Journal of Clinical Medicine

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9 pages, 401 KiB

Open AccessArticle

A Predominant Cause of Recurrence of Ventilator-Associated Pneumonia in Patients with COVID-19 Are Relapses

by Mirella van Duijnhoven, Manon Fleuren-Janssen, Frits van Osch and Jos L. M. L. LeNoble

J. Clin. Med. 2023, 12(18), 5821; https://doi.org/10.3390/jcm12185821 - 7 Sep 2023

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Abstract

The diagnosis of ventilator-associated pneumonia (VAP) recurrence in patients with coronavirus disease 2019 (COVID-19) pneumonia is challenging, and the incidence of recurrence is high. This study aimed to investigate the incidence and recurrence of VAP. Furthermore, we investigated the causative microorganisms of VAP [...] Read more.

The diagnosis of ventilator-associated pneumonia (VAP) recurrence in patients with coronavirus disease 2019 (COVID-19) pneumonia is challenging, and the incidence of recurrence is high. This study aimed to investigate the incidence and recurrence of VAP. Furthermore, we investigated the causative microorganisms of VAP and recurrent VAPs in patients with COVID-19. This retrospective, single-centre case series study was conducted during the COVID-19 pandemic from October 2020 to June 2021 at VieCuri MC Venlo. VAP and recurrent VAP were defined based on three criteria (clinical, radiological, and microbiological). During the study period, 128 mechanically ventilated patients with COVID-19 were included. The incidence ranged from 9.2 to 14 VAP/1000 ventilator days, which was higher than that in the non-COVID-19 controls. The most commonly cultured microorganisms in VAP were Pseudomonas (9/28; 32%), Klebsiella (8/28; 29%), Escherichia coli (5/28; 18%), and Staphylococcus aureus (5/28; 18%). VAP recurred often (5/19, 26%). The overall VAP rate confirmed previous findings of an increased incidence of VAP in critically ill patients with severe COVID-19 requiring mechanical ventilation. VAP recurrences occur often and are mainly relapses. A duration of antibiotic therapy longer than 7 days and therapeutic drug monitoring should be considered for VAP caused by Gram-negative microorganisms. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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13 pages, 2196 KiB

Open AccessArticle

A Predictive Model of Major Postoperative Respiratory Adverse Events in Pediatric Patients Undergoing Rigid Bronchoscopy for Exploration and Foreign Body Removal

by Xiuwen Yi, Wenwen Ni, Yuan Han and Wenxian Li

J. Clin. Med. 2023, 12(17), 5552; https://doi.org/10.3390/jcm12175552 - 25 Aug 2023

Viewed by 1122

Abstract

Background: No nomogram has been established to predict the incidence of major postoperative respiratory adverse events (mPRAEs) in children undergoing rigid bronchoscopy for airway foreign bodies (AFB) removal and exploration of the airway, though some studies have confirmed the risk factors. Methods: 1214 [...] Read more.

Background: No nomogram has been established to predict the incidence of major postoperative respiratory adverse events (mPRAEs) in children undergoing rigid bronchoscopy for airway foreign bodies (AFB) removal and exploration of the airway, though some studies have confirmed the risk factors. Methods: 1214 pediatric patients (≤3 years old) undergoing rigid bronchoscopy for AFB from June 2014 to December 2020 were enrolled in this study. The primary outcome was the occurrence of mPRAEs, including laryngospasm and bronchospasm. Following that, a nomogram prediction model for the mPRAEs was developed. Results: The incidence of mPRAEs was 84 (6.9%) among 1214 subjects. American Society of Anesthesiologists physical status (ASA-PS), intraoperative desaturation (SpO₂ < 90%), procedural duration and ventilatory approach were all independent risk factors of mPRAEs. The area under the receiver operating characteristic curve (AUC) value of the nomogram for predicting mPRAEs was 0.815 (95% CI: 0.770–0.861), and the average AUC for ten-fold cross-validation was 0.799. These nomograms were well calibrated by Hosmer-Lemshow (p = 0.607). Decision curve analysis showed that the nomogram prediction model is effective in clinical settings. Conclusions: Combining ASA-PS, intraoperative desaturation, procedural duration, and ventilatory approach, the nomogram model is adequate for predicting the risk of developing mPRAEs, followed by rigid bronchoscopy for AFB removal and exploration. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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8 pages, 407 KiB

