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Healthcare
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New Developments in Endotracheal Intubation and Airway Management
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New Developments in Endotracheal Intubation and Airway Management

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Critical Care".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 9307

Special Issue Editors

Prof. Dr. Tomasz M. Gaszyński

E-Mail Website
Guest Editor
Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, 90-419 Lodz, Poland
Interests: airway management; anesthesiology
Special Issues, Collections and Topics in MDPI journals
Dr. Manuel Ángel Gómez-Ríos

E-Mail Website
Guest Editor
Department of Anesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain
Interests: anesthesiology; perioperative medicine; airway management

Special Issue Information

Dear Colleagues,

New devices and techniques of endotracheal intubation have been recently developed. These include new laryngoscopes, video laryngoscopes, and new supraglottic airway devices with increased seal and vision-guided systems. These devices increase safety and effectiveness in airway management. The new developments have generated the need for their clinical and experimental evaluation. I invite you to design, conduct, and publish studies on these new devices and techniques. This Special Issue is open to all ideas that could improve airway management and aims to make share them widely to the scientific world.

Prof. Dr. Tomasz M. Gaszyński
Dr. Manuel Ángel Gómez-Ríos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endotracheal intubation
  • airway management
  • supraglottic devices

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Published Papers (5 papers)

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11 pages, 574 KiB  
Article
Lidocaine vs. Mometasone Furoate Around the Pediatric Tracheal Tube Cuff: Hemodynamic Stress Response and Postoperative Airway Complications: A Prospective, Randomized, Controlled Study
by Ali Ulvi Ölç, Mehmet Yılmaz, Kemal Tolga Saraçoğlu, Ayşe Zeynep Turan Cıvraz, Ayten Saraçoğlu and Paweł Ratajczyk
Healthcare 2025, 13(3), 205; https://doi.org/10.3390/healthcare13030205 - 21 Jan 2025
Viewed by 476
Abstract
Introduction: According to the results of the APRICOT study, airway and respiratory complications constitute 60% of all anesthesia-related complications and may be life-threatening. The primary aim of this study was to evaluate the effect of lidocaine and mometasone spray on the hemodynamic stress [...] Read more.
Introduction: According to the results of the APRICOT study, airway and respiratory complications constitute 60% of all anesthesia-related complications and may be life-threatening. The primary aim of this study was to evaluate the effect of lidocaine and mometasone spray on the hemodynamic stress response during tracheal intubation and extubation in children. Our secondary aim was to determine its effect on the incidence of postoperative airway complications. Materials and Methods: Following Ethics Committee approval (No: KIIA 2018/489) and clinical trial registration (No: NCT04085744), patient recruitment was initiated only after obtaining parental consent. Children of ASA I-II aged 0 to 16 years and undergoing elective surgery were included. A total of 91 patients were randomly divided into 3 groups. Group M: Patients treated with a topical corticosteroid 0.05% mometasone furoate spray (n = 30). Group L: Patients sprayed with 10% lidocaine (n = 30). Control group: Patients treated with 0.9% normal saline applied around the cuff (n = 31). The systolic, diastolic, and mean blood pressures, heart rate, and SpO2 values were recorded before operation, after induction, before and after tracheal intubation, and before and after extubation. Patients were followed up for 24 h postoperatively. Results: A statistically significant decrease was found in the lidocaine group for diastolic and mean arterial pressures measured after tracheal intubation (p = 0.018 and p = 0.027, respectively). There was a significant decrease in heart rate values in Group L after extubation (p = 0.024). Cough was observed in 5 patients in the control group at the postoperative 12th hour, but not in the other groups (p = 0.009). The distribution of sore throat severity, dyspnea, and hoarseness and the incidence of early postoperative bronchospasm, recorded in all follow-up periods, decreased; however, it did not show a statistically significant difference. Conclusions: In conclusion, this study revealed that the topical application of lidocaine and mometasone around the tracheal tube cuff in children not only reduces postoperative cough but also, in the case of lidocaine, suppresses the hemodynamic stress response during both tracheal intubation and extubation. Full article
