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Relevant bibliographies by topics / Difficult Intubation

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Academic literature on the topic 'Difficult Intubation'

Author: Grafiati

Published: 4 June 2021

Last updated: 20 June 2025

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Journal articles on the topic "Difficult Intubation"

1

Tsay, Pei-Jiuan, Chih-Pin Yang, Hsiang-Ning Luk, Jason Zhensheng Qu, and Alan Shikani. "Video-Assisted Intubating Stylet Technique for Difficult Intubation: A Case Series Report." Healthcare 10, no. 4 (2022): 741. http://dx.doi.org/10.3390/healthcare10040741.

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Induction of anesthesia can be challenging for patients with difficult airways and head or neck tumors. Factors that could complicate airway management include poor dentition, limited mouth opening, restricted neck motility, narrowing of oral airway space, restricted laryngeal and pharyngeal space, and obstruction of glottic regions from the tumor. Current difficult airway management guidelines include awake tracheal intubation, anesthetized tracheal intubation, or combined awake and anesthetized intubation. Video laryngoscopy is often chosen over direct laryngoscopy in patients with difficult airways because of an improved laryngeal view, higher frequency of successful intubations, higher frequency of first-attempt intubation, and fewer intubation attempts. In this case series report, we describe the video-assisted intubating stylet technique in five patients with difficult airways. We believe that the intubating stylet is a feasible and safe airway technique for anesthetized tracheal intubation in patients with an anticipated difficult airway.

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2

Adnet, Frederic, Stephen W. Borron, Stephane X. Racine, et al. "The Intubation Difficulty Scale (IDS)." Anesthesiology 87, no. 6 (1997): 1290–97. http://dx.doi.org/10.1097/00000542-199712000-00005.

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Background A quantitative scale of intubation difficulty would be useful for objectively comparing the complexity of endotracheal intubations. The authors have developed a quantitative score that can be used to evaluate intubating conditions and techniques with the aim of determining the relative values of predictive factors of intubation difficulty and of the techniques used to decrease such difficulties. Methods An Intubation Difficulty Scale (IDS) was developed, based on parameters known to be associated with difficult intubation. It was then evaluated prospectively in a group of 311 consecutive prehospital intubations and 315 intubations in an operating room. In the operating room, the IDS was compared with two other parameters: the time to completion of intubation and the visual analog scale (VAS). Time was measured by an independent observer. Operators in both groups completed a checklist regarding the conditions of intubation. Results There is a good correlation between the IDS scale and the VAS assessment of difficulty and time to completion of intubation. VAS and time to completion have a significant but lesser correlation to each other. Comparison of IDS with operator-assessed subjective categorical impression of difficulty by Kruskall-Wallis was statistically significant. Conclusions The IDS correlates with but is less subjective than the VAS and categorical classification. IDS correlates with time to intubation, but it offers details regarding the difficulty encountered that time alone does not. This score may not only aid in evaluation of factors linked to difficult intubations, but it may provide a uniform approach to comparing studies related to this subject.

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Artawan, I. Made, Su Djie To Rante, and Sidarta Sagita. "Comparison of the Thyromental Distance, Thyrohyoid Distance, and Mallampati Scores in Prediction of Difficult Intubation in Patients Undergoing General Anaesthesia: An Observational Study." Bali Journal of Anesthesiology 8, no. 3 (2024): 154–57. http://dx.doi.org/10.4103/bjoa.bjoa_116_24.

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Abstract Background: Several studies have been conducted to assess the accuracy of predictors of difficult intubation, but the results are still very variable. This study aims to discover the incidence of difficult intubation in our cohort. We also compared the accuracy of the Mallampati score, thyromental distance, and thyrohyoid distance in predicting intubation difficulties in patients who will undergo surgery under general anesthesia. Materials and Methods: This prospective, observational study was conducted on 100 subjects who met the inclusion and exclusion criteria and had their Mallampati score, thyromental distance, and thyrohyoid distance measured preoperatively. After inducing anesthesia, the degree of difficulty in intubation was assessed using the Cormack-Lehane grading. The Mallampati score, thyromental distance, and thyrohyoid distance were then tested for accuracy as predictors of the occurrence of difficult intubation using the binomial logistic regression. Results: The incidence of difficult intubation was 21%. We found a significant difference (P < 0.001) between the Mallampati score and the degree of intubation difficulty, where subjects with a Mallampati score of 1–2 experienced fewer intubation difficulties. The mean thyromental distance differed significantly between subjects with and without difficulty intubating (6.3 ± 0.6 vs. 4.6 ± 0.6 cm, P < 0.001). There was also a significant difference in the mean thyrohyoid distance between subjects with and without difficulty intubating (3.6 ± 0.4 vs. 2.0 ± 0.2, P < 0.001). Conclusion: Mallampati score, thyromental distance, and thyrohyoid distance were not significant as single predictors of difficult intubation, but they were significant when combined.

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Dr., Maira Mansoor Dr. Rija Khalid Dr. Muhammad Usman Khalid. "POSITIVE PREDICTIVE VALUE OF RESTRICTED NECK MOVEMENT IN ASSESSING DIFFICULT INTUBATION TAKING INTUBATION DIFFICULTY SCALE AS GOLD STANDARD." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 05 (2018): 4483–92. https://doi.org/10.5281/zenodo.1256353.