Open AccessArticle

Feasibility and Short-Term SpO₂/FiO₂ Changes in Hospitalized Adults with COVID-19 Pneumonia after Chest Physiotherapy with Threshold PEP Valve: A Cross-Sectional Study

by Júlia Estela, Emilio José Sánchez, Georgina Mateu, Elena Fernández, Eva Robert, Silvia Pozo, Mariona Noray, Joan C. Oliva, Fernanda M. Caballero and Manel Luján

J. Clin. Med. 2023, 12(17), 5544; https://doi.org/10.3390/jcm12175544 - 25 Aug 2023

Viewed by 1074

Abstract

Background: One of the main features of COVID-19 pneumonia is hypoxemic acute respiratory failure (ARF), often requiring ventilatory support. The influence of chest physiotherapy in patients with ARF is not extensively studied. The aim of the study was to analyze the short-time effects [...] Read more.

Background: One of the main features of COVID-19 pneumonia is hypoxemic acute respiratory failure (ARF), often requiring ventilatory support. The influence of chest physiotherapy in patients with ARF is not extensively studied. The aim of the study was to analyze the short-time effects of chest physiotherapy using a 10 cm H₂O threshold valve in patients with COVID-19 and ARF. Methods; Quasi-experimental cross-sectional study, in hospitalized patients from March to May 2020. The fractions of inspired oxygen, oxygen saturation, heart rate, respiratory rate and dyspnea were collected before and after the starting session (day 1) and after the 5th day of therapy. Results: The final sample size included 125 patients. Significant differences (p < 0.01) were found in the pre-post intervention SpO₂/FiO₂ ratio (250 ± 88.4 vs. 275.6 ± 97.5, p < 0.001), reaching 354.4 ± 110.2 after 5 days of therapy (p < 0.001 with respect to the baseline). The respiratory and heart rate dyspnea level did not change during the intervention. In patients needing FiO₂ > 0.4, the SpO₂/FiO₂ ratio improvement was higher than in patients with milder severity (46.85 ± 77.69, p < 0.01). Conclusions: Chest physiotherapy with a 10 cm H₂O threshold valve seems to be a safe and tolerated intervention with short-term improvement in oxygenation in patients with COVID-19 pneumonia. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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11 pages, 1568 KiB

Open AccessFeature PaperArticle

Does Regular Practice with a “Flexible Bronchoscopy Simulator” Improve Fibreoptic Intubation Skills in Experts and Novices? A Randomized Controlled Study

by Maartje van Haperen, Tom C. P. M. Kemper, Jeroen Hermanides, Susanne Eberl, Markus W. Hollmann, Jennifer S. Breel and Benedikt Preckel

J. Clin. Med. 2023, 12(16), 5195; https://doi.org/10.3390/jcm12165195 - 9 Aug 2023

Viewed by 722

Abstract

Background: The appropriate management of a “difficult airway” remains a challenge for novices and experienced anaesthetists. With the current available airway technologies, e.g., video laryngoscopy, flexible bronchoscopy (fibreoptic intubation (FOI)) for endotracheal intubation is decreasing, likely diminishing caregiver skills. We investigated whether bronchoscopy [...] Read more.

