Search Our Scientific Publications & Authors

J Formos Med Assoc 2021 Feb 25. Epub 2021 Feb 25.

Department of Anesthesiology, Taipei Veterans General Hospital, Taipei and Institute of Medicine, National Yang Ming Chiao Tung University, Hsinchu, 30010, Taiwan. Electronic address:

Background/purpose: Increasing evidence indicates an association of video laryngoscopy with the success rate of airway management in patients with neck immobilization. Nevertheless, clinical practice protocols for tracheal intubation in patients immobilized using various types of cervical orthoses and the outcomes remain unclear.

Methods: We retrospectively assessed the tracheal intubation techniques selected for patients immobilized using cervical orthoses from 2015 to 2018. Read More

Ann Transl Med 2021 Jan;9(1):75

Department of Anesthesiology, Peking University Third Hospital, Beijing, China.

Diffuse idiopathic skeletal hyperostosis (DISH), asymptomatic in most cases, is a degenerative condition that commonly leads to anterior cervical osteophytes in most elderly patients. Clinically significant airway compression is rare. However, in some cases, the seemingly insignificant osteophytes could become a threat to airway management during intubation. Read More

BMC Anesthesiol 2019 12 30;19(1):244. Epub 2019 Dec 30.

School of Medicine, Department of Anesthesiology and Reanimation, Inonu University, Malatya, Turkey.

Background: This study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal™ laryngeal mask airway (PLMA).

Methods: Prospective, one hundred and nineteen patients (ASA I-II, aged 18-65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer's instructions in the standard digital technique group. Read More

Curr Opin Anaesthesiol 2019 Dec;32(6):764-768

Department of Anaesthesia, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada.

Purpose Of Review: The difficult airway remains an ongoing concern in daily anesthesia practice, with awake intubation being an important component of its management. Classically, fiberoptic bronchoscope-assisted tracheal intubation was the method of choice in the awake patient. The development of new generation videolaryngoscopes has revolutionized the approach to tracheal intubation in the anesthetized patient. Read More

Eur J Pediatr 2019 Jul 23;178(7):1105-1111. Epub 2019 May 23.

Children's Acute Transport Service, Ormond House, 26-27 Boswell Street, London, UK.

Airway management in children is associated with anatomical and physiological challenges compared with adults. Pierre Robin sequence (PRS) is a condition characterized by micrognathia, glossoptosis, and cleft palate and related to a difficult airway. Both the Airtraq™ and GlideScope® have never been previously directly compared in PRS. Read More

Anesth Analg 2019 06;128(6):1264-1271

From the Department of Anesthesiology and Pain Medicine, Hospital de Manises, Valencia, Spain.

Background: Tracheal intubation failure in patients with difficult airway is still not uncommon. While videolaryngoscopes such as the Glidescope offer better glottic vision due to an acute-angled blade, this advantage does not always lead to an increased success rate because successful insertion of the tube through the vocal cords may be the limiting factor. We hypothesize that combined use of Glidescope and fiberscope used only as a dynamic guide facilitates tracheal intubation compared to a conventional Glidescope technique with a preshaped nondynamic stylet. Read More

J Med Syst 2019 Feb 11;43(3):72. Epub 2019 Feb 11.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA, 02115, USA.

Few studies have examined the impact of video laryngoscopy (VL) on operating room efficiency. We hypothesized that VL reduces anesthesia control time (ACT), a metric of anesthesia efficiency, compared with fiberoptic intubation (FOI) in potentially difficult airways, but that direct laryngoscopy (DL) remains more efficient in routine cases. We performed a multi-institutional, retrospective chart review of anesthetic cases from 2015 to 2016. Read More

J Clin Anesth 2019 08 15;55:132-133. Epub 2019 Jan 15.

Department of Anaesthesiology, Tri-Service General Hospital and National Defense Medical Center, #325, Section 2, Chenggung Road, Neihu, 114 Taipei, Taiwan, Republic of China. Electronic address:

Anesth Analg 2018 08;127(2):450-454

Harborview Medical Center, Seattle, Washington.

Background: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Read More

J Cardiothorac Vasc Anesth 2018 02 9;32(1):267-274. Epub 2017 May 9.

Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

Objective: To compare the incidence of fiberoptic bronchoscope (FOB) use (1) during verification of initial placement and (2) for reconfirmation of correct placement following repositioning, when either a double-lumen tube (DLT) or video double-lumen tube (VDLT) was used for lung isolation during thoracic surgery.

Design: A randomized controlled study.

Setting: Single-center university teaching hospital. Read More

Paediatr Anaesth 2017 Nov 20;27(11):1115-1119. Epub 2017 Sep 20.

Department of Anesthesiology, Jikei University, Minato-ku, Tokyo, Japan.

Background: With the increasing popularity of video laryngoscopy during intubation of pediatric patients with normal or difficult airways, fiberoptic-assisted tracheal intubation, traditionally considered the gold standard for difficult intubation, may become underused.

