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Petzoldt M, Grün C, Wünsch VA, Bauer M, Hardel TT, Grensemann J. In reply: Parallel intubation technique with the Vie Scope ® laryngoscope. Can J Anaesth 2024; 71:437-438. [PMID: 38243095 PMCID: PMC10923732 DOI: 10.1007/s12630-023-02685-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 01/21/2024] Open
Affiliation(s)
- Martin Petzoldt
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Catharina Grün
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Viktor A Wünsch
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcus Bauer
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim T Hardel
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörn Grensemann
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Henlin T, Michalek P, Gaszynski T, Soltes J. Parallel intubation technique with the Vie Scope ® laryngoscope. Can J Anaesth 2024; 71:435-436. [PMID: 38243097 DOI: 10.1007/s12630-023-02683-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 01/21/2024] Open
Affiliation(s)
- Tomas Henlin
- Department of Anesthesia and Intensive Care Medicine, First Medical Faculty and University Military Hospital, Prague, Czech Republic
| | - Pavel Michalek
- Department of Anaesthesiology, Resuscitation and Intensive Care Medicine, General University Hospital in Prague, Prague, Czech Republic.
| | - Tomasz Gaszynski
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland
| | - Jan Soltes
- Department of Anaesthesiology, Resuscitation and Intensive Care Medicine, General University Hospital in Prague, Prague, Czech Republic
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Zeidan A, Quintard H, Myatra S, El-Tahan M. Direct versus video-laryngoscopy: A game-changer for tracheal intubation in critically ill adult patients. Anaesth Crit Care Pain Med 2024; 43:101316. [PMID: 37865218 DOI: 10.1016/j.accpm.2023.101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023]
Affiliation(s)
- Ahed Zeidan
- Department of Anesthesiology, King Fahad Specialist Hospital, Dammam, Saudi Arabia and Lebanese University, Faculty of Medicine, Beirut, Lebanon.
| | - Hervé Quintard
- Division of Intensive Care, Geneva University Hospitals, the Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Sheila Myatra
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, India
| | - Mohamed El-Tahan
- Department of Cardiothoracic Anesthesia, Iman Abdulrahamn Bin Faisal, Dammam, Saudi Arabia and Mansoura University, Mansoura, Egypt
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Bhakta P, Karim HMR, Mandal M, O'Brien B. Comparing devices for managing the difficult airway. Can J Anaesth 2024; 71:154-155. [PMID: 37919625 DOI: 10.1007/s12630-023-02626-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Pradipta Bhakta
- Department of Anesthesiology, Hull University Teaching Hospital NHS Trust, Hull, East Yorkshire, UK.
| | - Habib Md Reazaul Karim
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Mohanchandra Mandal
- Department of Anaesthesiology and Intensive Care, Institute of Postgraduate Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | - Brian O'Brien
- Department of Anaesthesiology and Intensive Care, Cork University Hospital, Cork, Ireland
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5
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Petzoldt M, Grün C, Wünsch VA, Bauer M, Hardel TT, Grensemann J. In reply: Comparing devices for managing the difficult airway. Can J Anaesth 2024; 71:156-157. [PMID: 37919626 PMCID: PMC10858088 DOI: 10.1007/s12630-023-02627-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Martin Petzoldt
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Catharina Grün
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Viktor A Wünsch
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcus Bauer
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim T Hardel
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörn Grensemann
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Wünsch VA, Köhl V, Breitfeld P, Bauer M, Sasu PB, Siebert HK, Dankert A, Stark M, Zöllner C, Petzoldt M. Hyperangulated blades or direct epiglottis lifting to optimize glottis visualization in difficult Macintosh videolaryngoscopy: a non-inferiority analysis of a prospective observational study. Front Med (Lausanne) 2023; 10:1292056. [PMID: 38098848 PMCID: PMC10720620 DOI: 10.3389/fmed.2023.1292056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023] Open
Abstract
