Articles: intubation.
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Comparative Study
Comparison of NoSAS score with STOP-Bang and Berlin scores in predicting difficult airway.
This study aimed to compare the effectiveness of the NoSAS, STOP-Bang, and Berlin scoring systems, which are utilized to predict obstructive sleep apnea syndrome (OSAS), in forecasting difficult airway management. Additionally, the study sought to determine which of these scoring systems is the most practical and effective for this purpose. ⋯ The routine implementation of the NoSAS score, an easy-to-use, rapid and objective tool primarily developed for OSAS screening, is likely to be effective in preoperatively identifying difficult airways in patients undergoing general anesthesia.
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Prehospital endotracheal intubation (ETI) is a lifesaving procedure with known complications. To reduce ETI-associated morbidity and mortality, organizations prioritize first-pass success (FPS). However, there are few data evaluating the association of FPS with clinician licensure. ⋯ Critical care paramedics and nurses perform ETI with similar proficiency. In this analysis of 7,812 intubations, clinician licensure was not associated with FPS nor LPS after controlling for multiple common confounders. Further research evaluating training schemes especially in early years of experience is needed.
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Given the prevalence of cardiovascular disease, encountering difficult airways in this patient population is quite common. The challenge for anesthesiologists lies not only in establishing the airway but also in managing the hemodynamic instability caused by sympathetic activation during intubation. The purpose of this report is to describe the anesthetic experience of this patient with severe mitral and tricuspid regurgitation, atrial fibrillation with rapid ventricular response, and moderate pulmonary hypertension with an anticipated difficult airway. ⋯ This case highlights the importance of considering both airway safety and maintaining hemodynamic stability when cardiac surgery patients encounter an anticipated difficult airway. Awake intubation is not the only option, and intubation after general anesthesia may be considered when the benefits are evaluated to outweigh the risks.