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Difficult Tracheal Intubation (difficult + tracheal_intubation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

A survey of tracheal intubation difficulty in the operating room: a prospective observational study

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2001
F. Adnet
Background: The purpose of this study is to describe all degrees of endotracheal intubation difficulty among patients attended by eight anesthesiologists during routine surgery over a six-month period. Airway characteristics were routinely assessed preoperatively, according to the anesthesiologists' usual practice. Methods: Difficult tracheal intubation was evaluated by the Intubation Difficulty Scale (IDS), a quantitative score based on seven variables. An IDS value of 0 is consistent with a procedure without difficulty, and an IDS > 5 with a procedure involving moderate to major difficulty. Results: For 1171 patients undergoing tracheal intubation, IDS was 0 in 55%, and greater than 5 in 8% of cases. External laryngeal pressure, repositioning the patient and added use of a stylet were the most frequent methods chosen to facilitate tracheal intubation. Conclusion: There was a high incidence (37%) of minor difficulties encountered during routine surgery. [source]

Difficult tracheal intubation of a patient with cervical fracture due to osteopetrosis

PEDIATRIC ANESTHESIA, Issue 6 2001
Gökcen Basaranoglu
No abstract is available for this article. [source]

Difficult intubation of a child through laryngeal mask airway with two tracheal tubes

ACTA PAEDIATRICA, Issue 12 2006
TANIL KENDIIRLI
Abstract Difficult tracheal intubation occurs infrequently. It is estimated that difficult laryngoscopy occurs in 1,2% of patients. Tracheal intubation of especially small infants can be challenging. When faced with a difficult airway, intubation through a laryngeal mask airway is one method of obtaining a secure airway. Here, we report a 23-mo-old girl with chronic lung disease and severe pneumonia, who was admitted to our paediatric intensive care unit. Since the patient could not be intubated by the standard method, because her larynx was up and forward, she was intubated successfully with a laryngeal mask airway through which two consecutive tracheal tubes were inserted. Conclusion: Laryngeal mask airway has an important role as a back-up device in case direct visualization of the larynx is not possible. [source]

The prolonged use of the laryngeal mask airway in a neonate with airway obstruction and Treacher Collins syndrome

PEDIATRIC ANESTHESIA, Issue 6 2003
Martin J.L. Bucx MD
Summary Upper airway obstruction and difficult tracheal intubation are often encountered in patients with Treacher Collins syndrome (mandibulofacial dysostosis). In this case report, the use of a laryngeal mask airway (LMATM) in a 10-day-old newborn with severe Treacher Collins syndrome and acute airway obstruction is described. It successfully relieved the airway obstruction and was left in situ for an exceptionally long period of 4 days. The difficult decisions with respect to the management of the airway and specifically the role of the laryngeal mask are described. In our opinion, in some newborns with severe mandibulofacial disorders and upper airway obstruction, where conservative airway management procedures have failed, the laryngeal mask can be considered not only to relieve the obstruction but also to buy time until there is full insight into the medical condition and its consequences. [source]

Use of the Ambu® aScopeÔ in 10 patients with predicted difficult intubation

ANAESTHESIA, Issue 10 2010
E. Pujol
Summary Fibreoptic intubation is the gold standard for patients with predicted difficult intubation. The Ambu® aScopeÔ is a single-use device for fibreoptic tracheal intubation. We assessed its performance in 10 patients with predicted difficult tracheal intubation. The procedure was easy and successful in nine patients. However, the limited time of use did not permit intubation in one patient who required three attempts with different size tracheal tubes. The limited image resolution that can be expected of a single-use fibreoptic system and the absence of a suction channel are other potential limitations. On the other hand, being single-use this device has the advantage of avoiding the risk of infectious disease transmission and is always ready to use. [source]

A documented previous difficult tracheal intubation as a prognostic test for a subsequent difficult tracheal intubation in adults

ANAESTHESIA, Issue 10 2009
L. H. Lundstrøm
Summary We investigated the diagnostic accuracy of a documented previous difficult tracheal intubation as a stand-alone test for predicting a subsequent difficult intubation. Our assessment included patients from the Danish Anaesthesia Database who were scheduled for tracheal intubation by direct laryngoscopy. We used a four-point scale to grade the tracheal intubation. A previous difficult intubation was defined according to the presence of a record documenting a difficult penultimate tracheal intubation-score for the 15 499 patients anaesthetised more than once. Our assessment demonstrates that a documented history of previous difficult or failed intubation using direct laryngoscopy are strong predictors of a subsequent difficult or failed intubation and may identify 30% of these patients. Although previous investigators have reported predictive values that exceed our findings markedly, a documented previous difficult or failed tracheal intubation appears in everyday anaesthetic practice to be a strong predictor of a subsequent difficult tracheal intubation. [source]

The rigid nasendoscope as a tool for difficult tracheal intubation: A manikin study,

ANAESTHESIA, Issue 7 2003
N. Goodwin
Summary We examined the use of the 30° rigid nasendoscope in aiding difficult tracheal intubations. A Cormack and Lehane grade 4 difficult intubation (no view of glottis or epiglottis) was set up on a manikin. After 10 s of tuition, 40 anaesthetists attempted to pass a standard gum elastic bougie between the cords, with and without the nasendoscope, in randomised order. A bougie curved to an ,optimal curve' was also tested. Using the standard bougie 13/40 (33%) passed the bougie between the cords without the nasendoscope, compared with 31/40 (78%) when using the nasendoscope (p < 0.001). The ,optimal curve' bougie resulted in 29/40 (73%) and 39/40 (98%) success rates without and with the nasendoscope, respectively (p = 0.004). The nasendoscope is a simple and easy to use tool in grade 4 intubation, and results are improved further by the use of an ,optimal curve' bougie. [source]