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J Anaesthesiol Clin Pharmacol 2022 Jan-Mar;38(1):48-57. Epub 2021 Dec 30.

Institute of Anaesthesiology, Pain and Perioperative Medincine, Sir Ganga Ram Hospital, New Delhi, India.

Tracheal resection anastomosis is one of the most challenging surgeries. Notable advances in this field have made possible a variety of surgical, anesthetic, and airway management options. There are reports of newer approaches ranging from use of supraglottic airway devices, regional anesthesia, and extracorporeal support. Read More

BMC Emerg Med 2022 Jun 15;22(1):110. Epub 2022 Jun 15.

Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, P.O. Box, 100, FI-00029 HUS, Helsinki, Finland.

Background: Numerous guidelines highlight the need for early airway management in facial trauma patients since specific fracture patterns may induce airway obstruction. However, the incidence of these hallmark injuries, including flail mandibles and posterior displacement of the maxilla, is contentious. We aim to evaluate specific trauma-related variables in facial fracture patients, which affect the need for on-scene versus in-hospital airway management. Read More

Transl Lung Cancer Res 2022 May;11(5):880-889

Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Background: Upper tracheal surgery is used to treat patients who with tracheal tumors or tracheal stenosis. The non-intubated spontaneous ventilation anesthesia (NSVA) may have advantages over endotracheal intubation and surgical cross-field intubation in upper tracheal surgery. This study aimed to illustrate and assess the feasibility of NSVA strategy for upper tracheal surgery. Read More

BMC Anesthesiol 2022 May 30;22(1):166. Epub 2022 May 30.

Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Shingil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea.

Background: The head-elevated laryngoscopy position has been described to be optimal for intubation, particularly in obese patients and those with anticipated difficult airways. Horizontal alignment of the external auditory meatus and sternal notch (AM-S) can be used as endpoints for optimal positioning. Thus, we aligned the head-elevated position with the AM-S in the horizontal plane and evaluated its effect on laryngeal visualization and ease of intubation using a McGrath MAC videolaryngoscope in patients with a simulated difficult airway. Read More

Yonsei Med J 2022 Jun;63(6):545-553

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: Long-term tracheal stent placement can increase the risk of stent-related complications; hence, removal of the stent after stabilization is attempted. However, little evidence has been established regarding the risk factors for tracheal restenosis. We aimed to identify the risk factors for tracheal restenosis in patients with post-intubation tracheal stenosis (PITS) and post-tracheostomy tracheal stenosis (PTTS). Read More

Acta Otorhinolaryngol Ital 2022 Apr;42(2):99-105

Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, School of Medicine, Genoa, Italy.

Objective: The COVID-19 pandemic was an extraordinary challenge for the global healthcare system not only for the number of patients affected by pulmonary disease, but also for the incidence of long-term sequalae. In this regard, laryngo-tracheal stenosis (LTS) represents one of the most common complications of invasive ventilation.

Methods: A case series of patients who underwent tracheal resection and anastomosis (TRA) for post-COVID-19 LTS was collected from June 2020 to September 2021. Read More

Niger J Clin Pract 2022 May;25(5):683-689

Department of Oral and Maxillofacial Surgery, Gazi University Faculty of Dentistry, Ankara, Turkey.

Background And Aim: Nasotracheal intubation is the main route to secure the airway in oral and maxillofacial surgery patients. This study was aimed to compare the intubation times and glottis visualization of McGrath video laryngoscope with the Macintosh laryngoscope for routine nasotracheal intubation.

Materials And Methods: Records of seventy-one ASA (American Society of Anesthesiologists) I-II patients were evaluated and allocated into two groups (McGrath video laryngoscope (VL) and Macintosh groups). Read More

Sensors (Basel) 2022 Apr 28;22(9). Epub 2022 Apr 28.

U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA.

Tracheal intubation is the preferred method of airway management, a common emergency trauma medicine problem. Currently, methods for confirming tracheal tube placement are lacking, and we propose a novel technology, spectral reflectance, which may be incorporated into the tracheal tube for verification of placement. Previous work demonstrated a unique spectral profile in the trachea, which allowed differentiation from esophageal tissue in ex vivo swine, in vivo swine, and human cadavers. Read More

BMC Anesthesiol 2022 May 14;22(1):145. Epub 2022 May 14.