(This article belongs to the Special Issue New Developments in Endotracheal Intubation and Airway Management)
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8 pages, 1292 KiB  
Article
Standard Gum Elastic Bougie Versus Flexible Tip Bougie: Evaluation of Airway Adjuncts for Intubation by Paramedics in Entrapped Manikins with Difficult Airway Access—A Randomised, Controlled Trial
by Dawid Aleksandrowicz and Paweł Ratajczyk
Healthcare 2024, 12(22), 2232; https://doi.org/10.3390/healthcare12222232 - 8 Nov 2024
Viewed by 647
Abstract
Introduction: Airway management in pre-hospital settings is often challenging and difficult to perform. This is particularly true during tracheal intubation of entrapped patients with difficult airway access. There are various airway adjuncts available in the current practice. Their aim is to facilitate tracheal [...] Read more.
Introduction: Airway management in pre-hospital settings is often challenging and difficult to perform. This is particularly true during tracheal intubation of entrapped patients with difficult airway access. There are various airway adjuncts available in the current practice. Their aim is to facilitate tracheal intubation. One of the recently introduced devices is the flexible tip bougie. The aim of this study was to evaluate the flexible tip bougie for intubation in a simulated condition of an entrapped trauma patient with simultaneous cervical spine immobilisation. Methods: An intubation manikin with the cervical collar on was placed on and secured to the driver’s seat of a passenger car. The car was then positioned on its left side. The first attempt success rate as well as the intubation and successful ventilation time were recorded. The ease of use by the operator and user-friendliness were also assessed. Results: The standard gum elastic bougie required the shortest mean intubation to successful ventilation time, 38.4 s (±9.6) vs. 41.4 s (±6.8), p = 0.46. The first attempt success rate was higher in the standard gum elastic bougie group, 92% vs. 88%, p = 0.04. There were no failed intubations when the standard gum elastic bougie was used. The flexible tip bougie was found to be more difficult to use and less user-friendly, 7.6 (±1.5) vs. 5.8 (±2.9), p = 0.02. Conclusions: The standard gum elastic bougie was superior in terms of the first attempt success and the time required for intubation and successful ventilation. Moreover, it was found to be easier to use and more user-friendly. Full article
(This article belongs to the Special Issue New Developments in Endotracheal Intubation and Airway Management)
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11 pages, 1737 KiB  
Article
Comparison of Three Video Laryngoscopes and Direct Laryngoscopy for Emergency Endotracheal Intubation While Wearing PPE-AGP: A Randomized, Crossover, Simulation Trial
by Przemysław Kluj, Anna Fedorczak, Michał Fedorczak, Tomasz Gaszyński, Cezary Kułak, Mikołaj Wasilewski, Mateusz Znyk, Maria Bartczak and Paweł Ratajczyk
Healthcare 2023, 11(6), 884; https://doi.org/10.3390/healthcare11060884 - 18 Mar 2023
Cited by 5 | Viewed by 2951
Abstract
Background: The COVID-19 pandemic has necessitated changes in the safety protocols of endotracheal intubation at every level of care. This study aimed to compare the first-pass success rates (FPS) and intubation times (IT) of three video laryngoscopes (VL) and direct laryngoscopy (DL) for [...] Read more.
Background: The COVID-19 pandemic has necessitated changes in the safety protocols of endotracheal intubation at every level of care. This study aimed to compare the first-pass success rates (FPS) and intubation times (IT) of three video laryngoscopes (VL) and direct laryngoscopy (DL) for simulated COVID-19 patient emergency intubation (EI). Methods: The study was a prospective, randomized, crossover trial. Fifty-three active paramedics performed endotracheal intubation with the I-viewTM VL, UESCOPE® VL, ProVu® VL and Macintosh direct laryngoscope (MAC) wearing personal protective equipment for aerosol-generating procedures (PPE-AGP) on a manikin with normal airway conditions. Results: The longest IT was noted when the UESCOPE® (29.4 s) and ProVu® (27.7 s) VL were used. The median IT for I-view was 17.4 s and for MAC DL 17.9 s. The FPS rates were 88.6%, 81.1%, 83.0% and 84.9%, respectively, for I-view, ProVu®, UESCOPE® and MAC DL. The difficulty of EI attempts showed a statistically significant difference between UESCOPE® and ProVu®. Conclusions: The intubation times performed by paramedics in PPE-AGP using UESCOPE® and ProVu® were significantly longer than those with the I-view and Macintosh laryngoscopes. The use of VL by prehospital providers in PPE did not result in more effective EI than the use of a Macintosh laryngoscope. Full article
