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Early endotracheal intubation is not associated with the rate of return of spontaneous circulation following cardiac arrest at the emergency department:an exploratory analysis
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作者 Siwat Neamjun Phichayut Phinyo +1 位作者 Borwon Wittayachamnankul Wachira Wongtanasarasin 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第4期297-300,共4页
Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and r... Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and respiratory issues.[2]Recommendations emphasize the expertise of responders in airway management.[3]Various options exist,such as chest compression-only cardiopulmonary resuscitation(CPR),bag-mask ventilation(BMV),and advanced airways.The BMV and advanced airways are not deemed equivalent or superior based on previous evidence.[4]Achieving consistency in choosing and timing the optimal airway approach during IHCA is crucial.The current American Heart Association guidelines suggest an advanced airway strategy when endotracheal intubation(ETI)success rates are high,but the optimal time for advanced airway management remains unclear.[5]Wong et al[6]revealed that survival improved by less than 5 min with advanced airway management.According to a subgroup analysis of IHCA patients in emergency departments(EDs),early intubation was associated with a 1.5-fold greater rate of return of spontaneous circulation(ROSC)than in other locations.[7]ED patients’constant monitoring and immediate management,with readily available intubation equipment,enhance early intubation and survival rates.[6]Nonetheless,IHCA patients intubated within the first 15 min had a lower ROSC rate. 展开更多
关键词 intubation RETURN annually
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Evaluation of Risk Factors for Arytenoid Dislocation after Endotracheal Intubation: a Retrospective Case-control Study 被引量:5
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作者 Le Shen Wu-tao Wang +2 位作者 Xue-rong Yu Xiu-hua Zhang Yu-guang Huang 《Chinese Medical Sciences Journal》 CAS CSCD 2014年第4期221-224,共4页
Objective To investigate the risk factors for postoperative arytenoid dislocation. Methods From September 2003 to August 2013, the records of 16 patients with a history of postoperative arytenoid dislocation were revi... Objective To investigate the risk factors for postoperative arytenoid dislocation. Methods From September 2003 to August 2013, the records of 16 patients with a history of postoperative arytenoid dislocation were reviewed. Patients matched in terms of date and type of procedures were chosen as the controls(n=16). Recorded data for all patients were demographics, smoking status, alcoholic status, preoperative physical status, airway evaluation, intubation procedures, preoperative laboratory test results, anesthetic consumption and intensive care unit stay. For arytenoid dislocation cases, we further analyzed the incidences of the left and right arytenoid dislocation, and the outcomes of surgical repair and conservative treatment. Categorical variables were presented as frequencies and percentages, and were compared using the chi-squared test. Continuous variables were expressed as means±SD and compared using the Student's unpaired t-test. To determine the predictors of arytenoid dislocation, a logistic regression model was used for multivariate analysis. Results Sixteen patients with postoperative arytenoid dislocation were enrolled, with a median age of 52 years. Most postoperative arytenoid dislocation patients(15/16, 93.75%) received surgical repair, except one patient who recovered after conservative treatment. None of the postoperative arytenoid dislocation patients were smokers. Red blood cell(P=0.044) and hemoglobin(P=0.031) levels were significantly lower among arytenoid dislocation cases compared with the controls. Conclusions Non-smoking and anemic patients may be susceptible to postoperative arytenoid dislocation. However, neither of them was independent risk factor for postoperative arytenoid dislocation. 展开更多
关键词 arytenoid DISLOCATION COMPLICATION endotracheaL intubation
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Video versus direct laryngoscopy on successful firstpass endotracheal intubation in ICU patients 被引量:3
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作者 Yong-xia Gao Yan-bo Song +4 位作者 Ze-juan Gu Jin-song Zhang Xu-feng Chen Hao Sun Zhen Lu 《World Journal of Emergency Medicine》 SCIE CAS 2018年第2期99-104,共6页
