Use Of Video Laryngoscopy Research Articles

Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis.

Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis.

Did intubation procedures for critically ill patients without SARS-CoV-2 infection change during the pandemic? Secondary analysis of the INTUPROS multicenter study.

Did intubation procedures for critically ill patients without SARS-CoV-2 infection change during the pandemic? Secondary analysis of the INTUPROS multicenter study.

Video vsDirect Laryngoscopy for Tracheal Intubation After Cardiac Arrest: A Secondary Analysis of the Direct vsVideo Laryngoscope Trial.

Video vsDirect Laryngoscopy for Tracheal Intubation After Cardiac Arrest: A Secondary Analysis of the Direct vsVideo Laryngoscope Trial.

The C-MAC video laryngoscope helps presbyopic anesthetists to overcome difficulty in neonatal and infantile intubation: a randomized controlled trial

BackgroundEndotracheal intubation (ETI) is a life-saving procedure that must be accurately carried on to guard against complications. Presbyopia leads to difficulty in viewing close objects and may obstacle proper intubation even with the best hands.PurposeThis study supposed that the use of video-laryngoscope (VL) may provide better intubation conditions for presbyopic anesthetists and targets to evaluate the neonates and infants’ intubation success rates (ISR) by anesthetists aged ≥ 45 years using the C-MAC VL compared to the standard laryngoscope (SL).MethodsThirty-one neonates with an age of 18.2 ± 5.2 days and a body weight of 4.5 ± 0.3 kg and 103 infants aged 8.6 ± 1 months and weighing 9.4 ± 1.5 kg were randomly categorized into the SL group that received ETI using the SL and the VL group had intubated using the C-MAC® (Karl Storz, Germany) VL with the standard Miller blade and flexible Stylet (2 mm PORTEX® stylet; Smiths Medical International Ltd., UK) to strengthen the endotracheal tube (ETT) and adjust its curvature as C-shaped. The study outcomes included the frequency of successful intubation and the number of intubation attempts.ResultsThe ISR was significantly (P < 0.001) higher with significantly (P = 0.0037) lower frequency of using assistance maneuvers with VL. The mean score of the anesthetist’s difficulty rating was significantly (P < 0.001) higher with SL (2.7 ± 2) than with VL (1.27 ± 1.27). Times for the full intubation process were significantly (P < 0.001) shorter with VL than SL. The 1st attempt success rate was significantly (P = 0.0195) higher with VL than SL (86.6% vs. 67.2%). The frequency of maneuver-related complications was insignificantly (P = 0.116) reduced with the use of VL (4.5%) than with SL (12%). The ISR showed a negative significant correlation (r=−0.973, P = 0.005) with the anesthetist’s age.ConclusionNeonatal and infantile intubation using VL is feasible and easy to handle by aged anesthetists and allows higher ISR and 1st attempt rate with minimal need for external assistant maneuvers and maneuver-related complications. VL might be more appropriate for the presbyopic pediatric anesthetists than the SL.LimitationsThe limitations of the study are the small sample size of anesthetists and the use of one type of VLs.

Impacto del uso universal del videolaringoscopio McGrath como primera opción para todas las intubaciones en el quirófano: protocolo del estudio prospectivo, multicéntrico VIDEOLAR-SURGERY con metodología pre-post

Impacto del uso universal del videolaringoscopio McGrath como primera opción para todas las intubaciones en el quirófano: protocolo del estudio prospectivo, multicéntrico VIDEOLAR-SURGERY con metodología pre-post

Comparison of video laryngoscopy and direct laryngoscopy for urgent intubation in newborn infants: A meta-analysis.

Comparison of video laryngoscopy and direct laryngoscopy for urgent intubation in newborn infants: A meta-analysis.

