Three-Dimensional Printed Laryngoscopes as Allies Against COVID-19

Mendes, Florentino Fernandes; Spinelli, Leandro de Freitas; Dutra, Pedro Antônio Sartini; Braga, Eduard Santos de; Braga, Luis Fernando Marcelino; Aires, Andréia Gomes; Amaral, Simone S.; Reguly, Afonso; Introíni, Gisele Orlandi

doi:10.1089/3dp.2020.0328

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…Other studies on PLA durability demonstrated that PLA could withstand a force of approximately 200 N [33]. Mendes et al reported that the 3D-PVL model they developed for pediatric and adult patients could withstand forces of > 400 N [10]. Gorman et al reported that the 3D-PVL they produced complied with ISO7376:20 standards both in terms of rigidity and strength [19].…”

Section: Discussionmentioning

confidence: 99%

“…An easily accessible option in the production of devices and tools is 3D printing technology, the costs of which are di cult to meet in many countries. Offering the designed devices open access as downloadable les would allow these devices to be produced globally when needed [10]. The need for 3D…”

Section: Discussionmentioning

confidence: 99%

“…However, studies on this subject remain limited. Studies available in the literature produced new VLs based on the existing VLs and DLs as examples, in addition to developing their own unique devices [4,9,10,19,[27][28][29][30]. PLA material, which is considered biocompatible, was generally used in manufacturing these devices.…”

Section: Discussionmentioning

confidence: 99%

“…One of these applications is 3D-printed VL (3D-PVL), which has become prominent in pandemic conditions. A 3D-PVL can be obtained for only 6 − 30 United States dollars (USD) compared to a VL that costs thousands of US dollars [4,9,10].…”

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confidence: 99%

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Comparison of AirAngel® vs Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: Prospective randomized crossover study

Merter,

Kayayurt,

Kitapçıoğlu

et al. 2023

Preprint

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Background: Video laryngoscopy (VL) outperforms direct laryngoscopy (DL) in both normal and difficult airway situations. However, VL seems far from being offered as a standard option in both healthcare delivery and educational activities in low-income countries, considering its high costs. Therefore, three dimensional (3D)-printed VLs may be considered an alternative to conventional VLs in low-income countries and other places with limited resources. Our objective was to compare the efficacy of AirAngel 3D-printed VL (3D-PVL) with those of commercially available Storz® VL (SVL) and conventional Macintosh® laryngoscope (MCL) in normal and difficult airway scenarios in the hands of inexperienced users. Methods: This is a prospective randomized crossover manikin study that included 126 senior medical students with no experience in intubation. The effectiveness of all three laryngoscopy devices in the hands of inexperienced users was evaluated in terms of intubation time, glottic visualization, ease of use, endotracheal tube placement and intubation success rate. Between 2020 and 2022, 126 last year medical students participated in the study. Results: MCL resulted in significantly longer intubation times than 3D-PVL and SVL in the difficult airway scenario, with no significant difference between 3DPVL and SVL (Wilcoxon test, p < 0.016; Bonferroni correction MCL: 28.54 s; SVL: 26.68 s; 3DPVL: 26.64 s). Both SVL and 3D-PVL resulted in significantly better Cormack−Lehane grades in both normal and difficult airway scenarios, and thus provided better glottic viewing than MCL, with no significant difference between 3D-PVL and SVL (Wilcoxon test, p < 0.016; Bonferroni correction, MCL: 1.73; SVL: 1.29; 3DPVL: 1.25). SVL was the easiest (1: very easy, 5: very difficult) device for normal airway scenarios, while MCL was the most difficult (MCL: 2.64; 3DPVL: 1.98; SVL: 1.49). Conversely, no significant difference was found between 3DPVL and other devices in terms of ease of use in difficult airway scenarios and in terms of accurate placement of the endotracheal tube and successful intubation attempts. Conclusion: 3D-PVL is a good educational and possible clinical alternative to conventional VL, particularly in places with limited resources, due to its low cost.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of AirAngel® vs Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: Prospective randomized crossover study