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<strong><em>Introduction: </em></strong><em>Airway maintenance during anesthesia is crucial for adequate oxygenation and ventilation and failure to secure airway can lead to tissue hypoxia and ultimately death. The three main causes of respiratory related injuries of anesthesia are inadequate ventilation, esophageal intubation and difficult tracheal intubation. 17% of all respiratory related injuries are due to difficult intubation and it accounts for 28% of anesthesia related deaths'.</em> <strong><em>Subjects and Methods:</em></strong><em> This study involved 126 patients of both genders, aged between I8-70 years undergoing general anesthesia with endotracheal intubation on elective lists Difficult intubation was predicted on restricted neck movement (<80°) and was confirmed on IDS. IDS diagnosis was taken as gold standard and results of restricted neck movement were evaluated accordingly. Written informed consent was taken from every patient.</em> <strong><em>Results:</em></strong><em> The age of the patients ranged from 18 years to 70 years with a mean of 42.49 + 14.56 years. There were 64 (50.8%) male and 62 (49.2%) female patients in the study group. There were 52 (41.3%) obese patients. Difficult intubation was confirmed in 90 (71.4%) patients on intubation difficulty scale (as per operational definition). 1'he frequency of difficult intubation was higher among obese patients (80.8% vs. 64.9%; p 0.052) however the difference was insignificant. There were 90 (71.4%) true positive patients with 36 false positive patients. It yielded a positive predictive value of 71.4% for restricted neck movement in the prediction of difficult intubation taking IDS as gold standard. Similar positive predictive value was observed across age, gender and obesity groups.</em> <strong><em>Conclusion:</em></strong><em> The positive predictive value of restricted neck movement (<80°) was found to be 71.4% in predicting difficult intubation among patients undergoing general anesthesia with endotracheal intubation on elective list while taking intubation difficulty scale as the gold standard.</em> <strong>Keywords:</strong><em> Difficult Intubation. Intubation Difficulty Scale. Restricted Neck Movement</em>.

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Dr., Salman Hameed Dr. Jumana Fatima Dr. Abdul Sami. "BY TAKING INTUBATION DIFFICULTY SCALE AS GOLD STANDARD IN ASSESSING DIFFICULT INTUBATION AND PREDICTIVE VALUE OF RESTRICTED NECK MOVEMENT." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 05 (2018): 4493–98. https://doi.org/10.5281/zenodo.1256355.

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<strong><em>Introduction: </em></strong><em>The three main causes of respiratory related injuries of anesthesia are inadequate ventilation, esophageal intubation and difficult tracheal intubation. 17% of all respiratory related injuries are due to difficult intubation and it accounts for 28% of anesthesia related deaths’. Airway maintenance during anesthesia is crucial for adequate oxygenation and ventilation and failure to secure airway can lead to tissue hypoxia and ultimately death. </em> <strong><em>Subjects and Methods:</em></strong><em> This study involved 126 patients of both genders, aged between I8-70 years undergoing general anesthesia with endotracheal intubation on elective lists Difficult intubation was predicted on restricted neck movement (<80°) and was confirmed on IDS. IDS diagnosis was taken as gold standard and results of restricted neck movement were evaluated accordingly. Written informed consent was taken from every patient.</em> <strong><em>Results:</em></strong><em> The age of the patients ranged from 18 years to 70 years with a mean of 42.49 + 14.56 years. There were 64 (50.8%) male and 62 (49.2%) female patients in the study group. There were 52 (41.3%) obese patients. Difficult intubation was confirmed in 90 (71.4%) patients on intubation difficulty scale (as per operational definition). 1'he frequency of difficult intubation was higher among obese patients (80.8% vs. 64.9%; p 0.052) however the difference was insignificant. There were 90 (71.4%) true positive patients with 36 false positive patients. It yielded a positive predictive value of 71.4% for restricted neck movement in the prediction of difficult intubation taking IDS as gold standard. Similar positive predictive value was observed across age, gender and obesity groups.</em> <strong><em>Conclusion:</em></strong><em> The positive predictive value of restricted neck movement (<80°) was found to be 71.4% in predicting difficult intubation among patients undergoing general anesthesia with endotracheal intubation on elective list while taking intubation difficulty scale as the gold standard.</em> <strong>Keywords:</strong> <em>Difficult Intubation. Intubation Difficulty Scale. Restricted Neck Movement.</em>

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Dr., Salman Hameed Dr. Jumana Fatima Dr. Abdul Sami. "BY TAKING INTUBATION DIFFICULTY SCALE AS GOLD STANDARD IN ASSESSING DIFFICULT INTUBATION AND PREDICTIVE VALUE OF RESTRICTED NECK MOVEMENT." Indo American Journal of Pharmaceutical Sciences 05, no. 06 (2018): 5142–47. https://doi.org/10.5281/zenodo.1301279.