Background: The appropriate management of a “difficult airway” remains a challenge for novices and experienced anaesthetists. With the current available airway technologies, e.g., video laryngoscopy, flexible bronchoscopy (fibreoptic intubation (FOI)) for endotracheal intubation is decreasing, likely diminishing caregiver skills. We investigated whether bronchoscopy simulator training improved FOI skills. Methods: 72 volunteers, consisting of anaesthetists, anaesthesia residents, and nurses, performed six exercises on a bronchoscopy simulator. At baseline and after 12 months, the six exercises included one serious game (to train agility), two basic airways, and three difficult airways. After a baseline assessment, subjects were randomly allocated to the intervention group (with) or control group without bronchoscopy simulator training every six weeks for 10 min using a preloaded serious game. The primary outcome was the difference in the time to reach the carina after 12 months, as measured objectively by the simulator. The level of stress and FOI confidence after 12 months were secondary outcomes. Results: The control and intervention groups had a similar time to reach the carina in difficult airway cases and the reported stress levels, at baseline and 12 months, showed no difference. In contrast, the intervention group’s self-reported confidence in FOI skills improved more. Conclusions: Although participants rated higher in confidence, practicing FOI skills on an airway simulator with an agility game did not increase their performance in simulated challenging airway instances. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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13 pages, 1538 KiB

Open AccessFeature PaperArticle

Glidescope Video Laryngoscopy in Patients with Severely Restricted Mouth Opening—A Pilot Study

by Zohal Popal, André Dankert, Philip Hilz, Viktor Alexander Wünsch, Jörn Grensemann, Lili Plümer, Lars Nawrath, Linda Krause, Christian Zöllner and Martin Petzoldt

J. Clin. Med. 2023, 12(15), 5096; https://doi.org/10.3390/jcm12155096 - 3 Aug 2023

Cited by 1 | Viewed by 1101

Abstract

Background: An inter-incisor gap <3 cm is considered critical for videolaryngoscopy. It is unknown if new generation GlideScope Spectrum™ videolaryngoscopes with low-profile hyperangulated blades might facilitate safe tracheal intubation in these patients. This prospective pilot study aims to evaluate feasibility and safety of [...] Read more.

Background: An inter-incisor gap <3 cm is considered critical for videolaryngoscopy. It is unknown if new generation GlideScope Spectrum™ videolaryngoscopes with low-profile hyperangulated blades might facilitate safe tracheal intubation in these patients. This prospective pilot study aims to evaluate feasibility and safety of GlideScope^TM videolaryngoscopes in severely restricted mouth opening. Methods: Feasibility study in 30 adults with inter-incisor gaps between 1.0 and 3.0 cm scheduled for ENT or maxillofacial surgery. Individuals at risk for aspiration or rapid desaturation were excluded. Results: The mean mouth opening was 2.2 ± 0.5 cm (range 1.1–3.0 cm). First attempt success rate was 90% and overall success was 100%. A glottis view grade 1 or 2a was achieved in all patients. Nasotracheal intubation was particularly difficult if Magill forceps were required (n = 4). Intubation time differed between orotracheal (n = 9; 33 (25; 39) s) and nasotracheal (n = 21; 55 (38; 94) s); p = 0.049 intubations. The airway operator’s subjective ratings on visual analogue scales (0–100) revealed that tube placement was more difficult in individuals with an inter-incisor gap <2.0 cm (n = 10; 35 (29; 54)) versus ≥2.0 cm (n = 20; 20 (10; 30)), p = 0.007, while quality of glottis exposure did not differ. Conclusions: Glidescope^TM videolaryngoscopy is feasible and safe in patients with severely restricted mouth opening if given limitations are respected. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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12 pages, 1573 KiB

Open AccessArticle

ETView SL versus Macintosh Direct Laryngoscope for Endotracheal Intubation Amid Simulated COVID-19 Cardiac Arrest: A Randomized Crossover Study

by Togay Evrin, Miroslaw Dabkowski, Michal Pruc, Jacek Hernik, Wojciech Wieczorek, Lukasz Chabowski, Pawel Wieczorek, Jaroslaw Chmielewski, Stepan Feduniw and Lukasz Szarpak

J. Clin. Med. 2023, 12(15), 5074; https://doi.org/10.3390/jcm12155074 - 2 Aug 2023

Viewed by 958

Abstract

Airway management procedures, such as endotracheal intubation (ETI), pose a significant risk of aerosol generation, requiring robust personal protective equipment (PPE) against aerosol-generating procedures (AGP). This study aimed to assess the impact of PPE-AGP on intubation success rates, time to intubation, and glottic [...] Read more.

