Articles: intubation.
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J Clin Monit Comput · Apr 2023
Randomized Controlled TrialComparative evaluation of King Vision videolaryngoscope channeled and non-channeled blades with direct laryngoscope for intubation performance and skill retention by medical students: a randomized cross over two period study.
A videolaryngoscope(VL) with an intubation conduit like KingVision channeled(KVC) blade may provide an added advantage over a non-channeled VL like a KingVision non-channeled (KVNC) blade and direct laryngoscope (DL) for acquiring and retention of intubation skills, especially in novices. ⋯ KVC performed better in terms of time to intubation, success rate and ease of procedure as compared to KVNC and DL, both for acquisition and retention of skill. Hence, we advocate that KVC should be the preferred device over KVNC and DL for teaching intubation skills to novices.
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Acta Anaesthesiol Scand · Apr 2023
Randomized Controlled TrialInfrared flashing light through the cricothyroid membrane as guidance to awake intubation with a flexible bronchoscope: A randomised cross-over study.
In case of distorted airway anatomy, awake intubation with a flexible bronchoscope can be extremely difficult or even impossible. To facilitate this demanding procedure, an infrared flashing light source can be placed on the patient's neck superficial to the cricothyroid membrane. The light travels through the skin and tissue to the trachea, from where it can be registered by the advancing bronchoscope in the pharynx and seen as flashing white light on the monitor. We hypothesised that the application of this technique would allow more proximal and easier identification of the correct pathway to the trachea in patients with severe airway pathology. ⋯ NCT03930550.
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Pediatric emergency care · Apr 2023
Survey About Second-Line Agents for Pediatric Convulsive Status Epilepticus.
Convulsive status epilepticus (CSE) is the most common neurological emergency in children. It is a frequent cause of admission to pediatric intensive care units and is associated with significant short- and long-term morbidity. Management of CSE is a step-wise approach: first-line antiseizure agents (typically benzodiazepines) followed by a second-line agent before deeper anesthesia usually accompanied by intubation and ventilation. Current guidelines in the United Kingdom specify phenytoin as the second-line agent of choice for CSE. Two recent large international randomized controlled trials compared the efficacy of phenytoin with that of another second-line agent levetiracetam. Both studies found levetiracetam to be noninferior to phenytoin. ⋯ To facilitate use of levetiracetam for treatment of CSE in pediatrics, it should be included as a second-line agent in addition to phenytoin in the next update of the National Institute for Health and Care Excellence and other United Kingdom clinical guidelines.
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Case Reports
Using a Kirschner Wire as a Stylet for the Management of a Difficult Neonatal Airway: A Case Report.
We report the successful management of a difficult airway in an extremely low birth weight neonate (700 g) using a Kirschner wire as a substitute for an endotracheal tube stylet. Several intubation attempts were unsuccessful because of the difficulty in guiding a very small and malleable tube under the epiglottis. This study highlights that every maternity hospital should be prepared to manage airways in unexpected extremely low birth weight neonates. Appropriate size equipment and protocols should be readily available.
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Acta clinica Croatica · Apr 2023
ReviewIS SURGICAL TREATMENT OF VELOPHARYNGEAL INSUFFICIENCY BY MYOMUCOSAL POSTERIOR PHARYNGEAL FLAP A CONTRAINDICATION FOR NASAL INTUBATION? A NARRATIVE REVIEW.
Velopharyngeal insufficiency is a disorder where the soft palate directs the air through the nose. It is often present in patients with previous cleft or short palate, but also in many other conditions. Symptoms are primarily to be found in speech, with very distinct nasal sound. ⋯ The high risk of damage to the flap with possible bleeding can put the anesthesiologist in a very unpleasant situation if not aware of the permanent effect of this surgery. During preanesthetic assessment, if there is information on a previous pharyngoplasty, one should consider alternative options for nasotracheal intubation. All nasal insertion procedures must be either avoided or carried out with great caution, under fiberoptic visual control.