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<strong><em>Introduction: </em></strong><em>The three main causes of respiratory related injuries of anesthesia are inadequate ventilation, esophageal intubation and difficult tracheal intubation. 17% of all respiratory related injuries are due to difficult intubation and it accounts for 28% of anesthesia related deaths’. Airway maintenance during anesthesia is crucial for adequate oxygenation and ventilation and failure to secure airway can lead to tissue hypoxia and ultimately death. </em> <strong><em>Subjects and Methods:</em></strong><em> This study involved 126 patients of both genders, aged between I8-70 years undergoing general anesthesia with endotracheal intubation on elective lists Difficult intubation was predicted on restricted neck movement (<80°) and was confirmed on IDS. IDS diagnosis was taken as gold standard and results of restricted neck movement were evaluated accordingly. Written informed consent was taken from every patient.</em> <strong><em>Results:</em></strong><em> The age of the patients ranged from 18 years to 70 years with a mean of 42.49 + 14.56 years. There were 64 (50.8%) male and 62 (49.2%) female patients in the study group. There were 52 (41.3%) obese patients. Difficult intubation was confirmed in 90 (71.4%) patients on intubation difficulty scale (as per operational definition)1. The frequency of difficult intubation was higher among obese patients (80.8% vs. 64.9%; p 0.052) however the difference was insignificant. There were 90 (71.4%) true positive patients with 36 false positive patients. It yielded a positive predictive value of 71.4% for restricted neck movement in the prediction of difficult intubation taking IDS as gold standard. Similar positive predictive value was observed across age, gender and obesity groups.</em> <strong><em>Conclusion:</em></strong><em> The positive predictive value of restricted neck movement (<80°) was found to be 71.4% in predicting difficult intubation among patients undergoing general anesthesia with endotracheal intubation on elective list while taking intubation difficulty scale as the gold standard.</em> <strong>Keywords:</strong><em> Difficult Intubation. Intubation Difficulty Scale. Restricted Neck Movement.</em>

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Sawyer, Taylor, Elizabeth E. Foglia, Anne Ades, et al. "Incidence, impact and indicators of difficult intubations in the neonatal intensive care unit: a report from the National Emergency Airway Registry for Neonates." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 5 (2019): F461—F466. http://dx.doi.org/10.1136/archdischild-2018-316336.

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ObjectiveTo determine the incidence, indicators and clinical impact of difficult tracheal intubations in the neonatal intensive care unit (NICU).DesignRetrospective review of prospectively collected data on intubations performed in the NICU from the National Emergency Airway Registry for Neonates.SettingTen academic NICUs.PatientsNeonates intubated in the NICU at each of the sites between October 2014 and March 2017.Main outcome measuresDifficult intubation was defined as one requiring three or more attempts by a non-resident provider. Patient (age, weight and bedside predictors of difficult intubation), practice (intubation method and medications used), provider (training level and profession) and outcome data (intubation attempts, adverse events and oxygen desaturations) were collected for each intubation.ResultsOut of 2009 tracheal intubations, 276 (14%) met the definition of difficult intubation. Difficult intubations were more common in neonates <32 weeks, <1500 g. The difficult intubation group had a 4.9 odds ratio (OR) for experiencing an adverse event and a 4.2 OR for severe oxygen desaturation. Bedside screening tests of difficult intubation lacked sensitivity (receiver operator curve 0.47–0.53).ConclusionsDifficult intubations are common in the NICU and are associated with adverse event and severe oxygen desaturation. Difficult intubations occur more commonly in small preterm infants. The occurrence of a difficult intubation in other neonates is hard to predict due to the lack of sensitivity of bedside screening tests.

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Imtiaz, Sana, Madiha Zafar, Mariam Waheed, Lala Rukh Bangash, Varda Baloch, and Mubashra Hamza. "Diagnostic Accuracy of Neck Circumference and Thyromental Distance Ratio for Assessing Difficult Intubation in Obese Patients: a Validation Study." Pakistan Journal of Medical and Health Sciences 16, no. 1 (2022): 612–15. http://dx.doi.org/10.53350/pjmhs22161612.

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Various tools for airway assessment are include Mallampati score, upper lip bite test, Wilson scoring and extent of mouth opening; none have high investigative precision especially in obese patients. Objectives: To assess the diagnostic accuracy of neck circumference and thyromental distance ratio for assessing difficult intubation in obese patients using intubation difficulty score as gold standard. Setting: Department of Anesthesiology in East and West operation theatres of Mayo hospital Lahore. Duration: 12 months (From Oct 2015 – Oct 2016) Sample Size: 220 obese patients Methods: Patients undergoing elective surgery were enrolled. Height, weight and body mass index was documented. At the cricoid cartilage level, the neck circumference was measured. All tracheal intubations were conducted by a three-year-experienced anaesthesiologist who was unaware of the study's findings. Cormack and Lehane's grading system was used to rate the laryngoscopy image. Difficult intubation was assessed according to intubation difficulty scoring. Results: The diagnostic accuracy of neck circumference and thyromental distance ratio in assessment of difficulty intubation (DI) among obese patients was 47%, sensitivity 85% and specificity of 37%. Conclusion: NC/TM ratio was a good interpreter in assessing difficult intubation in obese patients. This variable can be incorporated in our preoperative assessment for difficult intubation (DI). It is simple, requires very less time and is economical. Keywords: Airway management, obese, difficult intubation, neck circumference, laryngoscopy, tracheal intubation.

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Chan, Gene Wai Han, Chew Yian Chai, Joy Su-Yue Teo, Calvin Kai En Tjio, Mui Teng Chua, and Calvin A. III Brown. "Emergency airway management in a Singapore centre: A registry study." Annals of the Academy of Medicine, Singapore 50, no. 1 (2021): 42–51. http://dx.doi.org/10.47102/annals-acadmedsg.2020331.