Merter,

Kayayurt,

Kitapçıoğlu

et al. 2023

Preprint

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“…The widespread adoption of the 2022 ASA Guidelines may be limited in this regard, as access to both paediatric videolaryngoscopy and providers with the knowledge to appropriately use this equipment may place financial strain on disadvantaged institutions. This financial strain has been reported in the literature and was especially relevant during the COVID‐19 pandemic, where the overwhelming numbers of patients requiring hospitalisation and videolaryngoscopy for tracheal intubation prompted research into alternatives, such as the three‐dimensional printing of laryngoscopes [11]. As a final aside, the multidisciplinary team debrief following the patient's procedures identified the utility of having a videolaryngoscope equipped for paediatric patients and the value of having all team members (multi‐speciality surgeons, perfusionist, oncologist and anaesthetist) present for time‐out and contingency planning.…”

Section: Discussionmentioning

confidence: 99%

Implementation of the American Society of Anesthesiologists 2022 paediatric guidelines in a child with mandibular metastasis

Larkins,

Iasiello,

Travia

et al. 2024

Anaesthesia Reports

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SummaryThe 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway differ significantly from prior guidelines, particularly regarding paediatric patients. These guidelines place new emphasis on establishing a multidisciplinary team led by an anaesthetist trained in paediatric anaesthesia. Here, we demonstrate the clinical application of the new guidelines by presenting the case of a 16‐month‐old girl with a rapidly growing mandibular mass. The new guidelines stipulated the need for multidisciplinary team assembly; planning with indirect laryngoscopy; the availability of surgical tracheostomy and extracorporeal membrane oxygenation; and multiple ‘time out’ stops to confirm team members and plans. The patient tolerated induction of general anaesthesia and mask‐ventilation and tracheal intubation was achieved uneventfully on the first attempt. Her trachea was extubated uneventfully 5 days later. We emphasise the importance of paediatric anaesthesia training and videolaryngoscopy and discuss components of the 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway with reference to a successful outcome in a paediatric difficult airway scenario.

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Comparison of AirAngel® vs. Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: prospective randomized crossover study

Merter,

Kayayurt,

Kitapçıoğlu

et al. 2024

BMC Med Educ

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Background For both normal and difficult airway management, VL is thought to be more effective. However, VL seems far from being offered as a standard option in both healthcare delivery and educational activities in low-income countries, considering its high costs. Therefore, three-dimensional(3D)printed VLs may be considered an alternative to conventional VLs in low-income countries and other places with limited resources. Our objective was to compare the efficacy of AirAngel 3D-printed VL (3D-PVL) with those of commercially available Storz® VL (SVL) and conventional Macintosh® laryngoscope (MCL) in normal and difficult airway scenarios in the hands of inexperienced users. Methods This is a prospective randomized crossover manikin study that included 126 senior medical students with no experience in intubation. The effectiveness of all three laryngoscopy devices in the hands of inexperienced users was evaluated in terms of intubation time, glottic visualization, ease of use, endotracheal tube placement, and intubation success rate. Between 2020 and 2022, 126 last year medical students participated in the study. Results MCL resulted in significantly longer intubation times than 3D-PVL and SVL in the difficult airway scenario, with no significant difference between 3DPVL and SVL (Wilcoxon test, p < 0.016; Bonferroni correction MCL: 28.54 s; SVL: 26.68 s; 3DPVL: 26.64 s). Both SVL and 3D-PVL resulted in significantly better Cormack − Lehane grades in both normal and difficult airway scenarios, and thus provided better glottic viewing than MCL, with no significant difference between 3D-PVL and SVL (Wilcoxon test, p < 0.016; Bonferroni correction, MCL: 1.73; SVL: 1.29; 3DPVL: 1.25). The SVL was the easiest device to use for normal airway scenarios (1: very easy, 5: very difficult), while the MCL was the most difficult (MCL: 2.64; 3DPVL: 1.98; SVL: 1.49). Conversely, no significant difference was found between 3DPVL and other devices in terms of ease of use in difficult airway scenarios and in terms of accurate placement of the endotracheal tube and successful intubation attempts. Conclusion 3D-PVL is a good educational and possible clinical alternative to conventional VL, particularly in places with limited resources, due to its low cost.

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Three-Dimensional Printed Laryngoscopes as Allies Against COVID-19

Cited by 4 publications

References 14 publications

Comparison of AirAngel® vs Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: Prospective randomized crossover study

Comparison of AirAngel® vs Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: Prospective randomized crossover study

Implementation of the American Society of Anesthesiologists 2022 paediatric guidelines in a child with mandibular metastasis

Comparison of AirAngel® vs. Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: prospective randomized crossover study

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