The Physiologically Difficult Intubation

Butler, Kenneth H.; Winters, Michael E.

doi:10.1016/j.emc.2022.05.011

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…This concept centers on the understanding that critically ill emergency department patients are frequently challenged by disease states that may cause abrupt, predictable physiological deterioration before, during, or after intubation, manifest as hypoxia, hypotension and cardiac arrest. [27][28][29]46,47 Three countermeasures have helped emergency physicians better anticipate and prevent this challenge: the identification of predictable markers of peri-intubation physiologic decompensation, the development of sophisticated pre-oxygenation techniques, and new approaches to managing peri-intubation hemodynamic optimization. The thoughtful use of intubation checklists has been shown to help operationalize these countermeasures and decrease adverse physiologic events during emergency airway management.…”

Section: A Sophisticated Understanding Of the Physiologically Of The ...mentioning

confidence: 99%

Emergency airway management in Brazil

Gibbs,

Amoroso

2023

JBMEDE

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Section: A Sophisticated Understanding Of the Physiologically Of The ...mentioning

confidence: 99%

Emergency airway management in Brazil

Gibbs,

Amoroso

2023

JBMEDE

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“…Intubation outside the OR, including the resuscitation suites and medical transport services, is probably the most challenging scenario for the definitive management of the airway, because of the above-mentioned anatomical and physiological differences present in critical patients. There are risk factors for mortality and peri-intubation collapse such as hypoxemia or hypotension, high shock index, absence of pre-oxygenation and emergent intubation (40,41). Hence, the management of the AW must be efficient and fast.…”

Section: Emergency Medicinementioning

confidence: 99%

Should videolaryngoscopy be routinely used for airway management? An approach from different scenarios in medical practice

Becerra Gómez,

Ángel Rojas

2023

Colomb. J. Anesthesiol.

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During the past two decades, the videolaryngoscope (VDL) has become a valuable and effective tool for the management of the airway, not just in the realm of anesthesiology, but also in other medical specialties in clinical scenarios requiring tracheal intubation. In countries such as the United States, this represents over 15 million cases in the operating room and 650,000 outside the OR. The overall accumulated incidence of difficult airway is 6.8% events in routine practice and between 0.1 and 0.3 % of failed intubations, both associated with complications such as desaturation, airway injury, hemodynamic instability and death. Notwithstanding the fact that the VDL has proven advantages such as improved visualization of the glottis, higher first attempt success rates, and a shortened learning curve, most of the time its use is limited to rescue attempts or as a secondary option. The objective of this article is to review the advantages and limitations of the VDL vs. the direct laryngoscope in a wide range of clinical settings, including the operating room, intensive care units, emergency departments, pediatrics, obstetrics, and Covid-19 to consider its routine use.

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“…The deep insertion of the catheter into the bronchus can cause hypoxia and atelectasis on one side, affecting lung ventilation. In addition, intubation can stimulate the vagus nerve, which in severe cases may lead to respiratory and cardiac arrest ( 7 , 8 ). Endotracheal intubation can stimulate the glottis and airway, potentially causing damage to the oral mucosa in children, glottic edema and complications, such as laryngeal spasm and sore throat ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of laryngeal mask airway and endotracheal tube in general anesthesia in children

Dong,

Zhang,

et al. 2023

Exp Ther Med

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At present, there is no relevant expert consensus indicating which ventilation device is more efficient for general anesthesia. The present literature review and meta-analysis compared the effects of the laryngeal mask airway and endotracheal intubation on airway complications during general anesthesia. The keywords ‘laryngeal mask airway’, ‘endotracheal tube’, ‘tracheal tube’, ‘children’, ‘pediatric’, ‘anesthesia’, ‘randomized controlled trials’ (RCTs) and ‘randomized’ were used to perform the literature search in PubMed. Quality assessment was performed by two reviewers according to domains defined by the Cochrane Collaboration tool. Data extraction, risk of bias assessment and quality of evidence assessment were performed with the Cochrane tool. A total of 16 RCTs were included. The results indicated that the effects of the laryngeal mask airway group on heart rate variability [mean difference=-13.76; 95% CI, -18.19-(-9.33); P<0.00001], the incidence of hypoxemia [odds ratio (OR)=0.52; 95% CI, 0.28-0.97; P=0.04] and the incidence of postoperative cough (OR=0.22; 95% CI, 0.12-0.40; P<0.0001) were significantly lower than those of the endotracheal intubation group. The success rate of one-time implantation in the laryngeal mask airway group was significantly higher than that noted in the endotracheal intubation group (OR=0.20; 95% CI, 0.07-0.59; P=0.003). However, no significant differences were noted between the two groups in bronchospasm, sore throat, mucosal injury, nausea and vomiting and reflux aspiration. In conclusion, the results indicated that laryngeal mask airway application can reduce complications during general anesthesia compared with endotracheal intubation.

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The Physiologically Difficult Intubation

Cited by 8 publications

References 41 publications

Emergency airway management in Brazil

Emergency airway management in Brazil

Should videolaryngoscopy be routinely used for airway management? An approach from different scenarios in medical practice

Comparison of laryngeal mask airway and endotracheal tube in general anesthesia in children

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