Airway management procedures, such as endotracheal intubation (ETI), pose a significant risk of aerosol generation, requiring robust personal protective equipment (PPE) against aerosol-generating procedures (AGP). This study aimed to assess the impact of PPE-AGP on intubation success rates, time to intubation, and glottic visualization using ETView and a standard Macintosh laryngoscope (MAC). A total of 52 physicians participated in this prospective, observational, randomized crossover study conducted in a medical simulation setting. Participants included COVID-19 patients with cardiac arrest scenarios with and without PPE-AGP who were intubated with ETView and MAC. During intubation without PPE-AGP, ETView showed a similar first-pass success rate (FPS) but had a shorter intubation time and better glottal hydration compared to MAC. In scenario B (with PPE-AGP), ETView outperformed MAC in FPS, initiation time, and glottic visualization. The use of PPE-AGP had little impact on ETView’s performance. However, it negatively affected the Macintosh laryngoscope, reducing FPS and glottic visibility. Participants found intubation with ETView easier in both scenarios. In conclusion, as compared to the Macintosh laryngoscope, ETView demonstrated higher performance under the circumstances of the simulation, especially when PPE-AGP was used. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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12 pages, 953 KiB

Open AccessFeature PaperArticle

High Frequency Jet Ventilation or Mechanical Ventilation for Panendoscopy for Cervicofacial Cancer: A Retrospective Study

by Stephanie Suria, Raphaëlle Galy, Lauriane Bordenave, Cyrus Motamed, Jean-Louis Bourgain, Joanne Guerlain, Antoine Moya-Plana and Jamie Elmawieh

J. Clin. Med. 2023, 12(12), 4039; https://doi.org/10.3390/jcm12124039 - 14 Jun 2023

Viewed by 1145

Abstract

Introduction—the upper airway panendoscopy, performed under general anesthesia, is mandatory for the diagnosis of cervicofacial cancer. It is a challenging procedure because the anesthesiologist and the surgeon have to share the airway space together. There is no consensus about the ventilation strategy to [...] Read more.

Introduction—the upper airway panendoscopy, performed under general anesthesia, is mandatory for the diagnosis of cervicofacial cancer. It is a challenging procedure because the anesthesiologist and the surgeon have to share the airway space together. There is no consensus about the ventilation strategy to adopt. Transtracheal high frequency jet ventilation (HFJV) is the traditional method in our institution. However, the COVID-19 pandemic forced us to change our practices because HFJV is a high risk for viral dissemination. Tracheal intubation and mechanical ventilation were recommended for all patients. Our retrospective study compares the two ventilation strategies for panendoscopy: high frequency jet ventilation (HFJV) and mechanical ventilation with orotracheal intubation (MVOI). Methods—we reviewed all panendoscopies performed before the pandemic in January and February 2020 (HFJV) and during the pandemic in April and May 2020 (MVOI). Minor patients, patients with a tracheotomy before or after, were excluded. We performed a multivariate analysis adjusted on unbalanced parameters between the two groups to compare the risk of desaturation. Results—we included 182 patients: 81 patients in the HFJV group and 80 in the MVOI group. After adjustments based on BMI, tumor localization, history of cervicofacial cancer surgery, and use of muscle relaxants, the patients from the HFJV group showed significantly less desaturation than the intubation group (9.9% vs. 17.5%, OR_a = 0.18, p = 0.047). Conclusion—HFJV limited the incidence of desaturation during upper airway panendoscopies in comparison to oral intubation. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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13 pages, 749 KiB

