European journal of anaesthesiology
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Comparative Study Observational Study
Comparison between bougies and stylets for simulated tracheal intubation with the C-MAC D-blade videolaryngoscope.
The C-MAC D-blade is a new, highly angulated, videolaryngoscope blade designed for use in patients with difficult airways. Directing a tracheal tube into the trachea with any indirect viewing laryngoscope can be difficult, even with a good view of the laryngeal inlet. ⋯ The differences in time to intubate in both the easy and difficult laryngoscopy settings were minor for the different introducer strategies studied. The stylet introducers tended to take less time, but this did not result in important statistical differences. When using the C-MAC D-blade videolaryngoscope for simulated tracheal intubation, stylets and bougies performed in a similar fashion.
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Reflective intubation is a recently described technique to facilitate tracheal intubation. ⋯ Reflective intubation proved to be successful in moderately difficult intubation conditions (Cormack and Lehane classes 2 and 3a). Reflective intubation represents a very useful first-line methodological extension of direct laryngoscopic tracheal intubation.
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Observational Study
Improvement in glottic visualisation by using the C-MAC PM video laryngoscope as a first-line device for out-of-hospital emergency tracheal intubation: An observational study.
Out-of-hospital tracheal intubation is associated with life-threatening complications. To date, no study has compared direct and video laryngoscopic views simultaneously in the same patients in an out-of-hospital setting. ⋯ Use of the C-MAC PM video laryngoscope is associated with improved visualisation of the glottis according to the Cormack and Lehane grading system and an excellent success rate for out-of-hospital tracheal intubation. These results suggest that the use of C-MAC PM as a first-line device for tracheal intubation by out-of-hospital emergency medical services is a safe procedure.
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Little is known about real-time in-vivo microscopy of pulmonary capillary perfusion because current microscopy requires direct access to lung tissue with surgical intervention such as the thoracic-window technique and open-lung model. ⋯ pCLE allows endoscopic real-time in-vivo imaging of pulmonary capillary morphology and perfusion. Alterations in pulmonary capillary blood flow induced by different ventilator regimens can be detected. This minimally invasive approach via the endotracheal route is feasible in an experimental setting and may help to understand changes in regional pulmonary capillary perfusion.