Accidental extubation in prone position

Bosch, Lluís; Pacreu, S.; Castelltort, Laura; Gallart, Lluís

doi:10.1097/eja.0000000000001341

Cited by 3 publications

(7 citation statements)

References 7 publications

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“…We would like to reply to the letter 'Accidental extubation in prone position: Report of two cases and proposal of an algorithm for airway management', by Bosch et al, published in a recent issue of the Eur J Anaesthesiol. 1 We fully support the authors' initiative to propose a working flowchart for the use of supraglottic airways (SGA) in the potentially life-threatening scenario described.…”

Section: Editormentioning

confidence: 77%

“…We were interested to read the report by Choi et al 1 and we would like to highlight our methodological and epistemological (Editor's note: epistemology is a branch of philosophy that is defined as the study of the method or grounds of knowledge) concerns to contextualise their results. We appreciate that Choi et al 1 had a well intentioned desire to better understand gender-related inequities in anaesthesiology within their cultural context but the framing of the message may have opposite and damaging effects on our specialty. Authors, researchers, reviewers and editors must recognise and guard against these detrimental effects.…”

Section: Editormentioning

confidence: 99%

“…We would like to reply to the letter ‘Accidental extubation in prone position: Report of two cases and proposal of an algorithm for airway management’, by Bosch et al , published in a recent issue of the Eur J Anaesthesiol 1 …”

mentioning

confidence: 99%

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The use of supraglottic airways in the prone position is useful in specific situations

Zilberman

Hinkelbein

2022

European Journal of Anaesthesiology

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Section: Editormentioning

confidence: 77%

Section: Editormentioning

confidence: 99%

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The use of supraglottic airways in the prone position is useful in specific situations

Zilberman

Hinkelbein

2022

European Journal of Anaesthesiology

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“…Proposals for an algorithm of airway management in accidental extubation in patients positioned in prone positions were proposed recently, underpinning the role of a supraglottic airway device (SAD) as a first-line approach. [ 1 , 2 ] (Bosch / Gaszynski). Bosch et al [ 1 ] proposed using the SAD as an intubation conduit but did not specify how it could be performed.…”

mentioning

confidence: 99%

“…[ 1 , 2 ] (Bosch / Gaszynski). Bosch et al [ 1 ] proposed using the SAD as an intubation conduit but did not specify how it could be performed. Gaszynski’s algorithm added the use of a videolaryngoscope (VL) and of the option of fiberoptic intubation through SADs in the prone position.…”

mentioning

confidence: 99%

New vision-incorporated third-generation video laryngeal mask airways for intubation of patients in prone position

Gaszyński

2023

J Clin Monit Comput

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Exchange of a Tracheal Tube and Supraglottic Airway Device: Evaluation of Different Techniques in Three Simulated Airway Scenarios (TUBE Study)—A Prospective, Randomised Controlled Study

Kriege,

Demare,

Ruemmler

et al. 2023

JCM

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Background: The swapping of a supraglottic airway device or a tracheal tube in anaesthetised adult patients is a challenging procedure because potential complications through hypoxemia and loss of airway may occur, with life-threatening implications. This study aims to evaluate which airway technique offers the highest success rate concerning a secure airway in established supraglottic airway and tracheal tube airway exchange scenarios. Methods: After ethical approval, anaesthesiologists were randomised 1:1 into simulated scenarios: an LTS group (malpositioned laryngeal tube) and a Cuff group (relevant cuff leakage of a placed tracheal tube). After that, both groups completed a common scenario consisting of a partially obstructed tracheal tube lumen in a fixed prone position with a Mayfield clamp. The primary endpoint was a successful tracheal airway exchange within ten minutes after the start of the scenario and before severe hypoxemia (SpO2 < 80%) arose. Secondary endpoints were the evaluation of factors influencing success after 10 min. Results: In total, 60 anaesthesiologists (LTS group n = 30; Cuff group n = 30) with a median experience of 7 years (IQR 4-11) were observed. Within 10 min, a malpositioned laryngeal tube was successfully exchanged by 27/30 (90%) participants, compared to the exchange of a tracheal tube with a relevant cuff leakage by 29/30 (97%; p > 0.05). An airway exchange in an obstructed tube scenario occurred in 22/59 (37%). Loss of airway maintenance showed an obvious association with failure in the common scenario (p = 0.02). Conclusion: The results of this simulation-based study reflect that the exchange of an existing but insufficient airway device in clinical practice is a high-risk procedure. Especially in a fixed prone position, the deliberate evaluation of the existing airway patency and well-conceived airway management in the case of the accidental loss of the airway or obstructed airway access are crucial.

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Accidental extubation in prone position

Cited by 3 publications

References 7 publications

The use of supraglottic airways in the prone position is useful in specific situations

The use of supraglottic airways in the prone position is useful in specific situations

New vision-incorporated third-generation video laryngeal mask airways for intubation of patients in prone position

Exchange of a Tracheal Tube and Supraglottic Airway Device: Evaluation of Different Techniques in Three Simulated Airway Scenarios (TUBE Study)—A Prospective, Randomised Controlled Study

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