Open AccessArticle

Nasendoscopy to Predict Difficult Videolaryngoscopy: A Multivariable Model Development Study

by Phillip Brenya Sasu, Jennifer-Isabel Pansa, Rupert Stadlhofer, Viktor Alexander Wünsch, Karolina Loock, Eva Katharina Buscher, André Dankert, Ann-Kathrin Ozga, Christian Zöllner and Martin Petzoldt

J. Clin. Med. 2023, 12(10), 3433; https://doi.org/10.3390/jcm12103433 - 12 May 2023

Cited by 5 | Viewed by 1516

Abstract

Background: Transnasal videoendoscopy (TVE) is the standard of care when staging pharyngolaryngeal lesions. This prospective study determined if preoperative TVE improves the prediction of difficult videolaryngoscopic intubation in adults with expected difficult airway management in addition to the Simplified Airway Risk Index (SARI). [...] Read more.

Background: Transnasal videoendoscopy (TVE) is the standard of care when staging pharyngolaryngeal lesions. This prospective study determined if preoperative TVE improves the prediction of difficult videolaryngoscopic intubation in adults with expected difficult airway management in addition to the Simplified Airway Risk Index (SARI). Methods: 374 anesthetics were included (252 with preoperative TVE). The primary outcome was a difficult airway alert issued by the anesthetist after Macintosh videolaryngoscopy. SARI, clinical factors (dysphagia, dysphonia, cough, stridor, sex, age and height) and TVE findings were used to fit three multivariable mixed logistic regression models; least absolute shrinkage and selection operator (LASSO) regression was used to select co-variables. Results: SARI predicted the primary outcome (odds ratio [OR] 1.33; 95% confidence interval [CI] 1.13–1.58). The Akaike information criterion for SARI (327.1) improved when TVE parameters were added (311.0). The Likelihood ratio test for SARI plus TVE parameters was better than for SARI plus clinical factors (p < 0.001). Vestibular fold lesions (OR 1.82; 95% CI 0.40–8.29), epiglottic lesions (OR 3.37; 0.73–15.54), pharyngeal secretion retention (OR 3.01; 1.05–8.63), restricted view on rima glottidis <50% (OR 2.13; 0.51–8.89) and ≥50% (OR 2.52; 0.44–14.56) were concerning. Conclusion: TVE improved prediction of difficult videolaryngoscopy in addition to traditional bedside airway examinations. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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11 pages, 1230 KiB

Open AccessArticle

A Randomized Study of Rigid Video Stylet versus Macintosh Laryngoscope for Double-Lumen Endobronchial Tube Intubation Assistance in Thoracoscopic Pulmonary Surgery

by Yang Gu, Qing Zhou, Huanping Zhou, Meiyun Liu, Di Feng, Juan Wei, Keting Min, Wanli Zhu, Yuanli Chen and Xin Lv

J. Clin. Med. 2023, 12(2), 540; https://doi.org/10.3390/jcm12020540 - 9 Jan 2023

Cited by 1 | Viewed by 1711

Abstract

Double-lumen endobronchial tube (DLT) intubation is more challenging than single-lumen tube intubation is, and the rigid video stylet (RVS) is one of the tools that has emerged to deal with this demanding intubation procedure. We evaluated whether the UE^® RVS can shorten [...] Read more.

