European journal of anaesthesiology
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Comparative Study Clinical Trial
Videolaryngoscopy in the management of the difficult airway: a comparison with the Macintosh blade.
Several studies have shown that videolaryngoscopes can provide better laryngeal exposure than conventional laryngoscopy. These studies, however, did not exclusively focus on patients with an anticipated difficult intubation. The aim of the present study was to assess whether a videolaryngoscope would provide better laryngeal exposure than conventional laryngoscopy and therefore facilitate intubation in cases of difficult laryngoscopy. ⋯ In patients with an anticipated difficult airway, videolaryngoscopy significantly improved the laryngeal exposure thus facilitating endotracheal intubation.
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An endotracheal cuff pressure of 20-30 cmH(2)O is recommended. Underinflation and overinflation are associated with complications such as aspiration and tracheal wall damage. The aim of this study was to identify prevalence of, and risk factors for, endotracheal cuff underinflation and overinflation. ⋯ Variations in endotracheal cuff pressure are common in ICU patients. Duration of prior intubation and absence of sedation are independently associated with increased risk for cuff underinflation.
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Randomized Controlled Trial Comparative Study
Feasibility and safety of antegrade radial artery cannulation.
The purpose of this study was to compare thrombosis rates in antegrade (catheter directed toward the hand) versus retrograde (catheter directed toward the elbow) cannulation of the radial artery. Our secondary objectives were to compare these two techniques in terms of success rate, differences in noninvasive versus invasive blood pressure measurement and complications. ⋯ We conclude that antegrade radial artery cannulation has no advantage over the retrograde approach in terms of reducing thrombosis, but it can be used in cases when the retrograde approach has failed.
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Randomized Controlled Trial Comparative Study
Tracheal intubating conditions using propofol and remifentanil target-controlled infusion: a comparison of remifentanil EC50 for Glidescope and Macintosh.
The combination remifentanil-propofol was used for tracheal intubation without muscle relaxant in patients with anticipated difficult airway. Using a target-controlled infusion, we compared the remifentanil concentrations required for intubation with the Macintosh laryngoscope and the Glidescope, at a constant plasma concentration of propofol without muscle relaxant. ⋯ There is no strong evidence that the target remifentanil concentrations required for adequate intubating conditions differed according to the technique used for intubation in the nonparalysed patient. We did not detect any major complications using this technique for either method.