Articles: intubation.
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Transporting spontaneously ventilating adults with tracheostomies from the operating room (OR) or other anesthetizing locations to the intensive care unit (ICU) or other recovery locations presents significant challenges, as traditional T-pieces may not be readily available. This article describes a novel modification to the Ayre's T-piece, designed to address this gap by using readily available equipment. The modification integrates a 3-mL syringe, a size 7.0 endotracheal tube (ETT) connector, and oxygen tubing from an adult under-the-chin style facemask while adapting the expiratory and inspiratory limbs of the anesthesia circuit.
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Critical care medicine · Nov 2024
Meta AnalysisDirect Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials.
Given the uncertainty regarding the optimal approach to laryngoscopy for the intubation of critically ill adult patients, we conducted a systematic review and meta-analysis to compare video laryngoscopy (VL) vs. direct laryngoscopy (DL) for intubation in emergency department and ICU patients. ⋯ In critically ill adult patients undergoing intubation, the use of VL, compared with DL, probably leads to higher rates of FPS and probably decreases esophageal intubations. VL may result in fewer dental injuries as well as aspiration events compared with DL with no effect on mortality.
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Randomized Controlled Trial
A new video laryngoscope combined with flexible laryngeal mask insertion: A prospective randomized study.
The video laryngoscope (VLS) has been proven to be an effective insertion device for airway management. However, no laryngoscope has been specifically designed for the placement of the laryngeal mask airway (LMA). We improved the current VLS and developed a novel VLS method. This study aimed to evaluate the clinical efficacy of an improved VLS for inserting a flexible laryngeal mask airway (F-LMA) compared with the standard blind method. ⋯ The new VLS-guided insertion technology has a high success rate, achieves greater OLP, and provides an ideal anatomical position with minimal adjustment, without increasing the risk of hemodynamic stress or adverse events.