Introduction: In the management of the anticipated difficult airway (DA), awake intubation is the strategy of choice. In this context, flexible fibroscopy is the tool most widely used as the first choice. However, there is always the rare case where it may fail. Important findings: Six successful rescue cases using videolaryngoscopy following failed fibroscopy in patients with anticipated DA, and 1 case of rescued extubation of an airway previously secured with fiberoptic bronchoscopy. Conclusion: Videolaringoscopy may be an adequate tool to use as a backup plan for the management of an anticipated DA.

Semicrystalline polymeric systems are a type of Shape Memory Polymer (SMP), which are more straightforward to synthesize in comparison with other class of stimulus-responsive polymers. On these systems, the shape memory is triggered by temperature and partially driven by crystallization-induced elongation, heating-induced contraction, and elastic entropy. However, a stable temporary and permanent shape through cycling is not easy to achieve. For that reason, a laminar composite made based in the encapsulation of ethylene vinyl acetate (EVA) inside a PU matrix was developed, with the aim of obtaining an actuator with a preferred deformation direction and stable change of shape. In this study, chemically cross-linked ethylene vinyl acetate copolymer (cEVA) as SMP was synthesized and functionalized as a reinforcing strip. A temperature-memory actuator composite was manufactured by the encapsulation of a shape memory programmed strip in an elastomer matrix. The shape memory properties and thermocycling assessment were evaluated using differential scanning calorimetry and dynamic mechanical analysis. Results show the ability of the actuator to bend and unbend, following multiple consecutive heating-cooling cycles. The relationship between the strip, the matrix, and the interface is critical in the bending and shape memory maintenance.

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Complications in airway management remain a common cause of anesthesia-associated mortality. When a patient is considered with anticipated difficult airway, the management depends on several variables, however, at present, the standard of management continues to be the patient awake approach. In scenarios of acute upper airway obstruction, the only way to guarantee adequate ventilation is to obtain a translaryngeal or transtracheal access, for which, it is necessary to use local anesthesia and grade I / II sedation, avoiding loss of spontaneous ventilation. For this purpose, we propose ultrasound-guided superior laryngeal nerve block, in order to standardize an ultrasound landmark that is reproduceable, with a high success rate, which allows limiting complications related to regional anatomic techniques and thus facilitating the securing of the airway in these patients.