Department of Anesthesiology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla, Songkhla, 90110, Thailand.

Background: In morbidly obese patients, airway management is challenging since the incidence of difficult intubation is three times than those with a BMI within the healthy range. Standard preoperative airway evaluation may help to predict difficult laryngoscopy. Recent studies have used ultrasonography-measured distance from skin to epiglottis and pretracheal soft tissue at the level of vocal cords, and cut-off points of 27. Read More

Medicine (Baltimore) 2022 May 6;101(18):e29074. Epub 2022 May 6.

Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, Shandong, China.

Background: There are still controversies about the optimal anesthesia protocol for patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). The aim of this study was to explore the effect of supraglottic airway device (SAD) versus endotracheal intubation (EI) general anesthesia on clinical and angiographic outcomes in patients with AIS undergoing MT.

Methods: One hundred sixteen patients with large-vessel occlusion stroke were randomized to receive either SAD or EI general anesthesia. Read More

Am J Emerg Med 2022 Jul 27;57:47-53. Epub 2022 Apr 27.

Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States of America.

Introduction: Laryngoscope blade shape may differentially facilitate first-attempt success in patients intubated in non-supine positions in the emergency department (ED). Therefore, we analyzed first-attempt success in ramped and upright positions stratified by hyperangulated or standard geometry video laryngoscopes (VL).

Methods: We performed a secondary analysis of the National Emergency Airway Registry (NEAR) on ED intubations from January 1, 2016 to December 31, 2018. Read More

Anaesth Crit Care Pain Med 2022 Jun 25;41(3):101083. Epub 2022 Apr 25.

Department of Anaesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, China; Outcomes Research Consortium, Cleveland, OH, USA. Electronic address:

Background: General anaesthesia for thoracoscopic lung surgery can be performed with the opioid-sparing strategies without intubation and may reduce the risk of glottic injury and enhance recovery after surgery. We therefore tested the primary hypothesis that avoiding intubation reduces glottic injury.

Methods: Adults having elective thoracoscopic lung resections were randomised to: (1) intubated group: routine general anaesthesia with a double-lumen tube intubation; or, (2) non-intubated group: a bundle of opioid-sparing strategies, which included paravertebral blocks and total intravenous anaesthesia with minimal remifentanil infusion from 0. Read More

Medicine (Baltimore) 2022 Mar 11;101(10):e29041. Epub 2022 Mar 11.

Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Rationale: Goiter, an abnormal enlargement of the thyroid gland, can induce airway distortion or tracheal compression. Airway management can be challenging for anesthesiologists, depending on the location and size of the mass as well as the patient's airway conditions, although it is reported that most cases can easily be managed by oral intubation.

Patient Concerns: A 61-year-old female patient who had planned for a total thyroidectomy due to a huge goiter was intubated with nerve integrity monitoring (NIM) tubes, using video laryngoscopy (VL) and oral fiberoptic bronchoscopy (FOB) alone. Read More

Ann R Coll Surg Engl 2022 Apr 20. Epub 2022 Apr 20.

NHS Tayside, UK.

Introduction: Management of the airway in the perioperative period for patients requiring major head and neck ablative surgery has commonly included the performance of elective surgical tracheostomy. This has been standard practice in most maxillofacial units across the UK, including ours. However, the COVID-19 pandemic and emerging guidelines on aerosol-generating procedures required us to revisit the need for a perioperative tracheostomy. Read More

Int J Nurs Stud 2022 Jun 1;130:104214. Epub 2022 Mar 1.

