilitate endotracheal intubation. [56789] Ideally, it is used when the glottic opening is partially visible, it can also be effective when only the epiglottis is seen. The gum elastic bougie is effective to solve most problems occurring during predicted and unexpected difficult airway management.…”

Section: Introductionmentioning

confidence: 99%

Making endotracheal intubation easy and successful, particularly in unexpected difficult airway

Abdulla

Abdulla²,

Schwemm

et al. 2014

Int J Crit Illn Inj Sci

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Background:Difficult intubation, most often due to poor view of the vocal cords on laryngoscopy is an intermittent and often challenging problem for clinically practicing anesthesiologists, maxillofacial surgeons, ear nose, and throat (ENT), emergency, and critical care physicians.Purpose:We present a new approach for facilitating difficult intubation and evaluate its efficacy in a retrospective observational study.Settings and Design:Operating room, emergency department, intensive care unit (ICU), retrospective observational study.Materials and Methods:A semirigid 5.6 Rüsch tracheal tube introducer (bougie) with its soft tip protruding at least 6 cm (=4 digits) beyond the distal end of the tube was used. After its insertion through the larynx under laryngoscopy, the tube was gently advanced upon rotation at 360° clockwise.Statistical Analysis:Descriptive.Results:Anesthesia services were analyzed on 10,363 patients over 12 months. In 2453 patients (23.7%) (Group A) intubated in the usual way, difficulties were encountered in 63 patients (2.6%). They were managed either with tube rotation technique (n = 60) or Bonfils endoscope (n = 3). In contrast, 2807 patients (27.1%) (Group B) were intubated using tube rotation technique with introducer. Difficult intubations occurred only in three patients (0.11%) who could be managed with tube rotation by experienced consultant anesthesiologists.Conclusions:The tube rotation technique for intubation was introduced during the Gulf War and has been practiced for the past 19 years without any obvious damage to the trachea in Germany. However, it should be used only by physicians being well familiar with this technique. In addition, well designed controlled studies are needed.

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

Cited by 29 publications

References 33 publications

Le vidéolaryngoscope permet une intubation avec un tube à double lumière plus rapide que le laryngoscope standard

Le vidéolaryngoscope permet une intubation avec un tube à double lumière plus rapide que le laryngoscope standard

Fiberoptic Intubation: An Overview and UpdateDiscussion

Making endotracheal intubation easy and successful, particularly in unexpected difficult airway

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