Double-lumen endobronchial tube (DLT) intubation is more challenging than single-lumen tube intubation is, and the rigid video stylet (RVS) is one of the tools that has emerged to deal with this demanding intubation procedure. We evaluated whether the UE^® RVS can shorten the DLT intubation time and improve the first-attempt intubation success rate compared with that of Macintosh laryngoscope (ML). A total of 130 participants scheduled to undergo thoracoscopic pulmonary surgeries were enrolled. They were randomized to receive either ML- or RVS-assisted DLT intubation. The primary outcomes were the intubation time and first-attempt intubation success rate. The secondary outcomes were the overall intubation success rate, mean arterial pressure, postoperative sore throat (POST), and postoperative hoarseness at 1 h and 24 h. Compared with the ML group, the intubation time was significantly shorter in the RVS group (p < 0.001; 30.82 ± 10.61 vs. 39.62 ± 6.54 s), however, the first-attempt success rate was significantly lower (p = 0.048; 83.08% vs. 95.16%). The POST at 1 h was less severe in the RVS group (p = 0.021). No significant differences were found for the other indicators. Among the patients with normal airways, the UE^® RVS can achieve faster DLT intubation and decrease the severity of a POST at 1 h, although it was associated with a lower first-attempt intubation success rate. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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12 pages, 1370 KiB

Open AccessArticle

Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents

by Katharina Epp, Sophie Zimmermann, Eva Wittenmeier, Marc Kriege, Frank Dette, Irene Schmidtmann and Nina Pirlich

J. Clin. Med. 2022, 11(19), 5676; https://doi.org/10.3390/jcm11195676 - 26 Sep 2022

Cited by 1 | Viewed by 1231

Abstract

Background: Airway management in children is challenging due to anatomical and physiological differences. This randomized trial investigates whether anaesthesia residents can intubate the paediatric trachea more quickly and with a higher success rate using the King Vision™ Paediatric aBlade™ video laryngoscope (KVL) compared [...] Read more.

Background: Airway management in children is challenging due to anatomical and physiological differences. This randomized trial investigates whether anaesthesia residents can intubate the paediatric trachea more quickly and with a higher success rate using the King Vision™ Paediatric aBlade™ video laryngoscope (KVL) compared to conventional direct laryngoscopy (DL). Methods: Eleven anaesthesia residents (mean age: 31 years, mean training status 47 months) were each asked to perform intubations with the KVL and DL in paediatric patients. The primary outcome was the first-attempt success rate. Secondary outcomes were the time to best view (TTBV), time to placement of the tracheal tube (TTP), time to ventilation (TTV), and participant-reported ease of use on a Likert scale. Results: 105 intubations with the KVL and 106 DL were performed by the residents. The success rate on the first attempt with the KVL was 81%, and the success rate on the first attempt within a given time limit of 30 s was 45%, which was lower than with DL (93% and 77% with time limit, p < 0.01). The median TTBV [IQR] on the first attempt with KVL was 7 [5–10] s, the median TTP was 28 [19–44] s, and the median TTV was 51 [39–66] s. DL-mediated intubation was significantly faster (TTP: 17 [13–23] s; p < 0.0001 and TTV: 34 [28–44] s; p < 0.001). Application of the KVL was rated as difficult or very difficult by 60% of the residents (DL: 5%). Conclusion: In contrast to promising data on the paediatric training manikin, residents took longer to intubate the airway in children with the KVL and were less successful compared to the DL. Therefore, the KVL should not be recommended for learning paediatric intubation by residents. Full article

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Review

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24 pages, 6991 KiB

Open AccessReview

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

by Shuaijie Pei, Wei Wei, Kai Yang, Yiyi Yang, Yu Pan, Jinrui Wei, Shanglong Yao and Haifa Xia

J. Clin. Med. 2022, 11(19), 5841; https://doi.org/10.3390/jcm11195841 - 1 Oct 2022

Cited by 8 | Viewed by 2015

Abstract

Background: Lung-protective ventilation strategies are recommended for patients undergoing mechanical ventilation. However, there are currently no guidelines to follow regarding recruitment maneuvers (RMs). We attempted to identify the effects of RMs on patients undergoing laparoscopic abdominal surgery. Methods: We searched for randomized controlled [...] Read more.