Effects of GlideScope, Pentax Airway Scope, and Macintosh Blade on the incidence of postoperative sore throat: a cohort study of 9,881 patients

BackgroundPostoperative sore throat (POST) is a common complaint after general anesthesia. POST is defined by the presence of a self-reported foreign body sensation or a painful sensation in the throat after general anesthesia. This condition may affect recovery and patient satisfaction and is associated with many factors, including intubation tools. Previous studies have reported conflicting results on POST. This retrospective cohort study, with sample size of 9,881 patients, was conducted to confirm the hypothesis that the use of video laryngoscopy (VL) is associated with a lower incidence of POST compared with direct laryngoscopy (DL).MethodsData were extracted from a prospectively maintained quality improvement database. A total of 9,881 patients were included in the study. Statistical analysis was conducted for comparisons of demographic characteristics and to determine the effect of intubation tools on the incidence of POST.ResultsThe patients had similar baseline demographic characteristics. Compared with DL, VL was associated with a lower incidence of POST (12.98% vs. 17.49%, P < 0.001). In addition, the use of Pentax Airway Scope (AWS) was associated with a lower incidence of POST compared with the use of GlideScope (GVL, 8.14% vs. 16.25%, P < 0.001). To better adjust for possible confounding factors, mixed-effects generalized linear model analysis revealed that older age (odds ratio [OR]: 0.995, 95% confidence interval [CI]: 0.992–0.999, P = 0.006), AWS compared to DL (OR: 0.416, 95% CI: 0.350–0.494, P < 0.001), and male sex (OR: 0.836, 95% CI: 0.747–0.935, P = 0.002) are associated with reduced incidence of POST.ConclusionCompared with DL, VL is associated with a lower incidence of POST. In addition, the use of AWS is associated with a lower incidence of POST compared with the use of GVL.Trial registrationRetrospectively registered, NCT06515808, date of registration: 23/07/2024.

Impact of universal use of the McGrath videolaryngoscope as the first option for all intubations in the operating room: The multicentre prospective before-after VIDEOLAR-SURGERY study protocol

Impact of universal use of the McGrath videolaryngoscope as the first option for all intubations in the operating room: The multicentre prospective before-after VIDEOLAR-SURGERY study protocol

Changes in practice of less-invasive surfactant administration (LISA) in United Kingdom neonatal units.

To determine whether the use of less-invasive surfactant administration (LISA) had changed between 2018 and 2024. An online questionnaire was sent to all 191 neonatal units between June 2023 and May 2024. One consultant from each neonatal unit was randomly selected. Follow-up was done by telephone (middle-grade doctor grade and above or alternatively to Advanced Neonatal Nurse Practitioners) for the non-responders. Response rate was 100%from 191 units neonatal units. LISA was used in 134 (70%) neonatal units in 2024 compared to 35 (18.7%) units in 2018 (p < 0.001). The reason why LISA was not performed was lack of experience/training (51%) or not having a standardised practice/guideline (49%). LISA in the delivery suite (DS) had increased from 2% in 2018 to 16% in 2024, and the use of video laryngoscope for LISA is becoming standard of practice. The oxygen requirement criteria for the use of LISA in both the DS and on neonatal unit had reduced to FiO2 of 0.3 or more. The uptake of LISA had increased in the United Kingdom. There is greater use of LISA in the DS. Lack of training and expertise were the major limiting factors for LISA not being performed.

Video laryngoscopy may improve the intubation outcomes in critically ill patients: a systematic review and meta-analysis of randomised controlled trials

BackgroundThe role of video laryngoscopy in critically ill patients requiring emergency tracheal intubation remains controversial. This systematic review and meta-analysis aimed to evaluate whether video laryngoscopy could improve the clinical...

Problems during hospitalisation of morbidly obese patients in intensive care units. A narrative review.