(This article belongs to the Special Issue New Developments in Endotracheal Intubation and Airway Management)
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13 pages, 1280 KiB  
Article
Assessment of the Possibility of Using the Laryngoscopes Macintosh, McCoy, Miller, Intubrite, VieScope and I-View for Intubation in Simulated Out-of-Hospital Conditions by People without Clinical Experience: A Randomized Crossover Manikin Study
by Paweł Ratajczyk, Przemysław Kluj, Przemysław Dolder, Bartosz Szmyd and Tomasz Gaszyński
Healthcare 2023, 11(5), 661; https://doi.org/10.3390/healthcare11050661 - 23 Feb 2023
Cited by 1 | Viewed by 2053
Abstract
The aim of the study was to evaluate the laryngoscopes Macintosh, Miller, McCoy, Intubrite, VieScope and I-View in simulated out-of-hospital conditions when used by people without clinical experience, and to choose the one that, in the case of failure of the first intubation [...] Read more.
The aim of the study was to evaluate the laryngoscopes Macintosh, Miller, McCoy, Intubrite, VieScope and I-View in simulated out-of-hospital conditions when used by people without clinical experience, and to choose the one that, in the case of failure of the first intubation (FI), gives the highest probability of successful second (SI) or third (TI). For FI, the highest success rate (HSR) was observed for I-View and the lowest (LSR) for Macintosh (90% vs. 60%; p < 0.001); for SI, HSR was observed for I-View and LSR for Miller (95% vs. 66,7%; p < 0001); and for TI, HSR was observed for I-View and LSR for Miller, McCoy and VieScope (98.33% vs. 70%; p < 0.001). A significant shortening of intubation time between FI and TI was observed for Macintosh (38.95 (IQR: 30.1–47.025) vs. 32.4 (IQR: 29–39.175), p = 0.0132), McCoy (39.3 (IQR: 31.1–48.15) vs. 28.75 (IQR: 26.475–35.7), p < 0.001), Intubrite (26.4 (IQR: 21.4–32.3) vs. 20.7 (IQR: 18.3–24.45), p < 0.001), and I-View (21 (IQR: 17.375–25.1) vs. 18 (IQR: 15.95–20.5), p < 0.001). According to the respondents, the easiest laryngo- scopes to use were I-View and Intubrite, while the most difficult was Miller. The study shows that I-View and Intubrite are the most useful devices, combining high efficiency with a statistically significant reduction in time between successive attempts. Full article
(This article belongs to the Special Issue New Developments in Endotracheal Intubation and Airway Management)
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25 pages, 800 KiB  
Systematic Review
Clinically Preferred Videolaryngoscopes in Airway Management: An Updated Systematic Review
by Vikram Nedunchezhian, Ishvar Nedunchezhian and André Van Zundert
Healthcare 2023, 11(17), 2383; https://doi.org/10.3390/healthcare11172383 - 24 Aug 2023
Cited by 4 | Viewed by 2203
Abstract
Videolaryngoscopes (VLs) have emerged as a safety net offering several advantages over direct laryngoscopy (DL). The aim of this study is to expand on our previous study conducted in 2016, to deduce which VL is most preferred by clinicians and to highlight any [...] Read more.
Videolaryngoscopes (VLs) have emerged as a safety net offering several advantages over direct laryngoscopy (DL). The aim of this study is to expand on our previous study conducted in 2016, to deduce which VL is most preferred by clinicians and to highlight any changes that may have occurred over the past 7 years. An extensive systematic literature review was performed on Medline, Embase, Web of Science, and Cochrane Central Database of Controlled Studies for articles published between September 2016 and January 2023. This review highlighted similar results to our study in 2016, with the CMAC being the most preferred for non-channelled laryngoscopes, closely followed by the GlideScope. For channelled videolaryngoscopes, the Pentax AWS was the most clinically preferred. This review also highlighted that there are minimal studies that compare the most-used VLs, and thus we suggest that future studies directly compare the most-used and -preferred VLs as well as the specific nature of blades to attain more useful results. Full article
(This article belongs to the Special Issue New Developments in Endotracheal Intubation and Airway Management)
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