Aim: We aimed to assess the use of airway management techniques before and after introduction of video laryngoscopy in a cohort of school-aged children with microtia, who are at increased risk of difficult intubation.

Methods: We retrospectively reviewed intubation devices used for all pediatric patients with microtia who had undergone reconstructive ear surgery at a single institution during the period January 2008 to December 2012. Read More

J Emerg Med 2017 Oct 4;53(4):550-553. Epub 2017 Sep 4.

Department of Emergency Medicine, University of California-Los Angeles, Los Angeles, California.

Background: An obstructive neck lesion presents an airway challenge for any emergency physician. Retrograde intubation is an infrequently used airway alternative that can be employed in the difficult airway algorithm that requires little training and is less invasive than surgical cricothyrotomy.

Case Report: We report a case of a 31-year-old male patient who presented with respiratory distress progressing to respiratory failure from upper airway obstruction. Read More

BMJ Open 2017 Sep 1;7(8):e015307. Epub 2017 Sep 1.

Department of Trauma Surgery and Orthopedics, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany.

Introduction: Emergency management of upper cervical spine injuries often requires cervical spine immobilisation and some critical patients also require airway management. The movement of cervical spine created by tracheal intubation and cervical spine immobilisation can potentially exacerbate cervical spinal cord injury. However, the evidence that previous studies have provided remains unclear, due to lack of a direct measurement technique for dural sac's space during dynamic processes. Read More

J Emerg Med 2017 Aug 9;53(2):163-171. Epub 2017 Jun 9.

Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Arizona; Department of Medicine, Section of Pulmonary, Critical Care, Allergy and Sleep, University of Arizona College of Medicine, Tucson, Arizona.

Background: Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management.

Objectives: To determine the incidence, management, and outcomes of patients with predicted difficult airways in the ED.

Methods: Over the 1-year period from July 1, 2015 to June 30, 2016, data were prospectively collected on all patients intubated in an academic ED. Read More

Indian J Anaesth 2017 Jan;61(1):36-41

Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.

Background And Aims: The difficulty during flexible fiber-optic bronchoscopy (FOB) guided tracheal intubation could be because of inability in visualising glottis, advancing and railroading of endotracheal tube. Several methods are available for visualising glottis, but none is ideal. Hence, this randomised controlled study was designed to evaluate the simple pre-determined length insertion technique (SPLIT) during oral FOB. Read More

J Clin Anesth 2017 Feb 1;36:127-132. Epub 2016 Dec 1.

Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan.

Study Objectives: To identify airway management and tracheal intubation techniques for glossopexy in infants with preexisting airway obstruction under general anesthesia.

Design: Retrospective, observational study.

Settings: Operating room of a university hospital between January 2003 and March 2015. Read More

A A Case Rep 2017 Mar;8(6):139-141

From the *Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada; and †Department of Otolaryngology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada.

Airway management in trauma is a crucial skill, because patients are at risk of aspiration, hypoxia, and hypoventilation, all of which may be fatal in the setting of increased intracranial pressure. The King Laryngeal Tube reusable supraglottic airway (King Systems, Noblesville, IN) allows for temporary management of a difficult airway but poses a challenge when an attempt is made to exchange the device for an endotracheal tube, often managed by emergency tracheostomy. We describe a novel fiberoptic, video laryngoscope-assisted approach to intubation in a difficult trauma airway with an in situ King Laryngeal Tube. Read More

J Anaesthesiol Clin Pharmacol 2016 Oct-Dec;32(4):515-518

Department of Anaesthesiology, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bengaluru, Karnataka, India.

Background And Aims: Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2016 Nov 24;51(11-12):656-663. Epub 2016 Nov 24.

Department of Anesthesia & Peri-operative Medicine, Western University, London, Ontario, Canada.

Introduction: Awake video laryngoscopy is a novel option in airway management that is drawing more and more attention as an alternative to awake endoscopic guided intubation.Main issues: Intubation under preserved spontaneous breathing is the safest method to secure the expected difficult airway. In direct comparisons to awake flexible endoscopic intubation, awake video laryngoscopy achieves satisfactory intubation times and a high acceptance of patients and anesthesiologists. Read More

Acta Anaesthesiol Scand 2017 Jan 3;61(1):23-30. Epub 2016 Nov 3.

Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.

Introduction: supraglottic airway devices remain, despite advances in video laryngoscopy, important tools in the management of unexpected difficult airways. Intubation through a functioning supraglottic airway device with the aid of a fiberoptic bronchoscope is a well-known technique usually performed in apnoea. With a simple modification, the patient can be ventilated during this procedure. Read More

Rev Bras Anestesiol 2018 Jan - Feb;68(1):87-90. Epub 2016 Sep 28.