BACKGROUND: Airway management in intensive care unit(ICU) patients is challenging. The aim of this study was to compare the rate of successful first-pass intubation in the ICU by using the direct laryngoscopy(DL) and ... BACKGROUND: Airway management in intensive care unit(ICU) patients is challenging. The aim of this study was to compare the rate of successful first-pass intubation in the ICU by using the direct laryngoscopy(DL) and that by using the video laryngoscopy(VL).METHODS: A randomized, non-blinded trial comparing first-pass success rate of intubation between VL and DL was performed. Patients were recruited in the period from August 2014 to August 2016. All physicians working at ICU received hands-on training in the use of the video and direct laryngoscope. The primary outcome measure was the first-pass intubation success. RESULTS: A total of 163 ICU patients underwent intubation during the study period(81 patients in VL group and 82 in DL group). The rate of successful first-pass intubation was not significantly different between the VL and the DL group(67.9% vs. 69.5%, P=0.824). Moreover, the overall intubation success and total number of attempts to achieve intubation success did not differ between the two groups. In patients with successful first-pass intubation, the median duration of the intubation procedure did not differ between the two groups. The Cormack-Lehane grades and the percentage of glottic opening score were similar, and no significant differences were found between the two groups. There were no statistical differences between the VL and the DL group in intubation complications(all P>0.05). CONCLUSION: Among ICU patients requiring intubation, there was no significant difference in the rate of successful first-pass intubation between VL and DL. 展开更多
关键词 intubation VIDEO LARYNGOSCOPY DIRECT LARYNGOSCOPY INTENSIVE care unit
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Predictors of first-pass success intubations in the emergency departments in Germany:analysis of the German Airway Registry between 2015 and 2022
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作者 Christian Hohenstein Lucas Rudnik Frank Bloos 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第6期490-493,共4页
In the field of airway management,there is no national registry in Germany that captures data on emergency airway management.To improve quality,one needs to know the data first.Examples include gender,age,indications ... In the field of airway management,there is no national registry in Germany that captures data on emergency airway management.To improve quality,one needs to know the data first.Examples include gender,age,indications for emergency airway management,level of education,the intubating department,the intubation method,and other factors that can serve as a basis for quality improvement changes. 展开更多
关键词 intubation AIRWAY education
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Comment on: Effect of intubation in patients with functional epiphora after endoscopic dacryocystorhinostomy
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作者 Mansooreh Jamshidian-Tehrani Hossein Ghahvehchian +3 位作者 Christopher J Compton Jeremy D Clark Nicole L West Mohsen Bahmani Kashkouli 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第8期1576-1576,共1页
Dear Editor,We read with interest the article by Han et al[1]in which they retrospectively assessed the effect of bicanalicular intubation for functional epiphora after a failed endoscopic dacryocystorhinostomy(DCR).T... Dear Editor,We read with interest the article by Han et al[1]in which they retrospectively assessed the effect of bicanalicular intubation for functional epiphora after a failed endoscopic dacryocystorhinostomy(DCR).They confirmed the post-DCR“functional obstruction”based on fluorescein dye disappearance(FDDT)and irrigation test[1]. 展开更多
关键词 intubation assessed ENDOSCOPIC
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Treatment of acute dacryocystitis by translacrimal canalicular drainage and D-silicone intubation
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作者 Jin-Jing He Jing-Wen Gong +1 位作者 Jia-Ni Zhou Jin Jiang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第9期1628-1632,共5页
AIM:To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis(AD).METHODS:This retrospective study included 23 p... AIM:To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis(AD).METHODS:This retrospective study included 23 patients with AD and had undergone abscess decompression with the use of lacrimal probe and intranasal drainage by D-silicone intubation between January 2019 and December 2022.Patients received abscess decompression and systemic antibiotic-corticosteroid from the time of diagnosis.D-silicone tube was inserted within 10d after diagnosis and removed 3-6mo after intubation.The procedure and outcomes of this method were evaluated.RESULTS:All patients showed improvement of signs and symptoms of AD within 72h.No intraoperative and postoperative complications were observed.No recurrence of lacrimal sac abscesses occurred after D-silicone tube removed.CONCLUSION:Lacrimal probe and D-silicone intubation appear to be a feasible,minimally invasive,safe,and effective method,which could be a reasonable choice in the treatment of AD. 展开更多