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ABSTRACT Introduction: Intubations in the emergency department (ED) are often performed immediately without the benefit of pre-selection or the ability to defer. Multicentre observational data provide a framework for understanding emergency airway management but regional practice variation may exist. We aim to describe the intubation indications, prevalence of difficult airway features, peri-intubation adverse events and intubator characteristics in the ED of the National University Hospital, Singapore. Methods: We conducted a prospective observational study over a period of 31 months from 1 March 2016 to 28 September 2018. Information regarding each intubation attempt, such as indications for intubation, airway assessment, intubation techniques used, peri-intubation adverse events, and clinical outcomes, was collected and described. Results: There were 669 patients, with male predominance (67.3%, 450/669) and mean age of 60.9 years (standard deviation [SD] 18.1). Of these, 25.6% were obese or grossly obese and majority were intubated due to medical indications (84.8%, 567/669). Emergency physicians’ initial impression of difficult airway correlated with a higher grade of glottis view on laryngoscopy. First-pass intubation success rate was 86.5%, with hypoxia (11.2%, 75/669) and hypotension (3.7%, 25/669) reported as the two most common adverse events. Majority was rapid sequence intubation (67.3%, 450/669) and the device used was most frequently a video laryngoscope (75.6%, 506/669). More than half of the intubations were performed by postgraduate clinicians in year 5 and above, clinical fellows or attending physicians. Conclusion: In our centre, the majority of emergency intubations were performed for medical indications by senior doctors utilising rapid sequence intubation and video laryngoscopy with good ffirst-attempt success. Keywords: Difficult airway, emergency services, intubation, peri-intubation adverse events, rapid sequence induction

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Thampi, Suma Mary, Serina Ruth Salins, Divya P. Jacob, and Ahwad Sheetal Avinash. "The Feeding Tube- a Simple Yet Handy Aid to Intubate an Unanticipated Difficult Pediatric Airway." Journal of Nepal Medical Association 53, no. 198 (2015): 141–43. http://dx.doi.org/10.31729/jnma.2778.

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Pediatric intubation requires certain unique set of additional skills compared to intubating adults. The challenges of successfully intubation of a child increases as the age and size of the child decrease and are compounded when airway difficulties arise for various reasons. Often in the rural setting, such procedures may have to be carried out by health care personnel who get trained on-the-job, and in the absence of adequate technological back-up. This leads to an increased incidence of failed intubations which can have devastating complications, especially in the pediatric age group. We describe a simple technique which helped us while intubate a 40-day old infant, without any major catastrophes. Keywords: airway management; infant; newborn; intubation; endotracheal.

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Dissertations / Theses on the topic "Difficult Intubation"

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Dowdy, Regina Alma Evelyn. "Using Computed Tomography to Predict Difficult Tracheal Intubation." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586195479987532.

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Kerns, Nicholas Matthew. "Pediatric Anatomical Variations and their Implication on the Difficulty of Nasotracheal Intubation." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1408994437.

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Forsström, Thomas, and Martin Harrison. "Anestesipersonals upplevelser av att arbeta med Glidescope, ett videolaryngskop : en intervjustudie." Thesis, Mid Sweden University, Department of Health Sciences, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-11983.

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<p><strong>Bakgrund:</strong> Nya tekniska lösningar för att intubera patienter börjar bli tillgängliga för operationsavdelningar. Glidescope är ett videolaryngoskop som visar lovande resultat när det gäller underlättande av intubationer för personal framförallt vid svåra luftvägar och intubationer. Forskningen pekar på att Glidescope reducerar antalet intubationsförsök och ökar andelen lyckade förstagångsintubationer. Studier pekar på att det för patienten är fördelaktigt med så få intubationsförsök som möjligt.</p><p><strong>Syfte: </strong>Att undersöka anestesipersonals erfarenheter av att arbeta med Glidescope.</p><p><strong>Metod: </strong>Semistrukturerade individuella intervjuer genomfördes med nio anestesisjuksköterskor och två läkare. En kvalitativ beskrivande ansats med en kvalitativ innehållsanalys som analysmetod har använts. Intervjuerna genomfördes våren 2010 på ett sjukhus i södra norrland.</p><p><strong>Resultat: </strong>Glidescope är ett enkelt och lättanvänt redskap för intubation och detta gäller även för personer med begränsad erfarenhet av Glidescope. Det underlättar intubationer men kan förlänga tiden för att placera tuben. Det reducerar patienttraumat som förknippas med en intubation och ökar patientsäkerheten. Ur ett hygienperspektiv behövs bättre rutiner för användning av Glidescopet. En begränsning för Glidescopet är pågående blödning i svalget.</p><p><strong>Slutsats: </strong>Glidescope är i de flesta fall ett enkelt och lättanvänt redskap för intubation som underlättar främst vid svåra intubationer. Glidescope förbättrar patientsäkerheten. Glidescope är användbart vid studenthandledning. Glidescope begränsas av pågående blödning i svalget och är sämre ur ett hygienperspektiv jämfört med Macintoshlaryngoskopet.</p><br><p><strong>Background:</strong> New technical solutions for patient intubation are becoming available for surgical wards. Glidescope is a video laryngoscope which shows promising results for easy intubation for staff, especially in difficult airways and intubations. Research shows that Glidescope reduces the number of tries and increases the proportion of successful first try intubations. Studies show that the patient benefits from a reduced number of tried intubations.</p><p><strong>Purpose: </strong>To examine anaesthesia staffs experience of working with Glidescope.</p><p><strong>Method: </strong>Semi structured personal interviews were conducted with nine anaesthetic nurses and two anaesthesiologists. A qualitative descriptive approach with a qualitative content analysis as an analysis method was used. The interviews were conducted at a hospital in the middle part of Sweden during the spring of 2010.</p><p><strong>Results: </strong>Glidescope is an easy to use tool for intubation and this is also true for staff with limited experience with Glidescope. It makes intubation easier but may prolong the time to place the tube. Glidescope reduces the trauma for the patient associated with intubation and increases patient safety. From a hygiene perspective better routines are needed for the use of the Glidescope. Glidescope is limited by ongoing bleeding in the throat area.</p><p><strong>Conclusion: </strong>Glidescope is for the most part an easy to use tool which eases difficult intubations. Glidescope improves patient safety. Glidescope is useful in student instruction. Glidescope is limited by on going bleeding in the throat area and is less hygienic than the Macintoshlaryngscope.</p>

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Burger, Adrian. "Predictors of difficult intubation in obstetric cohort of patients: an analysis of the prospective obstetric airway management registry (OBAMR) (substudy – R025/2018)." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33677.

