Failed neonatal intubation rescued with a tongue stitch and Glidescope-assisted fiberoptic technique

Meselhy, Ehab; Akopyan, Remi; Onyewuche, Vivian

doi:10.1016/j.jclinane.2017.10.005

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…We found this case to be unique and educational for a number of reasons including the simultaneous use of VL and FOB to assess the extent of the traumatic airway injury and the concurrent use of two 8.0 ETTs to ensure safe transition of the airway. e simultaneous use of VL and FOB has been described in the literature in contexts ranging from the use as a teaching method, where an instructor uses a VL to monitor a trainee's use of an FOB [1], and to rescue in difficult airways [2][3][4][5][6][7]. With difficult airways, the FOB is often used as a "smart stylet" [8] to introduce an ETT directly into the 2 Case Reports in Anesthesiology trachea while the VL is used to visualize the glottic opening.…”

Section: Discussionmentioning

confidence: 99%

Two Endotracheal Tubes in One Trachea with a Traumatic Injury

Winegarner

Lecamwasam

Kendall

et al. 2021

Case Reports in Anesthesiology

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Background. Traumatic airway injuries often require improvising solutions to altered anatomy under strict time constraints. We describe here the use of two endotracheal tubes simultaneously in the trachea to facilitate securing an airway which has been severely compromised by a self-inflicted wound to the trachea. Case Presentation: A 71-year-old male presented with a self-inflicted incision to his neck, cutting deep into the trachea itself. An endotracheal tube was emergently placed through the self-inflicted hole in the trachea in the ED. The patient was bleeding profusely, severely somnolent, and desaturating upon arrival to the operating room. Preservation of the tenuous airway was a priority while seeking to establish a more secure one. A video laryngoscope was used to gain a wide view of the posterior oropharynx and assist with oral intubation using a fiberoptic scope loaded with a second endotracheal tube. The initial tube’s cuff was deflated as the second tube was advanced over the fiberoptic scope, thereby securing the airway while a completion tracheostomy was performed. Conclusions. Direct penetrating airway trauma may necessitate early, albeit less secure, intubations though the neck wounds prior to operating room arrival. The conundrum is weighing the risk of losing a temporary airway while attempting to establish a more secure airway. Here, we demonstrate the versatility of common anesthesia tools such as a video laryngoscope and a fiberoptic bronchoscope and the welcome discovery of the trachea’s ability to accommodate two endotracheal tubes simultaneously so as to ensure a patent airway at all points throughout resuscitation.

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Section: Discussionmentioning

confidence: 99%

Two Endotracheal Tubes in One Trachea with a Traumatic Injury

Winegarner

Lecamwasam

Kendall

et al. 2021

Case Reports in Anesthesiology

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A visual laryngoscope combined with a fiberoptic bronchoscope improves intubation outcomes in patients with predicted difficult airways in thoracic surgery

Hu,

Cheng,

Zhang

et al. 2024

BMC Pulm Med

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Objective To study the clinical effectiveness of visual laryngoscopy combined with fiberoptic bronchoscopy-guided double-lumen endotracheal tube intubation in thoracic surgery patients with predicted difficult airways in thoracic surgery airways. Methods We randomly divided 162 patients with predicted difficult airways who required double-lumen tracheal intubation for thoracic surgery and randomly divided them into the video laryngoscopy group (Group VL, n = 54),fiberoptic bronchoscopy group (Group F, n = 54), and video laryngoscopy combined with fiberoptic bronchoscopy group (Group FVL, n = 54) according to the randomized number table method. Then, the success rate of the first intubation, the duration of intubation, the duration of positioning, the degree of exposure of the vocal cords (Cormack-Lehane grade), and the adverse reactions during intubation were recorded and analyzed. Results The success rate of first-time intubation was significantly higher in the FVL group than in the F and VL groups (92.6% vs. 87.0% vs. 53.7%, P < 0.001), and the time of intubation in the FVL group was significantly shorter than that in the VL and F groups [(26.22 ± 9.34) s vs. (42.35 ± 11.21) s vs. (46.78 ± 21.96) s, P < 0.001)]. The positioning time in the FVL group was significantly shorter than that in the F and VL groups [(83.76 ± 15.18) s vs. (102.72 ± 21.89) s vs. (145.41 ± 20.12) s, F = 144.896, P < 0.001)].The number of patients with Cormack-Lehane grades I-II was significantly lower in the FVL group and the VL group than in the F group (88.9% vs. 77.8% vs. 59.3%, P < 0.05).The incidence of postoperative sore throat was significantly lower in the FVL group and the F group than in the VL group (22.4% vs. 27.6% vs. 50%, P < 0.001). Conclusion In difficult airway patients with high airway risk indices who require double-lumen endotracheal intubation, visual laryngoscopy combined with fiberoptic bronchoscopy improved the success rate of first-time intubation and shortened the intubation and positioning time. Trial registration Chinese Clinical Trial Register (identifier: ChiCTR2300076304; Date of registration: September 29, 2023).

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Failed neonatal intubation rescued with a tongue stitch and Glidescope-assisted fiberoptic technique

Cited by 2 publications

References 4 publications

Two Endotracheal Tubes in One Trachea with a Traumatic Injury

Two Endotracheal Tubes in One Trachea with a Traumatic Injury

A visual laryngoscope combined with a fiberoptic bronchoscope improves intubation outcomes in patients with predicted difficult airways in thoracic surgery

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