Background: The frequency of hospitalisation of patients with morbid obesity (Body Mass Index - BMI ≥ 40 kg/m2) is constantly increasing. The hospitalisation in the Intensive Care Units (ICUs) of such a group of patients, in addition to the common problems in care and treatment encountered in the rest of the hospital wards, additionally brings distinct challenges to be faced by the staff.Aim of the study: This review aims to clarify the distinctive physiological characteristics of morbidly obese patients and the resulting challenges during ICU hospitalisation, while also presenting appropriate therapeutic approaches and interventions.Material and methods: Based on the available medical literature and the authors' clinical experience, we have selected articles using PubMed, NIH (National Institutes of Health), SpringerMedizin, and Semantic Scholar, along with guidelines from the Medycyna Praktyczna website, WHO data, and book sources. We reviewed 693 articles, 3 books, and the websites of WHO and Medycyna Praktyczna. The final selection comprised 34 articles (32 in English, 1 in German, 1 in Polish), published between 2004 and 2023, with 12 published after 2020.Results: Morbid obesity disrupts the physiological homeostasis of the body, noticeably affecting the respiratory, cardiovascular or gastrointestinal systems, and is associated with the occurrence of a number of diseases. This necessitates specific distinctions in the intubation procedure, mechanical ventilation strategy as well as drug dosing. In addition, it should be noticed that life-threatening conditions such as acute respiratory distress syndrome (ARDS) or sepsis occur among patients hospitalised in the ICU, requiring additional modifications to the therapy.Conclusions: Morbidly obese ICU patients due to their anatomical and physiological characteristics belong to individuals at risk of difficult intubation requiring specific positioning, preoxygenation and the use of videolaryngoscopes, as well as implementing an appropriate mechanical ventilation strategy. Additionally, altered drug metabolism and distribution in these patients necessitate distinct dosing protocols for effective treatment.

PERI-OPERATIVE ANAESTHETIC CONCERNS IN COVID-19 ASSOCIATED MUCORMYCOSIS

Introduction: Mucormycosis is a fulminant life-threatening fungal infection requiring emergency surgical debridement. It is associated with immune-compromised status, multi-systemic involvement, and difficult airway posing challenges to anesthetic management. We conducted this study to find the peri-operative anesthesia concerns in patients of COVID-19-associated mucormycosis Methods: This retrospective observational study included COVID-19-infected patients operated for invasive mucormycosis under general anesthesia. Cases operated under local anesthesia were excluded from the study. Results: A total of 30 patients were included in the study where the majority of the patients were ASA physical status III. ASA classification uses a grading system of l(one) through V( five), with I identifying a person in good health and V as a person with a severe, life-threatening condition. The most common co-morbidity was diabetes mellitus plus hypertension 66% (n=20), followed by only diabetes 30% (n=9). Out of all patients, 33.3% (n=10) were intubated at the first attempt using direct laryngoscope, rest 66.6% required other interventions like the use of video laryngoscope, bougie, or external laryngeal pressure. Perioperative blood transfusion was required in 40% (n=12) of the patients. Of patients who required intensive care unit (ICU) admission 40% (n=12) out of them, 10% patients (n=3) did not survive. The average hospital stay was 55.9 +/-15.8 days with a maximum of 95 days and a minimum of 15 days. Conclusion: Mucormycosis is mostly associated with uncontrolled diabetes milletus in post-COVID patients. These require utmost care peri-operatively as they are associated with a difficult airway, intraoperative complications, prolonged morbidity, and mortality.

Continuous improvement of non-emergent neonatal intubations in a level IV NICU.

We sought to improve practices and outcomes related to non-emergent neonatal intubations in a level IV academic Neonatal Intensive Care Unit. A multidisciplinary team created guidelines for non-emergent neonatal intubations. In period 1, premedication practices were standardized. In period 2, paralytic use and video laryngoscope use were recommended. Premedication and video laryngoscopy practices were assessed along with number of intubation attempts and frequency of bradycardia and desaturation. 636 intubations performed by neonatology fellows and neonatal advanced practice providers were reviewed over six academic years. Two academic years were included in each of the following study periods: baseline, period 1, and period 2. In our unit, compliance with recommended premedication practices and administration of paralytic medication has increased considerably, and video laryngoscopy is now utilized in most of our procedures. The frequency of intubation success on the first attempt has increased, and the frequency of both bradycardia and desaturation during intubation has decreased. In our analysis, paralytic use (AOR 2.41, 95 CI (1.53, 3.81)) and the combination of paralytic and video laryngoscopy (AOR 4.07, 95 CI (2.09, 7.92)) are associated with increased odds of intubating successfully on the first attempt. This initiative increased the use of standardized premedication, paralytic medication and video laryngoscopy for non-emergent neonatal intubations with temporally associated improvement in patient outcomes including fewer intubation attempts and reduction in physiologic instability.

Optimizing intubation technique using a single-use video laryngoscope: A comparative study in a simulation model.