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Abstract Background: Hypoxaemia during tracheal intubation in obstetrics remains a lifethreatening complication. This study aimed to identify common clinical preinduction predictors of difficult intubation. Methods: A retrospective analysis was performed of data pertaining to tracheal intubation in patients requiring general anaesthesia for caesarean delivery, with a gestational age from 20 weeks, and until 7 days post-delivery, obtained from an obstetric airway management registry (ObAMR) at the University of Cape Town. Data was entered anonymously into a secure UCT REDCap database. Data categories were: patient and pregnancy characteristics, airway characteristics, details of management, and operator experience. The primary aim of the study was to identify anatomical and physiological risk factors for hypoxaemia. The primary outcome was defined as arterial desaturation to < 90% during obstetric airway management. For this purpose, multivariable binary logistic regression was performed. Hypoxaemia was thus used as a composite indicator of anatomical and physiological difficulty. Results: Data was collected for 1095 general anaesthetics in the ObAMR. Overall, 143/1091 of patients (13.1%, 95%CI 11.1 to 15.4%) experienced peripheral oxygen saturation below 90%. Univariate analysis showed that 91/142 (64.1%) of patients who desaturated were obese (body mass index [BMI]> 30 kg/m2 ), compared with 347/915 (37.9%) who were obese and did not experience desaturation (p< .001). A receiver operating curve (ROC) was constructed post hoc, which showed a cut-point for BMI of 29.76, and a sensitivity of 0.66, and specificity 0.62 for the prediction of hypoxaemia. Desaturation occurred in 17.0% of patients with hypertensive disorders of pregnancy, versus 11.0 % without (p=0.005). Increasing Mallampati class was associated with an increased incidence of hypoxaemia. The incidence of hypoxaemia was 25.8% for interns, compared with 8.0 % for consultant anaesthesiologists (p=0.005). In the multivariate analysis of factors associated with hypoxaemia, body mass index (p< 0.001), room air saturation prior to preoxygenation (p=0.008), and the presence of airway oedema (p=0.027), were independently associated with hypoxaemia. Conclusions: In this study, both anatomical and physiological predictors of hypoxaemia were identified. Using this concept, a predictive tool could be developed to aid in the identification of a difficult airway in obstetrics. Simple interventions such as face mask ventilation and the use of high flow nasal oxygenation, could be introduced to protect the parturient from the consequences of life-threatening hypoxaemia.

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Lédée, Patrick. "Facteurs prédictifs de l'intubation difficile." Université Louis Pasteur (Strasbourg) (1971-2008), 1991. http://www.theses.fr/1991STR1M074.

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DORENLOT, BRUNO. "L'intubation en urgence : ses difficultes en realisation extra-hospitaliere ; analyse de 6 mois d'activite primaire au samu de nice." Nice, 1992. http://www.theses.fr/1992NICE6539.

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Combes, Xavier. "Validation des stratégies de prise en charge des situations d'intubation difficile : Du bloc opératoire au préhospitalier." Paris 13, 2010. http://www.theses.fr/2010PA132012.

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Nos objectifs ont été d'évaluer l'utilisation de plusieurs dispositifs dans le cadre de la prise en charge des situations d'intubation difficile imprévue survenant au bloc opératoire et dans un contexte d’urgence extra hospitalière puis de valider leur efficacité lorsqu'ils furent intégrés dans des algorithmes précis de prise en charge. Nous avons évalué différents types de lames de laryngoscopes utilisées pour l'intubation en urgence et avons montré que les lames en métal usage unique étaient aussi performantes que les lames réutilisables. Nous avons évalué le masque laryngé d'intubation Fastrach au bloc opératoire et en médecine d’urgence pré hospitalière. Nous avons montré l'efficacité du long mandrin béquillé et du masque laryngé d'intubation Fastrach lorsqu'ils furent utilisés dans des algorithmes évalués d'abord au bloc opératoire puis en médecine d'urgence pré hospitalière<br>Our objectives were to assess some difficult intubation devices used for difficult airway management occurring in operating room and in emergency pre hospital setting and to valid their use when integrated in predefined difficult airway management algorithms. We have assessed different types of laryngoscope blades used for emergency intubation and have reported that single use metal blades were as effective as reusable ones. We have assessed intubating laryngeal mask airway in operating room and in prehospital setting. We have reported the great efficiency of the Gum elastic bougie and ILMA when used in difficult airway management algorithms assessed in operating room and in the pre hospital setting

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Wu, Yu-Shiue, and 吳玉雪. "The investigation of predictors of unanticipated difficult tracheal intubation for nonemergent and noncardiac surgeries in Taiwan." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/64356442425069587277.

