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- W1863417691 abstract "We read Kramer et al.'s recent study with interest and welcome research in this area 1. However, we dispute its principal finding that awake videolaryngoscopy is as good as fibreoptic intubation in anticipated difficult nasal intubation in patients with a mouth opening > 1.3 cm. Although the success rate for intubation with either technique was identical (48/50 patients), the discussion failed to acknowledge the large number of participants who continued to have a poor glottic view despite use of videolaryngoscopy, 11/50 (22%) participants having a Cormack and Lehane classification grade-3 or -4 view. We can only infer that these patients’ tracheas were intubated blindly, as by definition the glottis could not be seen. No mention was made of the views seen in the fibreoptic group, but we assume that the glottis would have been fully seen in all 50 cases. Are the authors confident in advocating a technique in which over 20% of the intubations performed on patients with anticipated difficult airways did not involve a direct view of the glottic opening? The authors emphasise the significantly reduced time to intubation using videolaryngoscopy compared with fibreoptic bronchoscopy, but we are unsure whether this is clinically relevant. In their accompanying editorial 2, Fitzgerald et al. suggest that the approximate mean reduction in time to intubation using videolaryngoscopy is only one minute. Given that operating lists should be scheduled to accomodate the length of time taken for awake intubation in patients with difficult airways, we question whether a time saving of one minute is of any advantage, particularly balanced against the concern we have raised about ‘blind’ intubations apparently occurring in 22% of cases when videolaryngoscopy is used." @default.
- W1863417691 created "2016-06-24" @default.
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- W1863417691 date "2015-06-09" @default.
- W1863417691 modified "2023-10-16" @default.
- W1863417691 title "Awake nasal intubation: were patients’ tracheas intubated ‘blindly’?" @default.
- W1863417691 cites W1972232503 @default.
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- W1863417691 doi "https://doi.org/10.1111/anae.13140" @default.
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