Research Centre for Nursing Theory and Practice, Fujian Provincial Hospital, 134 East Street, Gulou District, Fuzhou City, Fujian Province, China; School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China; Hospital Service Center, Fujian Provincial Hospital, 134 East Street, Gulou District, Fuzhou City, Fujian Province, China; Department of Nursing, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, 134 East Street, Gulou District, Fuzhou City, Fujian Province, China. Electronic address:

Background: When a patient emerges from cardiac surgery, they may experience intense thirst and discomfort or even impaired swallowing after endotracheal extubation. This may lead to feelings of suffocation, desperation, fear, and anxiety. Although thirst relief and dysphagia prevention share similar mechanisms, there is limited evidence for a combined intervention to alleviate thirst and prevent dysphagia. Read More

Ann Card Anaesth 2022 Apr-Jun;25(2):148-152

Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Background And Aim: Various devices such as single lumen tubes, balloon-tipped bronchial blockers, and double-lumen tubes can be used for lung isolation in children, but no particular device is ideal. As such, there is a wide variation in lung isolation techniques employed by anaesthesiologists in this cohort of patients. This study aims to describe our experience with Fogarty catheters for lung isolation in children. Read More

Anaesthesiol Intensive Ther 2022 Jun 15. Epub 2022 Jun 15.

Department of Anesthesiology and Intensive Care, Derince Research and Education Hospital, Health Sciences University, Kocaeli, Turkey.

Background: Fibreoptic intubation through a supraglottic airway device (SAD) is recom-mended in difficult airway management algorithms. The Difficult Airway Society published a guideline describing the details of this technique in 2011. This study was designed to compare the efficiency of two different 2nd generation SADs as a conduit for Aintree catheter-guided fibreoptic tracheal intubation. Read More

J Chin Med Assoc 2022 05 2;85(5):571-577. Epub 2022 May 2.

Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC.

Background: Obese people have a higher risk of difficult laryngoscopy due to their thick neck, large tongue, and redundant pharyngeal soft tissue. However, there is still no established predictive factor for difficult laryngoscopy in obese population.

Methods: We conducted a prospective assessor-blind observational study to enroll adult patients with a body mass index of 30 kg·m-2 or higher undergoing laparoscopic sleeve gastrectomy at a medical center between May 2020 and August 2021. Read More

BMC Anesthesiol 2022 04 5;22(1):97. Epub 2022 Apr 5.

General Hospital of Northern Theater Command, No. 83 Wenhua Road, Liaoning, Shenyang, China.

Background: The third-generation streamlined liner of the pharynx airway (SLIPA-3G) is a new-generation supraglottic airway device (SAD) that is non-cuffed and disposable, with a sealing pressure that varies dynamically with the airway pressure. This study compared the SLIPA-3G with the laryngeal mask airway supreme (LMAS) in patients undergoing laparoscopic cholecystectomy.

Methods: Two hundred and twenty patients scheduled for laparoscopic cholecystectomy were randomly allocated to either the SLIPA-3G group or the LMAS group. Read More

Anesth Prog 2022 04;69(1):42-45

Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York.

Traditional retrograde intubation consists of tracheal intubation performed over a guide wire inserted into the trachea inferior to the vocal cords and then passed transorally or transnasally. This intubation technique is reserved for patients with a difficult airway when other methods such as blind nasal intubation or video laryngoscopy fail. A guide wire passed blindly in a retrograde fashion, however, is not without its own constraints. Read More

Cochrane Database Syst Rev 2022 04 4;4:CD011136. Epub 2022 Apr 4.

Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK.

Background: Tracheal intubation is a common procedure performed to secure the airway in adults undergoing surgery or those who are critically ill. Intubation is sometimes associated with difficulties and complications that may result in patient harm. While it is traditionally achieved by performing direct laryngoscopy, the past three decades have seen the advent of rigid indirect videolaryngoscopes (VLs). Read More

Med J (Ft Sam Houst Tex) 2022 Apr-Jun(Per 22-04/05/06):22-26

Brooke Army Medical Center, JBSA Fort Sam Houston, TX; US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX; and Uniformed Services University of the Health Sciences, Bethesda, MD.

Introduction: Airway obstruction is the second leading cause of potentially preventable death on the battlefield. Previous studies demonstrate the most frequent airway intervention is intubation. Currently, the US Army has advanced video laryngoscopy (VL) in its sets, kits, and outfits (SKOs) at a cost of approximately $12,000 and generally only deploys them to the forward resuscitative surgical detachments and field hospitals. Read More

Am J Emerg Med 2022 Jun 18;56:87-91. Epub 2022 Mar 18.

Emergency Department, Royal North Shore Hospital, Sydney, Australia; CareFlight, Sydney, Australia.