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碩士<br>中國醫藥大學<br>生物統計研究所碩士班<br>101<br>Background: Smooth tracheal intubation is the first important document for general anesthesia. Once unanticipated difficult tracheal intubation (UDI) or failing tracheal intubation had happened, patients who were received general anesthesia would suffer possible hypoxia injuries, or even deaths. In a closed-claim analysis of American Society of Anesthesiologists, difficult tracheal intubation accounted for approximately 17% of adverse respiratory events and the outcome of 85% of these cases was either brain damage or death. Methods: We performed a prospective observational study to enroll adult patients presenting the hospital for general anesthesia with tracheal intubation for any type of nonemergency and noncadiac surgical procedures from August 2008 to December 2012. For each patient, preoperative patient characteristics, detailed airway physical exam, and airway outcome data were collected. Difficult tracheal intubation was defined as 3 or more attempts at placing the endotracheal tube. We investigated the possible different best cutpoint of predictors and predicting models of UDI between Easterners and Westerners. Multivariate logistic analysis and multivariate ROC curve analysis were performed. Results: A total of 1300 adult patients were enrolled in the study. The incidence of UDI was 1.46% (19 cases). The best cutpoint of two predictors (Hyomental distance ((HMD)≦4.2cm) and height (≦158cm)) suggested in our study was smaller than that reported for Westerners. Multivariate analysis revealed that the best predicting model of UDI in our study population consisted of four predictors (interincisor gap(IG)≦4.5cm, thyromental distance (TMD)≦6cm, height≦158cm, modified Mallapati score≧grade 2) had high sensitivity (85.7%) , specitity (74.5%) and good balance accuracy (80.1%). The area under the receiver operating characteristic curve (AUC) was 0.77. Two-fold cross validation also showed the similar result (mean AUC=0.73). Moreover, the ratio of TMD to HMD (TMD/HMD) showed high sensitivity and may be a not bad single predictor in obese patients. We also found IG (AUC=0.769) had high sensitivity and also a good single predictor in non-obese patients. Conclusions: Predictors of UDI need to have different concerns in Westerns and Easterners, especially in terms of the best cutoff values. Moreover, it seems that obese and non-obese patients have difficult pridictors of UDI.

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Kimball, Thomas. "The effectiveness of GlideScope video laryngoscopy in the management of pediatric difficult airways." Thesis, 2015. https://hdl.handle.net/2144/16205.

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The aim of this thesis is to quantify the intubation success rates and complication rates associated with GlideScope® video laryngoscopy in pediatric difficult airway patients. Difficult intubation is a major source of anesthesia-related morbidity and mortality in both adults and children (1-3). A number of studies have demonstrated that video laryngoscopy has helped to address this problem in adults, producing high intubation success rates with minimal complications (4-6). However, the literature on the use of videoscopes in children with difficult airways is sparse. We therefore sought to examine success and complication rates with the GlideScope®, a common type of video laryngoscope. To do so, we examined patient data from the Pediatric Difficult Intubation Registry, a collection of information on difficult airway incidents at fourteen pediatric teaching hospitals in the United States. From these data we calculated overall, first-pass, and rescue success rates on a per-attempt and per-patient basis, comparing them to success rates that resulted from using direct laryngoscopy. We also examined success rates for smaller groups of patients divided by Cormack-Lehane airway grade, weight, and muscle relaxant use. Finally, we assessed complication rates for patients undergoing GlideScope® intubation attempts and direct laryngoscopy. The GlideScope® produced lower success rates in our sample than those documented in adult difficult airway patients. This was particularly the case among smaller children and those with poor glottis visualization. However, the GlideScope® was superior to direct laryngoscopy by all measures and in all patient subgroups. We also found lower rates of hypoxemia and overall complications among patients receiving intubation attempts with only the GlideScope® versus only direct laryngoscopy. We believe this result may be related to the greater number of intubation attempts among patients receiving direct laryngoscopy.

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Buitenweg, Lize. "The preferences, experience and level of comfort of anaesthetists in managing difficult intubation and ‘cannot intubate, cannot ventilate’ scenarios." Thesis, 2017. https://hdl.handle.net/10539/24828.

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A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine in Anaesthesiology. Johannesburg, 2016.<br>Background: The “cannot intubate cannot ventilate” (CICV) scenario is a rare occurrence but can lead to significant morbidity and mortality if not managed appropriately. International data shows that anaesthetists lack knowledge of and fail to employ difficult airway algorithms. Method: A prospective, contextual, descriptive study was done to determine the preferences, experience and level of comfort of anaesthetists in the Wits Department of Anaesthesiology to manage difficult intubations and CICV situations. A previously validated questionnaire was adapted for local use and distributed to all available anaesthetists. Results: A total of 111 (88.1%) participants knew the location of the difficult airway trolley, but 43 (38.8%) stated that the trolley is not easily accessible. Ninety two (73%) participants preferred the videolaryngoscope as first choice device when facing a difficult airway. The predominant second choice devices were the flexible fibre-optic scope, chosen by 52 (43%) and the intubating laryngeal mask, chosen by 48 (38.1%). The majority of participants had no experience with the retrograde wire set, optical stylet and rigid bronchoscope. The most popular device for cricothyroidotomy, chosen by 47 (37.3%), was an IV cannula, but only 34.9% was comfortable with using this option. The majority of anaesthetists have no experience with the internationally recommended open surgical method. Sixty-three (50%) of the participants have experienced a CICV scenario in clinical practice. Conclusion: Airway training can be improved in our department. The location of the difficult airway trolley is not known by everyone and many believe that it is not readily available in an emergency. The videolaryngoscope is the preferred difficult airway device and the IV cannula the first choice in a CICV scenario. There is a significant difference in the comfort level of consultants and registrars with the use of most advanced airway devices.<br>LG2018

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Books on the topic "Difficult Intubation"

1

Popat, Mansukh T. Difficult airway management. Oxford University Press, 2009.

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L, Norton Martin, ed. Atlas of the difficult airway. 2nd ed. Mosby, 1996.