Tracheal intubation poses a high risk of infection to medical staff due to Coronavirus disease 2019 (COVID-19) highly infectious nature. To mitigate this risk, various medical devices, including video laryngoscopy, have been developed to assist intubation. This study compared conventional laryngoscopy (Macintosh) and disposable video laryngoscopes (Medcaptain VS-10s and Honestmc Laryngoscope_LA10000) in terms of their use and operation processes. We designed a questionnaire to assess the operator perception of performing intubation with the devices, and statistical analysis was performed on 50 clinical staff members from 2 hospitals who had performed intubation or had learned intubation techniques. The primary outcomes were time to glottic visualization, intubation time, intubation success rate, distance between the operator and training model, and time from glottic visualization to tube insertion. The secondary outcomes were as follows: overall laryngoscope quality, operative feel, maneuverability, ease of use, and video quality. This study showed that video laryngoscopes were superior to conventional laryngoscopes in terms of quality, operative feel, and ease of use. When LA10000 was employed, the intubation success rate was higher, and the operator risk of infection was lower because of the greater distance from the training model. However, the use of video laryngoscopes requires appropriate education and training use of the devices. This study also demonstrated that when participants viewed a simple operation video prior to using video laryngoscopes, tube insertion time was shorter. Overall, video laryngoscopy can provide a safer and more convenient option for clinical medical personnel during pandemics.

Anaesthetic Challenge in a Child with Hurler&amp;rsquo;s Syndrome: Encouraging Experience with Neuraxial Blockade

Mucopolysaccharidoses are uncommon genetic diseases with multisystem involvement. The potential for airway difficulties and varying success rate of neuraxial blockade demands considerable expertise in the anesthetic management in these patients. Airway management has evolved significantly in such syndromic patients with the increasing use of video laryngoscopes and Supraglottic airway devices. However, airway catastrophes are not uncommon. This calls for better utilization of neuraxial and peripheral nerve blocks along with the use of newer agents for sedation having a favorable pharmacological profile. Here, we present a case of child having Hurler disease with an inguinal hernia successfully operated under subarachnoid blockade.

Use of Video Laryngoscope during Intubation in Patients with Non Difficult Airway

Endotracheal intubation using laryngoscope which is an important skill required for all anesthesiologist in day to day practice is considered as gold standard for airway management. Various methods can be used for endotracheal intubation of which direct laryngoscopy is most commonly used and video laryngoscopy is an alternative. The success rate of tracheal intubation in cases of difficult airways has increased dramatically with the use of video laryngoscopes and improvements in the degree of glottic exposure. Hence this study aims to evaluate the laryngoscopic view, ease of intubation and haemodynamic changes during intubation using video laryngoscope in patients with non difficult airway. This interventional study was conducted in fifty nine patients of ASA I or II, ≥18 yrs of age with Mallampati grade I or II, mouth opening &gt;3 cms, thyromental distance &gt;6.5 cms of either sex planned for elective surgery under general anesthesia. General anesthesia was induced with similar doses for all the patients and intubated using video laryngoscope. Cormack-Lehane grade, intubation time, number of attempts for intubation and haemodynamic parameters were recorded. In this study, all patients had grade I type of laryngeal view during laryngoscopy and the mean time required for intubation was 18.93±7.08 sec. Out of 59 patients, 58 (98.3%) were intubated in single attempt and there was no significant haemodynamic changes during laryngoscopy with video laryngoscope. Hence, the result of this study concluded that endotracheal intubation using video laryngoscope provides good laryngoscopic view, better intubating condition for the ease of intubation without significant haemodynamic changes, thus considering worth for intubation of non difficult airway.

Pediatric airway management: A narrative review of the current practices and challenges

Pediatric patients are more susceptible to critical events, the management of their airway necessitates skilled and meticulous interventions. Thus, it is essential to be well versed with the knowledge that can aid in our understanding of the pediatric airway. We conducted a narrative review of the current understanding of pediatric airway assessment techniques, various airway adjuncts and devices, the use of video laryngoscopes for endotracheal intubation and future trends. The databases Ovid, Medline, PubMed, Web of Science, and Google Scholar were searched regarding various aspects of pediatric airway management from 2005 to 2024. The search terms were pediatric or infant difficult airway, pediatric difficult airway, apneic oxygenation, and pediatric airway assessment. One hundred articles were deemed relevant by abstract, and their full text was obtained and examined further for compliance, and finally, 40 full-text articles were included in the study. This article discusses the various challenges of pediatric anesthesia related to airway management, emphasizing the need for individualized perioperative methods due to children’s unique anatomical and physiological features.