Pontificia Universidad Católica de Chile, Facultad de Medicina, División de Anestesiología, Santiago, Chile. Electronic address:

Neonates and small infants with craniofacial malformation may be very difficult or impossible to mask ventilate or intubate. We would like to report the fiberoptic intubation of a small infant with Treacher Collins Syndrome using the technique described by Ellis et al.

Case Report: An one month-old infant with Treacher Collins Syndrome was scheduled for mandibular surgery under general endotracheal anesthesia. Read More

Middle East J Anaesthesiol 2016 Oct;23(6):665-73

Ludwig’s angina, although uncommon, remains a potentially life-threatening condition because of the risk of impending airway obstruction. Effective treatment is based on early recognition of the clinical process, with the appropriate use of parenteral antibiotics, securing the airway, and formal surgical drainage of the infection. Awake fiberoptic intubation under topical anesthesia may be the preferred method to secure the airway. Read More

Am J Emerg Med 2016 Dec 27;34(12):2408-2410. Epub 2016 Aug 27.

Department of Emergency Medicine, Cook County Hospital, 1900 W Polk St, 10th Floor, 60612, Chicago, IL.

Introduction: Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotracheal tube to maximum depth does not ensure that the proper (nonhemorrhagic) lung is ventilated. Therefore, single lung intubation may be significantly delayed in these patients. Read More

Anesthesiology 2016 10;125(4):656-66

From the Department of Anesthesiology, Oregon Health & Science University, Portland, Oregon (M.F.A., A.M.B.); Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan (D.W.H., A.S., T.T., J. Ragheb, S.K.); Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut (A.W.W.); Department of Anesthesiology, University of Colorado, Aurora, Colorado (L.J.); Department of Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (D.A.B.); Department of Anesthesiology, University of Vermont College of Medicine, Burlington, Vermont (W.C.P.); Department of Anesthesiology, Washington University, St. Louis, Missouri (J. Rao); Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee (J.L.E.); Department of Anesthesiology, University of Virginia, Charlottesville, Virginia (D.A.C.); and Department of Anesthesiology, University of Utah, Salt Lake City, Utah (P.B.).

Background: Multiple attempts at tracheal intubation are associated with mortality, and successful rescue requires a structured plan. However, there remains a paucity of data to guide the choice of intubation rescue technique after failed initial direct laryngoscopy. The authors studied a large perioperative database to determine success rates for commonly used intubation rescue techniques. Read More

Acta Clin Croat 2016 Mar;55 Suppl 1:108-11

Laryngeal chondrosarcoma is a rare mesenchymal tumor, most frequently affecting cricoid cartilage. The objective of this report is to present successful video laryngoscope usage in a patient with anticipated difficult airway who refused awake fiberoptic endotracheal intubation (AFOI). A 59-year-old male patient was admitted in our hospital due to difficulty breathing and swallowing. Read More

Acta Clin Croat 2016 Mar;55 Suppl 1:51-4

The primary goal of pediatric airway management is to ensure oxygenation and ventilation. Routine airway management in healthy pediatric patients is normally easy in experienced hands. Really difficult pediatric airway is rare and usually is associated with anatomically and physiologically important findings such as congenital abnormalities and syndromes, trauma, infection, swelling and burns. Read More

J Clin Anesth 2016 Jun 22;31:46-52. Epub 2016 Mar 22.

Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Study Objective: To compare the C-MAC video laryngoscope to the standard flexible fiberoptic scope (FFS) with an eye piece (but without a camera or a video screen) for intubation of patients undergoing cervical spine surgery with manual inline stabilization. The primary end point was the time to achieve successful tracheal intubation. Secondary end points included glottic view at intubation and number of intubation attempts. Read More

Paediatr Anaesth 2016 Apr 25;26(4):429-37. Epub 2016 Jan 25.

Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.

Background: Bardet-Biedl syndrome (BBS) is a rare genetic condition with manifestations that can impact anesthetic and perioperative care. There is a void of literature describing the perioperative anesthetic management in this complex patient population.

Objectives: The purpose of this retrospective series was to describe the perioperative care of patients diagnosed with BBS at a large academic tertiary referral center with experience in caring for these patients. Read More

Rev Esp Anestesiol Reanim 2016 Apr 8;63(4):189-91. Epub 2016 Jan 8.

Department of Anaesthesiology and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Head of the Anaesthesiology and Pain Management Research Group, Institute for Biomedical Research of A Coruña (INIBIC), A Coruña, Spain. Electronic address:

AANA J 2015 Dec;83(6):389-97

Occasionally intubation of patients is difficult using a video laryngoscope (GlideScope, Verathon Medical) because of an inability to guide the endotracheal tube to the glottis or pass the tube into the trachea despite an adequate view of the glottis. We examined methods to improve success when this difficulty occurs. A literature search revealed 253 potential sources, with 25 meeting search criteria: 7 randomized controlled trials, 4 descriptive studies, 8 case series, and 6 case reports. Read More