Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2025
Multicenter Study Comparative StudyBronchial Blocker Versus Endobronchial Intubation in Young Children Undergoing One-Lung Ventilation: A Multicenter Retrospective Cohort Study.
Thoracic surgery and one-lung ventilation in young children carry significant risks. Approaches to one-lung ventilation in young children include endobronchial intubation (mainstem intubation) and use of a bronchial blocker. We hypothesized that endobronchial intubation is associated with a greater prevalence of airway complications compared to use of a bronchial blocker. ⋯ Endobronchial intubation might be associated with a slightly increased risk of critical airway complications compared to use of a bronchial blocker in young children undergoing thoracic surgery and one-lung ventilation. Further, prospective studies are needed before a definitive change in practice is recommended.
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Anesthesia and analgesia · Feb 2025
Randomized Controlled Trial Multicenter Study Comparative StudyMcGrath MAC Versus Three-Dimensional Printed Video Laryngoscopes: A Randomized, Manikin-Simulated Noninferiority Controlled Study with Medical Students.
Proficiency in endotracheal intubation (ETI) is essential for medical professionals and its training should start at medical schools; however, large caseload may be required before achieving an acceptable success rate with direct laryngoscopy. Video laryngoscopy has proven to be an easier alternative for intubation with a faster learning curve, but its availability in medical training may be an issue due to its high market prices. We devised a low-cost 3-dimensionally printed video laryngoscope (3DVL) and performed a randomized trial to evaluate if the intubation success rate on the first attempt with this device is noninferior to a standard commercially available video laryngoscope (STVL). ⋯ The 3DVL was inferior in achieving first-attempt intubation when compared with the STVL with a difference in success rate >7.5% margin in simulated scenarios with medical students. Tracheal intubation might require a set of psychomotor skills for which the McGrath MAC device is superior to the low-cost alternative.
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Anesthesia and analgesia · Feb 2025
ReviewThe Future of Artificial Intelligence Using Images and Clinical Assessment for Difficult Airway Management.
Artificial intelligence (AI) algorithms, particularly deep learning, are automatic and sophisticated methods that recognize complex patterns in imaging data providing high qualitative assessments. Several machine-learning and deep-learning models using imaging techniques have been recently developed and validated to predict difficult airways. ⋯ We explore how these methods could impact clinical practice. Finally, we discuss predictive modeling for difficult laryngoscopy using machine-learning and the future approach with intelligent intubation devices.