关键词 acute dacryocystitis TREATMENT translacrimal canalicular drainage D-silicone intubation
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Ultrasound-guided sphenopalatine ganglion block for effective analgesia during awake fiberoptic nasotracheal intubation: A case report
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作者 Hangil Kang Seongjae Park Yehun Jin 《World Journal of Clinical Cases》 SCIE 2024年第14期2451-2456,共6页
BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distres... BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distress.This case report explores the application of a sphenopalatine ganglion(SPG)block as an alternative anal-gesic modality to mitigate the discomfort associated with AFNI.CASE SUMMARY A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion.The patient’s medical history included prior surgery,chemotherapy,and radiation therapy,resulting in signi-ficant jaw impairment and limited neck mobility.Considering the anticipated air-way challenges,AFNI was planned.A SPG block was performed under real-time ultrasound guidance,providing effective analgesia during nasotracheal intuba-tion.CONCLUSION The SPG block represents a promising analgesic approach in AFNI,offering po-tential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation. 展开更多
关键词 Sphenopalatine ganglion block Nerve block Regional anesthesia ANALGESIA Awake fiberoptic nasotracheal intubation Case report
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Endotracheal intubation in patients with COVID-19 using an ultrathin flexible gastrointestinal endoscope 被引量:1
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作者 Shigenori Masaki Chizuko Yamada Takashi Kawamoto 《World Journal of Gastrointestinal Endoscopy》 CAS 2020年第10期404-407,共4页
Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operat... Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operator needs to be in close proximity to the patient’s face during the procedure,which increases the risk of droplet exposure.Therefore,we simulated fiberoptic endotracheal intubation on a mannequin representing the patient,using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope,in order to maintain distance from the patient during the procedure.We performed this procedure 10 times and measured the time required;the median procedure time was 6.4 s(interquartile range,5.7-8.1 s).The advantage of this method is the short procedure time and distance maintained from the patients.The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients.In addition,this method can handle difficult airways without risk of misplacement of the endotracheal tube.However,it is necessary to consider the risk of aerosol generation associated with this procedure.In the pandemic setting of coronavirus disease 2019,this approach may be useful when a gastrointestinal endoscopist is in charge of endotracheal intubation of patients with coronavirus disease 2019. 展开更多
关键词 endotracheal intubation SARS-CoV-2 COVID-19 LARYNGOSCOPES BRONCHOSCOPES Gastrointestinal endoscopes
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Submental Intubation with LMAFastrach<sup>TM</sup>Endotracheal Tube in Maxillofacial Trauma: A Case Report
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作者 Daphne Moo Elizabeth Tan +1 位作者 Juen Bin Lai Soo Toon Chan 《Open Journal of Anesthesiology》 2019年第12期221-226,共6页
Securing a definitive airway in patients who require surgical fixation of complex maxillofacial fractures is an integral part of their perioperative management. For the ease of surgical access, an orotracheal tube is ... Securing a definitive airway in patients who require surgical fixation of complex maxillofacial fractures is an integral part of their perioperative management. For the ease of surgical access, an orotracheal tube is usually not preferred by surgeons. The presence of a base of skull or nasal bone fractures would also contraindicate nasotracheal intubation. Therefore, a tracheostomy may be the only option left to secure the airway in these patients who require surgical fixation. Submental intubation has been used as a safe and effective alternative method in patients who require intubation for maxillofacial reconstruction since it was first reported by Hernandez Altemir F in 1986. Many modifications to the original technique have been documented over the years, but there has been no consensus to support the use of a single method or device. In this case report, we described our experience with submental intubation using an LMAFastrachTM endotracheal tube (ETT) to facilitate the surgical fixation of bilateral Le Fort II fractures. We conclude that the LMAFastrachTM ETT is a suitable device for submental intubation. This technique should be included in airway workshops and courses for anaesthesia residents as it is a simple yet secure alternative to tracheostomy in the intraoperative airway management of maxillofacial trauma. 展开更多