Universal C-MAC® videolaryngoscope use in adult patients: a single-centre experience.

Universal use of Storz C-MAC® videolaryngoscopes was implemented for adult tracheal intubations in the operating theatres, intensive care unit and emergency department at Royal United Hospitals Bath NHS Foundation Trust in 2017. We report data from 1099 intubations from March 2020 to March 2022, collected contemporaneously and anonymously using a smartphone app, representing an estimated 18% of intubations in operating theatres and 30% of intubations in other locations during this period. Intubation success was 100%. The first-pass success rate was 87.3% overall: 87% with a Macintosh videolaryngoscope, 92% with a hyperangulated videolaryngoscope and 81% for users with ≤ 20 previous uses. First-pass success without complications was 87% overall: 87% in operating theatres (836/962), 93% in the emergency department (38/41) and 83% in the intensive care unit (73/88). Complications occurred during 0.6% of intubations: 0/962 in operating theatres and 7/137 in non-theatre locations. The rate of complications was unaltered by blade type (Macintosh 5/994 vs. hyperangulated 2/105, p = 0.14); intubator experience with the device (≤ 20 previous clinical uses 2/260 vs. > 20 previous uses 5/832, p = 0.67) and use of airborne personal protective equipment (PPE 6/683 vs. no-PPE 1/410, p = 0.27). Complication rates increased outside theatres (theatres 0/963 vs. non-theatre 7/136, p < 0.001) and during rapid sequence induction (RSI 6/379 (1.6%) vs. non-RSI 1/720 (0.1%), p = 0.008).

Macintosh-style videolaryngoscope use for tracheal intubation in elective surgical patients revisited: a sub-analysis of the 2022 Cochrane review data

The Cochrane systematic review and meta-analysis published in 2022 that compared videolaryngoscopy (VL) with direct laryngoscopy (DL) for facilitating tracheal intubation in adults found that all three types of VL device (Macintosh-style, hyper-angulated and channeled) reduced the risk of failed intubation and increased the likelihood of first-pass success. We report the findings of a subgroup re-analysis of the 2022 Cochrane meta-analysis data focusing on the Macintosh-style VL group. This was undertaken to establish whether sufficient evidence exists to guide airway managers in making purchasing decisions for their local institutions based upon individual device-specific performance. This re-analysis confirmed the superiority of Macintosh-style VL over Macintosh DL in elective surgical patients, with similar efficacy demonstrated between the Macintosh-style VL devices examined. Thus, when selecting which VL device(s) to purchase for their hospital, airway managers decisions are likely to remain focused upon issues such as financial costs, portability, cleaning schedules and previous device experience.

Glottis Recognition Software Development Using Artificial Intelligence.

The use of video laryngoscopes has enhanced the visualization of the vocal cords, thereby improving the accessibility of tracheal intubation. Employing artificial intelligence (AI) to recognize images obtained through video laryngoscopy, particularly when marking the epiglottis and vocal cords, may elucidate anatomical structures and enhance anatomical comprehension of anatomy. This study investigates the ability of an AI model to accurately identify the glottis in video laryngoscope images captured from a manikin. Tracheal intubation was conducted on a manikin using a bronchoscope with recording capabilities, and image data of the glottis was gathered for creating an AI model. Data preprocessing and annotation of the vocal cords, epiglottis, and glottis were performed, and human annotation of the vocal cords, epiglottis, and glottis was carried out. Based on the AI's determinations, anatomical structures were color-coded for identification. The recognition accuracy of the epiglottis and vocal cords recognized by the AI model was 0.9516, which was over 95%. The AI successfully marked the glottis, epiglottis, and vocal cords during the tracheal intubation process. These markings significantly aided in the visual identification ofthe respective structures with an accuracy of more than 95%. The AI demonstrated the ability to recognize the epiglottis, vocal cords, and glottis using an image recognition model of a manikin.