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3

Andranik, Ovassapian, and Ovassapian Andranik, eds. Fiberoptic endoscopy and the difficult airway. 2nd ed. Lippincott-Raven, 1996.

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4

Orlando, Hung, and Murphy Michael F. 1954-, eds. Management of the difficult and failed airway. McGraw-Hill, Medical Pub. Division, 2007.

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Frass, Michael. The difficult intubation in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0081.

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Airway management in the intensive care unit differs from conventional controlled settings such as general anaesthesia in the operating room (OR). Due to adequate patient preparation and positioning in the OR, endotracheal intubation is usually easy to perform. However, in the intensive care setting, endotracheal intubation is often difficult or impossible because patients are not prepared and intubation is immediately necessary without sufficient time for putting together technical and pharmaceutical equipment. As an alternative, non-invasive alternate airway management may be performed. Besides non-invasive ventilation via mask or helmet, the use of Combitube®, EasyTubeTM, and different types of laryngeal mask airway are described, in order to alleviate decision-making in emergency situations such as difficult intubation, vomiting and bleeding patients, small interincisor distance, etc.

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Howe, Peter. Difficult Airway. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0016.

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Airway management in otherwise healthy children is normally easy in experienced hands and an unexpected difficult intubation should be uncommon. Predictors of difficult intubation include mandibular hypoplasia, limited mouth opening, facial asymmetry, and a history of stridor or obstructive sleep apnea. Many of these features occur in conditions such as Treacher Collins syndrome, Goldenhar's syndrome, and the Pierre Robin sequence.

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7

Management of the Difficult and Failed Airway. McGraw-Hill Education, 2017.

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8

Handbook of difficult airway management. Churchill Livingston, 2000.

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Atlas of the difficult airway. 2nd ed. Mosby, 1996.

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Ilic, Romina G. Difficult Airway. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0014.

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The difficult airway chapter focuses on preparing the clinician for a challenging airway. Management of both the expected, as well as the unexpected, difficult airway is critical to the care of the perioperative patient. Proper patient evaluation, organization, and preparation with a variety of airway tools are imperative to successfully securing the airway. The chapter reviews the difficult airway algorithm and discusses advanced airway techniques such as the use of awake intubation, airway exchange catheters, supraglottic airway devices, and surgical airway. Gaining familiarity with and using these advanced airway techniques in non-urgent situations will help ensure success when they are needed in emergencies.

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Book chapters on the topic "Difficult Intubation"

1

Scherer, R. "Difficult Intubation." In Update 1988. Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-83392-2_63.

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Davies, Eryl. "Difficult Intubation." In The Final FFICM Structured Oral Examination Study Guide. CRC Press, 2022. http://dx.doi.org/10.1201/9781003243694-45.

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Dauber, Martin. "Role of Retrograde Intubation." In The Difficult Airway. Springer New York, 2012. http://dx.doi.org/10.1007/978-0-387-92849-4_11.

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Klock, P. Allan. "The Role of Awake Intubation." In The Difficult Airway. Springer New York, 2012. http://dx.doi.org/10.1007/978-0-387-92849-4_3.

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Brock-Utne, John G. "Case 12: Postinduction Difficult Intubation." In Near Misses in Pediatric Anesthesia. Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7040-3_12.

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Kofler, J., B. Stoiser, and M. Frass. "Emergency Intubation: The Difficult Airway." In Yearbook of Intensive Care and Emergency Medicine. Springer Berlin Heidelberg, 1998. http://dx.doi.org/10.1007/978-3-642-72038-3_33.

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Barjaktarevic, Igor, Jeffrey Albores, and David Berlin. "Noninvasive Ventilation in Difficult Endotracheal Intubation." In Noninvasive Mechanical Ventilation. Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-21653-9_68.

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Martinelli, G., C. Melloni, F. Petrini, and M. Volpini. "Difficult Tracheal Intubation and Airway Management." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E. Springer Milan, 1996. http://dx.doi.org/10.1007/978-88-470-2203-4_67.

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9

Caramon, Jaritzy Lagunez, and Ricardo Guzman Rojas. "Noninvasive Approaches in Difficult Endotracheal Intubation." In Upper Airway Disorders and Noninvasive Mechanical Ventilation. Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-32487-1_19.

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10

Phillips, Sioned, and Roshan Fernando. "Difficult and Failed Intubation in Obstetric Anaesthesia." In Quick Hits in Obstetric Anesthesia. Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-72487-0_64.

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Conference papers on the topic "Difficult Intubation"

1

Santoriello, Vittorio, Arturo Cuomo, Michela D'Antò, et al. "Multidimensional Assessment of Advanced Systems for Managing Difficult Intubation." In 2024 E-Health and Bioengineering Conference (EHB). IEEE, 2024. https://doi.org/10.1109/ehb64556.2024.10805710.

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El Amine Lazouni, Mohammed, Nesma Settouti, Mostafa El Habib Daho, Said Mahmoudi, and Amine Chikh. "Automatic detection of difficult tracheal intubation." In 2014 International Conference on Multimedia Computing and Systems (ICMCS). IEEE, 2014. http://dx.doi.org/10.1109/icmcs.2014.6911235.

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Pimentel, Joana L., and António Bugalho Almeida. "Difficult Intubation: 10 Years Of Experience." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a5916.

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Krivec, Uros, Spela Stupnik, and Matevz Srpcic. "Flexible bronchoscopy assistance for tracheal intubation in children with difficult airway." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa4173.

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Eckmann, David M., Raymond Glassenberg, and Noam Gavriely. "Acoustic reflection analysis of the upper airway to identify difficult intubation." In Medical Imaging 1996, edited by Eric A. Hoffman. SPIE, 1996. http://dx.doi.org/10.1117/12.237862.