Purpose It is unknown if direct epiglottis lifting or conversion to hyperangulated videolaryngoscopes, or even direct epiglottis lifting with hyperangulated videolaryngoscopes, may optimize glottis visualization in situations where Macintosh videolaryngoscopy turns out to be more difficult than expected. This study aims to determine if the percentage of glottic opening (POGO) improvement achieved by direct epiglottis lifting is non-inferior to the one accomplished by a conversion to hyperangulated videolaryngoscopy in these situations. Methods One or more optimization techniques were applied in 129 difficult Macintosh videolaryngoscopy cases in this secondary analysis of a prospective observational study. Stored videos were reviewed by at least three independent observers who assessed the POGO and six glottis view grades. A linear mixed regression and a linear regression model were fitted. Estimated marginal means were used to analyze differences between optimization maneuvers. Results In this study, 163 optimization maneuvers (77 direct epiglottis lifting, 57 hyperangulated videolaryngoscopy and 29 direct epiglottis lifting with a hyperangulated videolaryngoscope) were applied exclusively or sequentially. Vocal cords were not visible in 91.5% of the cases with Macintosh videolaryngoscopy, 24.7% with direct epiglottis lifting, 36.8% with hyperangulated videolaryngoscopy and 0% with direct lifting with a hyperangulated videolaryngoscope. Conversion to direct epiglottis lifting improved POGO (mean + 49.7%; 95% confidence interval [CI] 41.4 to 58.0; p < 0.001) and glottis view (mean + 2.2 grades; 95% CI 1.9 to 2.5; p < 0.001). Conversion to hyperangulated videolaryngoscopy improved POGO (mean + 43.7%; 95% CI 34.1 to 53.3; p < 0.001) and glottis view (mean + 1.9 grades; 95% CI 1.6 to 2.2; p < 0.001). The difference in POGO improvement between conversion to direct epiglottis lifting and conversion to hyperangulated videolaryngoscopy is: mean 6.0%; 95% CI -6.5-18.5%; hence non-inferiority was confirmed. Conclusion When Macintosh videolaryngoscopy turned out to be difficult, glottis exposure with direct epiglottis lifting was non-inferior to the one gathered by conversion to hyperangulated videolaryngoscopy. A combination of both maneuvers yields the best result. Clinical trial registration ClinicalTrials.gov, NCT03950934.
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Affiliation(s)
- Viktor A. Wünsch
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vera Köhl
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp Breitfeld
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcus Bauer
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Phillip B. Sasu
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah K. Siebert
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andre Dankert
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Stark
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Zöllner
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Petzoldt
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gaszyński T, Gómez-Ríos MÁ, Serrano-Moraza A, Sastre JA, López T, Ratajczyk P. New Devices, Innovative Technologies, and Non-Standard Techniques for Airway Management: A Narrative Review. Healthcare (Basel) 2023; 11:2468. [PMID: 37761667 PMCID: PMC10650429 DOI: 10.3390/healthcare11182468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
A wide range of airway devices and techniques have been created to enhance the safety of airway management. However, airway management remains a challenge. All techniques are susceptible to failure. Therefore, it is necessary to have and know the greatest number of alternatives to treat even the most challenging airway successfully. The aim of this narrative review is to describe some new devices, such as video laryngeal masks, articulated stylets, and non-standard techniques, for laryngeal mask insertion and endotracheal intubation that are not applied in daily practice, but that could be highly effective in overcoming a difficulty related to airway management. Artificial intelligence and 3D technology for airway management are also discussed.
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Affiliation(s)
- Tomasz Gaszyński
- Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, 90-154 Lodz, Poland;
| | - Manuel Ángel Gómez-Ríos
- Department of Anesthesiology and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain;
| | | | - José Alfonso Sastre
- Complejo Asistencial Universitario de Salamanca, 37001 Salamanca, Spain; (J.A.S.); (T.L.)
| | - Teresa López
- Complejo Asistencial Universitario de Salamanca, 37001 Salamanca, Spain; (J.A.S.); (T.L.)
| | - Paweł Ratajczyk
- Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, 90-154 Lodz, Poland;
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