关键词 SUBMENTAL intubation LMAFastrachTM MAXILLOFACIAL TRAUMA
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Effects of Tube Depth and Infusion Rate of Continuous Humidification by Endotracheal Intubation on Humidification Effect
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作者 Hui Sun Dan Li +1 位作者 Wan Luo Lin Feng 《Open Journal of Nursing》 2017年第1期123-127,共5页
Objective: To investigate the continuous humidification tube insertion depth of endotracheal intubation and the flow rate of the wetting effect. Methods: From October 2008 to May 2010, among 132 patients of oral and m... Objective: To investigate the continuous humidification tube insertion depth of endotracheal intubation and the flow rate of the wetting effect. Methods: From October 2008 to May 2010, among 132 patients of oral and maxillofacial surgery with tracheal intubation, continuous infusion can be adjusted to the wet method;according to the wet pipe, insertion depth of the flow rate is divided into four groups, by four different depths and velocities of the wetting effect, to be analyzed. Results: B group was significantly lower than other groups satisfied with indicators of four significantly different effects of humidification. Conclusion: When continuous humidification tube insertion depth of endotracheal intubation is 10 - 12 cm, and flow rate is 15 - 20 ml/h, the wetting effect will achieve greater satisfaction. 展开更多
关键词 intubation Continuous HUMIDIFICATION TUBE DEPTH INFUSION Rate HUMIDIFICATION EFFECT
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Assessing the Impact of General Anesthesia and Bronchial Intubation in Conjunction with Thoracic Paravertebral Nerve Block on Cellular Immunity and Surgical Management in Tuberculous Pyothorax Patients
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作者 Chunyu Duan Gang Wang +2 位作者 Bei Wang Man Xu Lijuan Gao 《Proceedings of Anticancer Research》 2024年第1期66-70,共5页
Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eight... Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax. 展开更多
关键词 General anesthesia and bronchial intubation Thoracic paravertebral nerve block Tuberculous pyothorax Surgical treatment effect
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The Feasibility of Endotracheal Intubation with Subcutaneous Dissociative Conscious Sedation versus General Anesthesia: A Prospective Randomized Trial
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作者 Sanaz Shabani Mihan J. Javid Jayran Zebardast 《Open Journal of Anesthesiology》 2014年第2期41-45,共5页
Despite outstanding improvements in anesthesia techniques and anesthetics, difficult airway is still a dilemma and is accompanied by morbidity and mortality. The aim of this study is to compare the feasibility of endo... Despite outstanding improvements in anesthesia techniques and anesthetics, difficult airway is still a dilemma and is accompanied by morbidity and mortality. The aim of this study is to compare the feasibility of endotracheal intubation with the traditional method of general anesthesia by using muscle relaxants, and “sDCS” (Subcutaneous Dissociative Conscious Sedation) which has been recently reported as an efficient method of anesthesia with the capability of maintaining spontaneous ventilation and providing an appropriate situation for larynxgoscopy and endotracheal intubation. Material and Methods: This randomized clinical trial was conducted on 100 patients who were scheduled for elective laparotomy. Patients were randomly divided into two groups: group A and group B. In group A, patients underwent general anesthesia with thiopental sodium and relaxant. In group B, patients underwent “subcutaneous Dissociative Conscious Sedation” and received low dose subcutaneous ketamine and intravenous narcotic with no relaxant. The feasibility of direct laryngoscopy and tracheal intubation, hemodynamic changes, desaturation (SpO2 < 90%), patient cooperation, patient comfort, hallucination, nausea and vomiting, nystagmus and salivation were evaluated in two