Articles: intubation.
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Increased regulatory requirements for sterilization in recent years have prompted a widespread transition from reusable to single-use laryngoscopes. The purpose of this study was to determine if the transition from metallic reusable to metallic single-use laryngoscopes impacted the performance of direct laryngoscopy at an academic medical center. ⋯ Metallic single-use laryngoscopes were associated with less need for rescue intubation with alternate devices and lower incidence of poor laryngeal view compared to reusable metallic laryngoscopes.
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Journal of critical care · Oct 2023
Meta AnalysisEtomidate as an induction agent for endotracheal intubation in critically ill patients: A meta-analysis of randomized trials.
We performed a meta-analysis of randomized controlled trials to evaluate if etomidate impacted mortality in critically ill adults when compared with other induction agents. ⋯ This meta-analysis found a high probability that etomidate increases mortality when used as an induction agent in critically ill patients with a number needed to harm of 31.
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Multicenter Study Observational Study
Laryngoscopy and Tracheal Intubation: Does Use of a Video Laryngoscope Facilitate Both Steps of the Procedure?
To compare the effect of the use of a video laryngoscope versus a direct laryngoscope on each step of emergency intubation: laryngoscopy (step 1) and intubation of the trachea (step 2). ⋯ Among critically ill adults undergoing tracheal intubation, the use of a video laryngoscope was associated both with a better view of the vocal cords and with a higher probability of successfully intubating the trachea when the view of the vocal cords was incomplete in this observational analysis. However, a multicenter, randomized trial directly comparing the effect of a video laryngoscope with a direct laryngoscope on the grade of view, success, and complications is needed.
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Multicenter Study
Defining Successful Intubation on the First Attempt Using Both Laryngoscope and Endotracheal Tube Insertions: A Secondary Analysis of Clinical Trial Data.
Successful intubation on the first attempt has historically been defined as successful placement of an endotracheal tube (ETT) using a single laryngoscope insertion. More recent studies have defined successful placement of an ETT using a single laryngoscope insertion followed by a single ETT insertion. We sought to estimate the prevalence of first-attempt success using these 2 definitions and estimate their associations with the duration of intubation and serious complications. ⋯ Defining successful intubation on the first attempt as placement of an ETT in the trachea using 1 laryngoscope and 1 ETT insertion identifies attempts with the shortest apneic time.
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Randomized Controlled Trial
Comparison of the novel membrane-based carbon dioxide filter memsorb™ with a chemical granulate absorbent using a high-fidelity lung simulator: a prospective randomized in vitro trial.
Memsorb™ is a novel device for carbon dioxide (CO2) removal from anesthesia circuits via a semipermeable polymeric membrane. We evaluated the performance of the memsorb device for the removal of CO2 in an Aisys™ CS2 machine and compared it with a standard chemical granulate absorber (CGA) using a high-fidelity lung simulator. ⋯ CO2 was successfully removed from the anesthesia circuit. FICO2 was significantly higher with memsorb throughout the observation period. Nevertheless, the clinical impact of these observations remains unclear. Further clinical trials are required to determine the utility of the novel device.