Introduction: Optimal patient positioning during intubation improves laryngeal view and first pass success, as well as reducing incidence of hypoxia. In certain pre-hospital situations, it may be impractical or impossible for the operator to stand behind the patient.

Objective: We compared intubation in the supine and upright face-to-face positions, with regards to time to intubate and the view of the vocal cords obtained. Read More

BMC Anesthesiol 2022 04 2;22(1):93. Epub 2022 Apr 2.

Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok, 10400, Thailand.

Background: Flexible scope intubation is an important airway management skill that requires hands-on training in a real airway. We compared flexible scope intubation by trainees between patients in the left lateral and supine positions.

Methods: Forty patients aged 20 to 80 years with American Society of Anesthesiologists physical status class I to III were scheduled for elective surgery under general endotracheal anesthesia in Ramathibodi Hospital from February 2020 to June 2020. Read More

BMC Anesthesiol 2022 04 2;22(1):92. Epub 2022 Apr 2.

Department of Anesthesiology and Intensive Care Medicine, Philipps-University, Marburg, Germany.

Background: Double lumen tube (DLT) intubation is the most commonly used technique for one lung ventilation. Bronchial blockers (BB) are an alternative, especially for difficult airways. The EZ-bronchial blocker (EZB) is an innovative y-shaped and double-ended device of the BB family. Read More

Ann Thorac Surg 2022 Mar 26. Epub 2022 Mar 26.

Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.

Background: Tracheobronchial injury is a rare but potentially life-threatening condition. Various surgical treatment options have been described for symptomatic patients with full-thickness injury. However, studies comprising a meaningful number of patients are sparse. Read More

BMC Anesthesiol 2022 03 26;22(1):81. Epub 2022 Mar 26.

Department of Anesthesiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, People's Republic of China.

Background: High-flow nasal cannula (HFNC) is a new type of oxygen therapy, but its application in surgery remains unclear, we tried to describe the application of HFNC in microlaryngoscopic surgery for the Chinese population.

Methods: Nineteen adults, American society of anesthesiology class (ASA) 1-2 patients with body mass index < 30 kg.m underwent microlaryngoscopic surgery using HFNC for airway management. Read More

J Cardiothorac Vasc Anesth 2022 Aug 17;36(8 Pt B):3021-3027. Epub 2022 Feb 17.

University Witten/Herdecke, Medical Centre Cologne-Merheim, Department of Anaesthesiology and Intensive Care Medicine, Cologne, Germany.

Objectives: To quantify dental forces during double-lumen tube intubations with different laryngoscopy techniques.

Design: Experimental biomechanical mannequin study.

Setting: Two German university hospitals. Read More

Paediatr Anaesth 2022 07 5;32(7):843-850. Epub 2022 Apr 5.

Department of Anesthesiology, AIIMS, Patna, India.

Background: Previous studies have shown Proseal LMA and I gel similar to endotracheal intubation in ventilatory ability in pediatric laparoscopic surgeries.

Aims: The primary aim of this study was to assess whether there is a significant difference in the oropharyngeal leak pressure between Ambu Auragrain, I-gel, and Proseal LMA during pediatric laparoscopic surgery.

Methods: In this randomized controlled trial, 90 male patients of American Society of Anesthesiologists physical status I aged between 6 months and 10 years who were scheduled for laparoscopic single-sided inguinal hernia repair were recruited and randomly allocated to three groups in which airway was secured with Ambu Auragain, I gel, or Proseal LMA. Read More

Respir Physiol Neurobiol 2022 07 17;301:103889. Epub 2022 Mar 17.

Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy; Anesthesia and Intensive Care, Ospedale Policlinico San Martino, IRCCS per l'Oncologia e le Neuroscienze, Genoa, Italy.

Purpose: To describe the effects of timing of intubation in COVID-19 patients that fail helmet continuous positive airway pressure (h-CPAP) on progression and severity of disease.

Methods: COVID-19 patients that failed h-CPAP, required intubation, and underwent chest computed tomography (CT) at two levels of positive end-expiratory pressure (PEEP, 8 and 16 cmHO) were included in this retrospective study. Patients were divided in two groups (early versus late) based on the duration of h-CPAP before intubation. Read More