groups. Adverse events including apnea and need for positive pressure mask ventilation, additional dose of fentanyl were recorded in group B. The anesthesiologist who performed the procedure was asked about the patient calmness and cooperation during the procedure and the feasibility of laryngoscopy and tracheal intubation. The incidence of nausea and vomiting in post-operative care unit was recorded too. Results: Hemodynamic variables were comparable in two groups. No event of irreversible respiratory depression, desaturation, need for positive pressure ventilation and hallucination was observed in group B. All patients were cooperative and obedient during the laryngoscopy and tracheal intubation. The incidence of nausea was not statistically significant. The anesthesiologist was satisfied by the quality of patient’s cooperation for laryngoscopy in both groups. Conclusion: Subcutaneous dissociative conscious sedation is comparable with general anesthesia to provide desirable situation for laryngoscopy and tracheal intubation. 展开更多
关键词 Difficult Airway KETAMINE LARYNGOSCOPY SUBCUTANEOUS Dissociative Conscious SEDATION TRACHEAL intubation
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A RETROSPECTIVE STUDY OF ARYTENOID DISLOCATION AFTER ENDOTRACHEAL INTUBATION
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作者 郭向阳 罗爱伦 +2 位作者 任洪智 叶铁虎 黄宇光 《Chinese Medical Sciences Journal》 CAS CSCD 1998年第2期119-122,共4页
Five cases of arytenoid dislocation after intubation under general anesthesia are reported in this article. The anatomical and anesthetic causes of this complication were studied restrospectively, and the methods of t... Five cases of arytenoid dislocation after intubation under general anesthesia are reported in this article. The anatomical and anesthetic causes of this complication were studied restrospectively, and the methods of treatment were discussed. The result showed that the incidence of arytenoid dislocation was about 0. 09% (5/5 826). Hoarseness, dysphonia and difficulty in feeding were the prevalent symptoms, and poor mobili- ty of the vocal fold was the most common sign. The treatment included closed reduction of the displaced arytenoid under local anesthesia, steroid and physical therapy. The possible causes of arytenoid dislocation were summarized as follows: (1) trauma produced by the blade tip of laryngoscope, (2) the use of stylet, (3) overstretching of aryepiglottic fold and vocal cord during laryngoscopy and intubation, and (4) cough- ing and movement of the endotracheal tube on the larynx during the endotracheal tube in place. It was sug- gested that correct technique and gentle manipulation during intubation could reduce the incidence of the complication. Timely postoperative follow-up and early reduction of arytenoid cartilage should be empha-sized in the diagnosis and treatment of the complication. 展开更多
关键词 arytenoid cartilage DISLOCATION intubation
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Clinical Criteria for Airway Assessment: Correlations with Laryngoscopy and Endotracheal Intubation Conditions
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作者 Gustavo Henrique S. Wanderley Luciana Cavalcanti Lima +4 位作者 Tania Cursino de Menezes Couceiro Waston Vieira Silva Raquel Queiroz G. A. Coelho Andrea Cavalcanti C. Lucena Anne Danielle Santos Soares 《Open Journal of Anesthesiology》 2013年第7期320-325,共6页
Difficult intubation, inadequate ventilation and esophageal intubation are the principal causes of death or brain damage related to airway manipulation. The objective of this cross-sectional study was to correlate a p... Difficult intubation, inadequate ventilation and esophageal intubation are the principal causes of death or brain damage related to airway manipulation. The objective of this cross-sectional study was to correlate a preanesthetic evaluation that may be capable of predicting a difficult intubation with the conditions encountered at laryngoscopy and endotracheal intubation. Eighty-one patients submitted to general anesthesia were evaluated at a preanesthetic consultation according to the modified Mallampati classification, the Wilson score and the American Society of Anesthesiologists (ASA) difficult airway algorithm. Findings were then correlated with the Cormack-Lehane classification and with the number of attempts at endotracheal intubation. No statistically significant correlations were found between the patients’ Mallampati classification and their Cormack-Lehane grade or between the Mallampati classification and the number of attempts required to achieve endotracheal intubation. Laryngoscopy proved difficult in four patients and in all of these cases the Wilson score had been indicative of a possibly difficult airway, highlighting its good predicting sensitivity. However, the specificity of this test was low, since another 24 patients had the same Wilson score but were classified as Cormack-Lehane I/II. Moreover, two patients who had a Wilson score ≥ 4 were also classified as Cormack-Lehane grade I/II. The study concluded that the Wilson score, although seldom used in clinical practice, is a highly sensitive predictor of a difficult airway;its specificity, however, is low. 展开更多