Background: Lung-protective ventilation strategies are recommended for patients undergoing mechanical ventilation. However, there are currently no guidelines to follow regarding recruitment maneuvers (RMs). We attempted to identify the effects of RMs on patients undergoing laparoscopic abdominal surgery. Methods: We searched for randomized controlled trials (RCTs) in PubMed, the Cochrane Library databases, Embase, Web of Science and the ClinicalTrials.gov registry for trials published up to December 2021. The primary outcome was postoperative pulmonary complications (PPCs). The secondary outcomes consisted of the static lung compliance, driving pressure (DP), intraoperative oxygenation index (OI), OI in the post-anesthesia care unit (PACU), mean arterial pressure (MAP) and heart rate (HR). Seventeen RCTs with a total of 3480 patients were examined. Results: Patients who received RMs showed a considerable reduction in PPCs (risk ratio (RR) = 0.70; 95% confidence interval (CI): 0.62 to 0.79; p < 0.01), lower DP (weighted mean difference (WMD) = −3.96; 95% CI: −5.97 to −1.95; p < 0.01), elevated static lung compliance (WMD = 10.42; 95% CI: 6.13 to 14.71; p < 0.01) and improved OI (intraoperative: WMD = 53.54; 95% CI: 21.77 to 85.31; p < 0.01; PACU: WMD = 59.40; 95% CI: 39.10 to 79.69; p < 0.01) without substantial changes in MAP (WMD = −0.16; 95% CI −1.35 to 1.03; p > 0.05) and HR (WMD = −1.10; 95% CI: −2.29 to 0.10; p > 0.05). Conclusions: Recruitment maneuvers reduce postoperative pulmonary complications and improve respiratory mechanics and oxygenation in patients undergoing laparoscopic abdominal surgery. More data are needed to elucidate the effect of recruitment maneuver on the circulatory system. Full article

(This article belongs to the Special Issue Airway Management & Respiratory Therapy)

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Other

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11 pages, 1370 KiB

Open AccessSystematic Review

Comparison of McGrath Videolaryngoscope versus Macintosh Laryngoscope in Tracheal Intubation: An Updated Systematic Review

by Pasquale Sansone, Luca Gregorio Giaccari, Antonio Bonomo, Francesca Gargano, Caterina Aurilio, Francesco Coppolino, Maria Beatrice Passavanti, Vincenzo Pota and Maria Caterina Pace

J. Clin. Med. 2023, 12(19), 6168; https://doi.org/10.3390/jcm12196168 - 24 Sep 2023

Cited by 1 | Viewed by 1319

Abstract

(1) Background: In the last few years, many randomized controlled trials (RCTs) have compared direct Macintosh laryngoscopy with McGrath videolaryngoscopy in order to assess the potential benefits of the latter; the results were sometimes controversial. (2) Methods: We conducted a comprehensive literature search [...] Read more.

(1) Background: In the last few years, many randomized controlled trials (RCTs) have compared direct Macintosh laryngoscopy with McGrath videolaryngoscopy in order to assess the potential benefits of the latter; the results were sometimes controversial. (2) Methods: We conducted a comprehensive literature search to identify our articles according to inclusion and exclusion criteria: to be included, each study had to be a prospective randomized trial or comparison between the McGrath videolaryngoscope and the Macintosh laryngoscope in an adult population. We did not include manikin trials or studies involving double-lumen tubes. (3) Results: 10 studies met the inclusion criteria necessary. In total, 655 patients were intubated with the McGrath and 629 with the Macintosh. In total, 1268 of 1284 patients were successfully intubated, showing equivalent results for the two devices: 648 of 655 patients with the McGrath videolaryngoscope and 620 of 629 patients with the Macintosh laryngoscope. No differences were noted in terms of hemodynamic changes or the incidence of adverse events. (4) Conclusions: We can assert that the McGrath videolaryngoscope and Macintosh laryngoscope, even if with equivalent tracheal intubation results, supplement each other. Full article

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