Segmental Cervical Spine Movement with the Intubating Laryngeal Mask During Manual In-Line Stabilization in Patients with Cervical Pathology Undergoing Cervical Spine Surgery

Kihara, Shinichi; Watanabe, Seiji; Brimacombe, J.; Taguchi, Noriko; Yaguchi, Yuichi; Yamasaki, Yonosuke

doi:10.1213/00000539-200007000-00037

Cited by 67 publications

(31 citation statements)

References 13 publications

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“…Also the ILMA, designed especially for the management of the difficult airway, has been described as being successfully used for ventilation in the anticipated [26][27][28][29][30][31][32] and unanticipated [33,34] difficult airway in 97-100% of cases. Case reports or series (level 4) of successful ventilation in patients with difficult airways have been described for many other SADs: the LMA PLMA [35][36][37][38][39][40][41], the SLMA [42][43][44], the i-gel [45][46][47][48][49][50], the Ambu-i TM [51], the Air-Q [52][53][54][55], the CobraPLA [56] and the CobraPLUS [57].…”

Section: Ventilation Via Different Sads In a Difficult To Manage Airwaymentioning

confidence: 99%

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Timmermann

2011

Anaesthesia

168

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SummarySupraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Unlike other alternatives to standard tracheal intubation, e.g. videolaryngoscopy or intubation stylets, they enable ventilation even in patients with difficult facemask ventilation and simultaneous use as a conduit for tracheal intubation. Insertion is usually atraumatic, their use is familiar from elective anaesthesia, and compared with tracheal intubation is easier to learn for users with limited experienced in airway management. Use of SADs during difficult airway management is widely recommended in many guidelines for the operating room and in the pre‐hospital setting. Despite numerous studies comparing different SADs in manikins, there are few randomised controlled trials comparing different SADs in patients with difficult airways. Therefore, most safety data come from extended use rather than high quality evidence and claims of efficacy and particularly safety must be interpreted cautiously.

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Section: Ventilation Via Different Sads In a Difficult To Manage Airwaymentioning

confidence: 99%

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Timmermann

2011

Anaesthesia

168

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“…Connelly et al [11] reported that when direct laryngoscopy is unsuccessful, additional attempts using the same technique have close to an 80% failure rate, while the use of an alternative technique (i.e., SGA and video laryngoscopy) is more successful. There is much evidence to support the usefulness of an SGA [12][13][14] and video laryngoscopy [15][16][17][18] in difficult airway management. Most airway management guidelines [19][20][21] also emphasize that attempts at direct laryngoscopy should be limited and that alternative techniques should be attempted.…”

Section: Discussionmentioning

confidence: 99%

Massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum after multiple direct laryngoscopies: an autopsy case report

et al. 2015

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Multiple endotracheal intubation (ETI) attempts increase the risk of airway-related adverse events. However, little is known about autopsy findings after severe ETI-related complications.We present the detailed pathological findings of a case with severe ETI-related complications. A 77-year-old obese male suffered cardiopulmonary arrest after choking at a rehabilitation facility.Spontaneous circulation returned after chest compressions and foreign-body removal. After multiple failed direct laryngoscopies, the patient was transferred to our hospital. He had massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum on admission and died from hypoxic brain injury 15 hours later. Autopsy revealed severe oropharyngeal; laryngeal; and left lung lower lobe injury. The likely mechanisms of diffuse emphysema were: 1) oropharyngeal injury associated with multiple ETI attempts and excessive ventilation pressures and 2) left lung lower lobe injury associated with chest compressions and other resuscitative procedures. Multiple laryngoscopies can cause severe upper-airway injury, worsen respiratory status, and make ETI more difficulta vicious circle that can be prevented by limiting ETI attempts. This is particularly important in unfavorable environments, in which backup devices and personnel are not easily obtained. The pathological findings of our patient caution against repeated attempts at ETI during resuscitation.

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“…42 Other observational studies cite 71.4 -100% intubation success rates in patients with difficult airways with the intubating LMA. [56][57][58][59][60][61] …”

Section: Fiberoptic-guided Tracheal Intubation Through Supraglottic Amentioning

confidence: 99%

Supraglottic Airway DevicesDiscussion

Ramachandran

Kumar

2014

Respir Care

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SummarySupraglottic airway devices (SADs) are used to keep the upper airway open to provide unobstructed ventilation. Early (first-generation) SADs rapidly replaced endotracheal intubation and face masks in > 40% of general anesthesia cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes. Individual second-generation SADs have allowed more dependable positive-pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement, and have reduced risk of pulmonary aspiration of gastric contents. SADs now provide successful rescue ventilation in > 90% of patients in whom mask ventilation or tracheal intubation is found to be impossible. However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. Careful patient selection and excellent technical skills are necessary for successful use of these devices.

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Segmental Cervical Spine Movement with the Intubating Laryngeal Mask During Manual In-Line Stabilization in Patients with Cervical Pathology Undergoing Cervical Spine Surgery

Cited by 67 publications

References 13 publications

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum after multiple direct laryngoscopies: an autopsy case report

Supraglottic Airway DevicesDiscussion

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