关键词 Preanesthetic Evaluation Respiratory System AIRWAY endotracheaL intubation Measurement Tech-niques Mallampati WILSON Cormack-Lehane
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Simulation and Acquisition of Endotracheal Intubation Skills by Medical Students—A Pilot Study
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作者 Abiodun Oyinpreye Jasper 《Open Journal of Anesthesiology》 2022年第7期240-247,共8页
Introduction: Endotracheal intubation is a vital life-saving skill required by physicians in life-threatening situations in and out of the hospital. Medical students are exposed to these procedures mainly as they rota... Introduction: Endotracheal intubation is a vital life-saving skill required by physicians in life-threatening situations in and out of the hospital. Medical students are exposed to these procedures mainly as they rotate through the department of Anaesthesia, in their subspecialty posting in Surgery. In this study, we sought to assess the ease of learning endotracheal intubation by medical students in the skills laboratory using an adult-sized (Laerdal Medical) manikin. Methods: This was a prospective descriptive study assessing the ability of medical students at endotracheal intubation during their 12-week rotation in the Anaesthesia Department during their subspecialty posting from August to October 2019 in the Skills Laboratory. An adult-sized manikin (Laerdal Medical) intubating head was used for the study. This was preceded by a detailed lecture and demonstration in the skills laboratory after successful passage of the endotracheal tube and connected to a self-inflating ventilation (Ambou) bag. Adequate chest movement meant proper placement, while the fullness of the stomach meant oesophageal intubation. Results: All the 500 level (45) students in the class were recruited for this prospective study. 30 (66%) had successful endotracheal intubation at the first attempt, 7 (14.4%) at the second attempt, 5 (11.1%) at the third attempt, 2 (4.4%) students at the fourth attempt and 1 (2.2%) had successful endotracheal intubation at the fifth attempt. Attempts were made to reinforce information on the practical procedure by a repeat performance by the instructor after each set of successful attempts was separated from the pack of unsuccessful candidates. In the end, however, we had 100% successful endotracheal intubation, but after 5 attempts by the last medical student. Conclusion: Endotracheal intubation skills can be learned with some level of ease when done after detailed information and training of medical students. More so when not under undue stress and life-threatening situations in the skills laboratory. By extension, this increases the confidence of medical students in the live patients in the Operating Theatre, after repeated attempts in the skills laboratory. This has the benefit of improving the chances of acquisition of endotracheal intubation in real-life situations. 展开更多
关键词 endotracheal intubation Medical Students MANIKIN Skills Laboratory
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Cardiopulmonary prognosis of prophylactic endotracheal intubation in patients with upper gastrointestinal bleeding undergoing endoscopy
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作者 Yufang Lin Fei’er Song +9 位作者 Weiyue Zeng Yichi Han Xiujuan Chen Xuanhui Chen Yu Ouyang Xueke Zhou Guoxiang Zou Ruirui Wang Huixian Li Xin Li 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第5期372-379,共8页
