Advances in Tracheal Intubation-Challenges of Airway Management in COVID-19 Infection

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 2362

Special Issue Editor


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Guest Editor
1. Department of Anaesthesia and Intensive Medicine, Charles University and General University Hospital, U nemocnice 2, 12028, Prague, Czech Republic
2. Department of Anaesthesia, Antrim Area Teaching Hospital, Bush Road, BT412RL, Antrim, UK
Interests: airway management; difficult intubation; video laryngoscopy; supraglottic airway devices; fiberoptic intubation
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Special Issue Information

Dear Colleagues,

Despite the rapid development of other techniques of airway management, such as insertion of a supraglottic airway device, tracheal intubation remains the “gold standard” for the maintenance of a patent airway during the majority of complex surgical procedures. Hundreds of millions of tracheal intubations are performed worldwide annually, not only in operating rooms but also in the intensive care setting, in accident and emergency departments, and also during life-threatening scenarios outside the hospital. Tracheal intubation is generally a safe technique but, if complicated or failed, it may affect patient outcome, including having fatal consequences. Proper assessment and preoperative diagnostics of potentially complicated conditions of tracheal intubation is a cornerstone of modern perioperative management. Several tools may help to diagnose a potentially difficult airway, including comprehensive physical examination, use of special scoring systems, application of an airway and neck ultrasound or the use of preoperative awake nasal endoscopy. According to these perioperative diagnostic tools, an appropriate plan for the technique of tracheal intubation and required equipment should be set up in advance.       

The aim of this Special Issue is to improve knowledge on recent advances in diagnostics of difficult tracheal intubation as well as the description of innovative or novel techniques concerning intubation of the trachea. Contributors may submit editorials, reviews, systematic reviews, meta-analyses, original articles, brief technical reports, and case reports.

Prof. Dr. Pavel Michalek
Guest Editor

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Keywords

  • tracheal intubation
  • diagnostics of difficult laryngoscopy
  • fiberoptic endoscopy
  • video laryngoscopy
  • airway ultrasound

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Published Papers (1 paper)

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Research

11 pages, 1761 KiB  
Article
An Evaluation of the Intubrite Laryngoscope in Simulated In-Hospital and Out-of-Hospital Settings by Individuals with No Clinical Experience: A Randomized, Cross-Over, Manikin Study
by Paweł Ratajczyk, Michał Fedorczak and Tomasz Gaszyński
Diagnostics 2022, 12(7), 1633; https://doi.org/10.3390/diagnostics12071633 - 5 Jul 2022
Cited by 2 | Viewed by 1752
Abstract
Introduction: The aim of the study was to compare the Intubrite laryngoscope and the standard Macintosh blade laryngoscope (MCL) used by persons with no clinical experience in simulated hospital and non-hospital conditions on a manikin model. Materials and methods: The study involved 50 [...] Read more.
Introduction: The aim of the study was to compare the Intubrite laryngoscope and the standard Macintosh blade laryngoscope (MCL) used by persons with no clinical experience in simulated hospital and non-hospital conditions on a manikin model. Materials and methods: The study involved 50 students of Medical Rescue. The hospital conditions (intubation height 110 cm—high position) and those occurring at the scene (intubation of a manikin located at floor level-low position) were simulated. The analysis included: duration of intubation, visibility of the laryngeal opening by the Cormack–Lehane scale, the bioelectrical activity of the intubating muscles, comfort and subjective assessment of physical effort by the Borg scale (Borg’s scale of subjective feeling of effort). The statistical analysis was performed with Microsoft Excel and T-student tests for pairs with unequal variables. The statistical importance was set at p < 0.05. Results: The use of an Intubrite laryngoscope significantly reduces the mean endotracheal intubation time compared to the Macintosh laryngoscope in a low position (17.34 s versus 19.04 s, p < 0.05). A higher rate of repeat intubations was observed in a low position for MCL (from 10% to 14%, p < 0.05). The reverse is true for Intubrite laryngoscope intubation (from 8% to 4%, p < 0.05 Please explain what is compared). The Intubrite laryngoscope improved visualization of glottis in the high and the low positions compared to the Macintosh laryngoscope (54% and 50% to 52% and 38%, respectively, p < 0.05). The risk of tooth damage was the same for the Intubrite and the MCL laryngoscopes in a high position (16% and 14%, respectively, p > 0.05), while in the simulated out-of-hospital setting, it was significantly higher for the MCL (22% versus 8%, p < 0.05). The subjective comfort of intubation in both simulated situations was similar according to the Borg scale (p-value, values). The use of the Intubrite laryngoscope was associated with less effort than the MCL in high versus low positions. For MCL, intubation in a high position was associated with lower mean muscle activity than in a low position (+48.24 µV versus +58.25 µV, p-value). For the Intubrite laryngoscope, these values were at similar levels (+52.03 µV and +52.65 µV, p-value). Conclusions: The use of the Intubrite laryngoscope by people with no clinical experience shortens the time of intubation and improves the laryngeal view compared to the standard Macintosh laryngoscope, but it requires similar muscle work in simulated conditions. Full article
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