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6

Morgan, S. E., B. Garrity, G. M. Logan, Z. Bilello, E. T. Naureckas, and J. P. Kress. "Mitigation of COVID-19 Exposure During Intubation of a Patient with a Difficult Airway." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3020.

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7

Salman, Muhammad Aldian, and Vani Virdyawan. "Stiffness Investigations of A Soft Robot Manipulator for Affordable Endotracheal Intubation Devices." In The Hamlyn Symposium on Medical Robotics. The Hamlyn Centre Imperial College London, 2024. http://dx.doi.org/10.31256/hsmr2024.59.

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Endotracheal intubation (ETI) is a crucial procedure, performed approximately 15 million times annually in the USA alone [1]. To enhance the efficiency of ETI, especially in difficult circumstances, tools like stylets and introducers (bougies) are commonly utilized [2]. One of the most widely used aid tools known as an introducer, also referred to as “bougie“, is a malleable rod, mostly made of low-density polyethylene (LDPE) or polyvinyl chloride (PVC), is used as a guide to ‘railroad’ the ETT right into the laryngeal opening [3]. Existing introducers are mainly passive instruments, having to be pre-shaped only before the insertion. The lack of controllability, along with the property of the material that is stiffer than the tissue with which the device will interact, can lower the first-attempt intubation success rate [2], [4] and may also lead to a higher risk of injuring the patient [5]. In this work, we propose a design of a soft pneumatic continuum actuator to replace the structure located on the distal tip of an introducer as shown in the schematic in Fig. 1A. This means that the actuator should have sufficient rigidity to bend the rest of the shaft to which it is attached. In this work, we investigate a way to increase the stiffness of a soft robot manipulator by 1) adding an inextensible central rod with a higher bending stiffness than the silicone and 2) investigating the effect of pressurization in each chamber.

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8

Rekha, N., and S. B. Gangadhar. "Comparative Evaluation of Styleted Versus Non Styleted Endotracheal Tube for Oro-Tracheal Intubation Using Mcgrath Mac Video Laryngoscope in Non-Difficult Appearing Airways." In ISACON KARNATAKA 2017 33rd Annual Conference of Indian Society of Anaesthesiologists (ISA), Karnataka State Chapter. Indian Society of Anaesthesiologists (ISA), 2017. http://dx.doi.org/10.18311/isacon-karnataka/2017/fp016.

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9

Santos, Maria do Carmo Vasconcelos, Mariana Moreira Soares de Sa, Emanuelle Ferreira Barreto, Aline Cursio Moraes, Roberta Kelly Netto Vinte Guimarães, and Antonio Pereira Gomes Neto. "Progressive myoclonic epilepsy: case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.688.

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Context: Progressive myoclonic epilepsy (PMS) begins in childhood or during adolescence, being a heterogeneous group of symptomatic progressive progressive generalized epilepsy. Composed of cortical myoclonus, multiple epileptic seizures, delayed or regressed neuropsychomotor development and cerebellar manifestations. Genetics is heterogeneous with a similar clinical presentation, which makes etiological definition difficult. Report a clinical case of generalized epilepsy, myoclonus, cerebellar condition and severe mental impairment. Analysis of medical records of a patient at Santa Casa de Belo Horizonte. Case report: MVPP, 17 years old, previously healthy, adopted son, normal neuropsychomotor development, first generalized tonic-clonic seizure at 8 years old, recurrence at 12 years old, being initiated by Valproato and Clobazam. In 2018 there was a worsening of the crises, perceived myoclonus, added Lamotrigine and Oxcarbazepine. EEG with continuous diffuse epileptic activity of subclinical epilepticus status and unchanged skull MRI. In 2019 he started with gait ataxia, balance changes, dysarthria, dysmetria, cognitive decline, loss of functionality and refractoriness to treatment. Valproate reduced and oxcarbazepine suspended. Video- EEG with ictal pattern of generalized wave polyspicle. Deteriorated cerebellar condition with extensive propaedeutic without alterations. There was no feasibility of genetic testing at the time. Methylprednisolone pulse therapy with partial improvement. Unsuccessful attempt to levetiracetam due to psychotic symptom. He presented lowering of the sensorium, bronchoaspiration and orotracheal intubation. He evolved with myoclonic status, adjusted for anti-crisis drugs, midazolam, thiopental, tracheostomy and gastrostomy. He maintained super- refractory status, being opted for callosotomy. He died within weeks of the procedure. Conclusion: The early diagnosis of PMS is a challenge, and its evolution is usually debilitating, with a poor prognosis and scarce specific treatment. Whenever possible, a genetic study is needed to define an etiological diagnosis.

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Habib, Madelene, Robert Sims, James Inziello, Fluvio Lobo, and Jack Stubbs. "Design and Optimization of Patient-Specific Pediatric Laryngoscopes." In 2020 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/dmd2020-9077.

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Abstract Pediatric laryngoscope blades do not vary in size and shape as patients’ airways do. Difficult airway intubations may require physicians to try different blade sizes and even improvise. In addition to physical trauma and complications, difficult intubations may result in longer operating room times. As advanced three-dimensional (3D) imaging, modeling, and printing technologies become more ubiquitous at the point-of-care, so will the development and fabrication of patient-specific solutions. Here we introduce a method for the design and fabrication of patient-specific, single-use pediatric laryngoscope blades. The process seeks to optimize procedures and mitigate complications by providing physicians with the right tool at the right time.

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