BACKGROUND:It is controversial whether prophylactic endotracheal intubation(PEI)protects the airway before endoscopy in critically ill patients with upper gastrointestinal bleeding(UGIB).The study aimed to explore the... BACKGROUND:It is controversial whether prophylactic endotracheal intubation(PEI)protects the airway before endoscopy in critically ill patients with upper gastrointestinal bleeding(UGIB).The study aimed to explore the predictive value of PEI for cardiopulmonary outcomes and identify high-risk patients with UGIB undergoing endoscopy.METHODS:Patients undergoing endoscopy for UGIB were retrospectively enrolled in the eICU Collaborative Research Database(eICU-CRD).The composite cardiopulmonary outcomes included aspiration,pneumonia,pulmonary edema,shock or hypotension,cardiac arrest,myocardial infarction,and arrhythmia.The incidence of cardiopulmonary outcomes within 48 h after endoscopy was compared between the PEI and non-PEI groups.Logistic regression analyses and propensity score matching analyses were performed to estimate effects of PEI on cardiopulmonary outcomes.Moreover,restricted cubic spline plots were used to assess for any threshold effects in the association between baseline variables and risk of cardiopulmonary outcomes(yes/no)in the PEI group.RESULTS:A total of 946 patients were divided into the PEI group(108/946,11.4%)and the non-PEI group(838/946,88.6%).After propensity score matching,the PEI group(n=50)had a higher incidence of cardiopulmonary outcomes(58.0%vs.30.3%,P=0.001).PEI was a risk factor for cardiopulmonary outcomes after adjusting for confounders(odds ratio[OR]3.176,95%confidence interval[95%CI]1.567-6.438,P=0.001).The subgroup analysis indicated the similar results.A shock index>0.77 was a predictor for cardiopulmonary outcomes in patients undergoing PEI(P=0.015).The probability of cardiopulmonary outcomes in the PEI group depended on the Charlson Comorbidity Index(OR 1.465,95%CI 1.079-1.989,P=0.014)and shock index>0.77(compared with shock index≤0.77[OR 2.981,95%CI 1.186-7.492,P=0.020,AUC=0.764]).CONCLUSION:PEI may be associated with cardiopulmonary outcomes in elderly and critically ill patients with UGIB undergoing endoscopy.Furthermore,a shock index greater than 0.77 could be used as a predictor of a worse prognosis in patients undergoing PEI. 展开更多
关键词 Prophylactic endotracheal intubation Upper gastrointestinal bleeding Cardiopulmonary outcomes eICU Collaborative Research Database
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Difficult Endotracheal Intubation -Scales and Causes
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作者 Dejan Stojanovic 《Journal of Pharmacy and Pharmacology》 2017年第10期775-786,共12页
The aim of the study is to assess the possibility of intubation in each patient, the lyche to be difficult intubation, to fred all the causes of the difficult intubation, to fred and apply appropriate scales for diffi... The aim of the study is to assess the possibility of intubation in each patient, the lyche to be difficult intubation, to fred all the causes of the difficult intubation, to fred and apply appropriate scales for difficult intubation, to estimate the frequency of difficult intubation. Endotmcheal intubation is the basic reanimation procedure performed both in hospital and out-of-hospital settings. It is carded out whenever chest movements and spontaneous respiration are compromised. Respiratory arrest may occur for a variety of reasons (such as cardac arrest, coma of any origin, poisining) or direct damage to the airways, e.g. in various traumas (damages to the face, oropharynx, larynx, trachea, chest). The basic endotracheal intubation kit contains: laryngoscope, endotracheal tubes, connectors (tube and Ambu bag connectors), complete Ambu kit (face mask and bag), 20 mL syringe for cuff inflating, suction apparatus, stylete, and Magill forceps. In order to assess the successfulness of endotracheal intubation, it is necessary first to identify patients who need to be intubated. With the aim of identifying such patients, numerous screening tests and scales have been created to predict difficult intubation. The best known and most commonly used are the Mallampati and Wilson classifications as well as the LEMON airway assessment method. Nevertheless, difficult intubation accounts for 1% of cases. It usually occurs when manipulation of the laryngoscope blade is not possible in obese patients and patients with short neck, in congenital restricted mouth opening, limited neck movement as well as limited temporomandibular joint mobility; in cases of edema, fibrosis and lesions of the tongue, pharynx and larynx; when there are anatomical variations and congenital malformations of the oral cavity, pharynx, larynx, head, neck and chest. 展开更多
关键词 endotracheal intubation difficult intubation screening tests LARYNGOSCOPE AIRWAY
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Effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation
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作者 Yi-Lin Yang Ting-Ting Wen +1 位作者 Xiu-Ze Li Hong Lu 《Journal of Hainan Medical University》 2018年第9期36-39,共4页
Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general ane... Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group (n=109) and the dexmedetomidine group (n=109) by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction (T0), 1 min after endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and 10 min after endotracheal intubation (T3).Results:At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group;serum stress hormones ACTH, Cor, NE, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Dexmedetomidine + propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation. 展开更多
关键词 endotracheaL intubation General ANESTHESIA induction period DEXMEDETOMIDINE PROPOFOL
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General anesthesia with endotracheal intubation ensures the quick removal of magnetic foreign bodies:A case report
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作者 Qi-Fei Tian Ai-Xiang Zhao +3 位作者 Ni Du Zeng-Juan Wang Ling-Ling Ma Fang-Li Men 《World Journal of Gastrointestinal Endoscopy》 2023年第11期676-680,共5页
BACKGROUND The incidence of ingestion of magnetic foreign bodies in the gastrointestinal tract has been increasing year by year.Due to their strong magnetic attraction,if multiple gastrointestinal foreign bodies enter... BACKGROUND The incidence of ingestion of magnetic foreign bodies in the gastrointestinal tract has been increasing year by year.Due to their strong magnetic attraction,if multiple gastrointestinal foreign bodies enter the small intestine,it can lead to serious complications such as intestinal perforation,necrosis,torsion,and bleeding.Severe cases require surgical intervention.CASE SUMMARY We report a 6-year-old child who accidentally swallowed multiple magnetic balls.Under timely and safe anesthesia,the magnetic balls were quickly removed through gastroscopy before entering the small intestine.CONCLUSION General anesthesia with endotracheal intubation can ensure full anesthesia under the condition of fasting for less than 6 h.In order to prevent magnetic foreign bodies from entering the small intestine,timely and effective measures must be taken to remove the foreign bodies. 展开更多
关键词 Magnetic foreign bodies General anesthesia with endotracheal intubation Magnetic balls ENDOSCOPY Case report
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Endotracheal intubation sedation in the intensive care unit
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作者 Pritee Tarwade Nathan J Smischney 《World Journal of Critical Care Medicine》 2022年第1期33-39,共7页
Endotracheal intubation is one of the most common,yet most dangerous procedure performed in the intensive care unit(ICU).Complications of ICU intubations include severe hypotension,hypoxemia,and cardiac arrest.Multipl... Endotracheal intubation is one of the most common,yet most dangerous procedure performed in the intensive care unit(ICU).Complications of ICU intubations include severe hypotension,hypoxemia,and cardiac arrest.Multiple observational studies have evaluated risk factors associated with these complications.Among the risk factors identified,the choice of sedative agents administered,a modifiable risk factor,has been reported to affect these complications(hypotension).Propofol,etomidate,and ketamine or in combination with benzodiazepines and opioids are commonly used sedative agents administered for endotracheal intubation.Propofol demonstrates rapid onset and offset,however,has drawbacks of profound vasodilation and associated cardiac depression.Etomidate is commonly used in the critically ill population.However,it is known to cause reversible inhibition of 11β-hydroxylase which suppresses the adrenal production of cortisol for at least 24 h.This added organ impairment with the use of etomidate has been a potential contributing factor for the associated increased morbidity and mortality observed with its use.Ketamine is known to provide analgesia with sedation and has minimal respiratory and cardiovascular effects.However,its use can lead to tachycardia and hypertension which may be deleterious in a patient with heart disease or cause unpleasant hallucinations.Moreover,unlike propofol or etomidate,ketamine requires organ dependent elimination by the liver and kidney which may be problematic in the critically ill.Lately,a combination of ketamine and propofol,“Ketofol”,has been increasingly used as it provides a balancing effect on hemodynamics without any of the side effects known to be associated with the parent drugs.Furthermore,the doses of both drugs are reduced.In situations where a difficult airway is anticipated,awake intubation with the help of a fiberoptic scope or video laryngoscope is considered.Dexmedetomidine is a commonly used sedative agent for these procedures. 展开更多
关键词 Critically ill endotracheal intubation ETOMIDATE HYPOTENSION Intensive care unit KETAMINE Ketofol PROPOFOL SEDATION
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