Videolaryngoscopy for Physician-Based, Prehospital Emergency Intubation: A Prospective, Randomized, Multicenter Comparison of Different Blade Types Using A.P. Advance, C-MAC System, and KingVision.

Background: Videolaryngoscopy is a valuable technique for endotracheal intubation. When used in the perioperative period, different videolaryngoscopes vary both in terms of technical use and intubation success rates. However, in the prehospital environment, the relative performance of different videolaryngoscopic systems is less well studied.

Improvement in glottic visualisation by using the C-MAC PM video laryngoscope as a first-line device for out-of-hospital emergency tracheal intubation: An observational study.

Background: Out-of-hospital tracheal intubation is associated with life-threatening complications. To date, no study has compared direct and video laryngoscopic views simultaneously in the same patients in an out-of-hospital setting.

Objectives: The aim of this study was to determine the effect of C-MAC PM video laryngoscope on laryngeal view, compared with direct laryngoscopy, and to estimate possible consequences for patient safety.

Airway management in pediatric patients using the Glidescope Cobalt®: a feasibility study.

Background: Video laryngoscopes are claimed to improve airway management. Several studies showed an equal or better glottic view using the Glidescope® compared with direct laryngoscopy in adults and in paediatric patients. Many case reports also described successful intubation in patients with a difficult airway.

The C-MAC videolaryngoscope for prehospital emergency intubation: a prospective, multicentre, observational study.

Background: In this preliminary prospective observational study at four physician-led air rescue centres, the efficacy of the C-MAC (Karl Storz, Tuttlingen, Germany), a new portable videolaryngoscope, was evaluated during prehospital emergency endotracheal intubations.

Methods: 80 consecutive patients requiring prehospital emergency intubation, treated by a physician introduced in the use of the C-MAC were enrolled in this study.

Results: Indication for prehospital intubation was trauma in 45 cases (including maxillo-facial trauma in 10 cases), cardiopulmonary resuscitation in 14 cases, and unconsciousness of neurological aetiology and cardiogenic dyspnoea in 21 cases.

A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesia.

Background: The C-MAC® (Karl Storz, Tuttlingen, Germany) has recently been introduced as a new device for videolaryngoscopy guided intubation. The purpose of the present study was to compare for the first time the C-MAC with conventional direct laryngoscopy in 150 patients during routine induction of anaesthesia.

Methods: After approval of the institutional review board and written informed consent, 150 patients (ASA I-III) with general anaesthesia were enrolled.

First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation.

In the present preliminary study we evaluated the C-MAC® D-Blade (Karl Storz, Tuttlingen, Germany), a new videolaryngoscopic C-MAC blade for difficult intubation, during both routine and difficult intubations. First, both the conventional direct laryngoscopy and the D-Blade were used in 15 consecutive patients with normal airways during routine induction of anesthesia. Second, the D-Blade was used as a rescue device in 20 of 300 (6.

Effects of cerebral hypoperfusion on bispectral index: a randomised, controlled animal experiment during haemorrhagic shock.

Background: The aim of this porcine haemorrhagic shock model was to investigate the changes of bispectral index (BIS) after slow and fast recovery of cerebral perfusion, and its correlation with plasma propofol concentrations.

Methods: After Animal Investigational Committee approval, 16 pigs during propofol anaesthesia underwent a liver trauma with severe hypotension, and were randomly assigned to receive therapy for either slow recovery (fluid resuscitation; slow group; n=8) or fast recovery of cerebral perfusion (vasopressor combined with hypertonic-saline-starch; fast group; n=8), respectively. Cerebral perfusion pressure (CPP=MAP-ICP), cerebral tissue oxygenation index (TOI), BIS, and plasma concentrations of propofol and haemoglobin were measured at baseline (Pre-shock), haemodynamic decompensation (Shock), and 5 (Therapy) and 30 min (End) after therapy, respectively.

Laryngeal tube S II, laryngeal tube S disposable, Fastrach laryngeal mask and Fastrach laryngeal mask disposable during elective surgery: a randomized controlled comparison between reusable and disposable supraglottic airway devices.

Background And Objective: Analogue disposable devices of the laryngeal tube S II (LTS II) and the Fastrach laryngeal intubation mask (ILMA, Fastrach), namely the laryngeal tube disposable (LTS-D) and the Fastrach laryngeal intubation mask disposable (Fastrach-D), have recently been introduced. The purpose of this study was to compare each reusable device with the corresponding disposable one, during routine surgery.

Methods: After informed consent, 120 American Society of Anesthesiologists I-III patients scheduled for routine minor surgery were randomly allocated to the LTS II (n = 30), the LTS-D (n = 30), the Fastrach (n = 30) and the Fastrach-D (n = 30) groups, respectively.

The C-MAC videolaryngoscope: first experiences with a new device for videolaryngoscopy-guided intubation.

We studied the efficacy of the C-MAC (Karl Storz, Tuttlingen, Germany), a new portable videolaryngoscope, in 60 patients during routine induction of anesthesia. It was possible to insert the blade (Size 3) of the C-MAC and to get a view of the glottis on the first attempt in all patients. Tracheal intubation also was successful in all 60 patients; 52 patients were intubated on the first attempt, 6 on the second, and 2 on the third.

A comparison of the i-gel with the LMA-Unique in non-paralysed anaesthetised adult patients.

This study assessed two disposable devices; the newly developed supraglottic airway device i-gel and the LMA-Unique in routine clinical practice. Eighty patients (ASA 1-3) undergoing minor routine gynaecologic surgery were randomly allocated to have an i-gel (n = 40) or LMA-Unique (n = 40) inserted. Oxygen saturation, end-tidal carbon dioxide, tidal volume and peak airway pressure were recorded, as well as time of insertion, airway leak pressure, postoperative sore-throat, dysphonia and dysphagia for each device.

Laryngeal tube S II, ProSeal laryngeal mask, and EasyTube during elective surgery: a randomized controlled comparison with the endotracheal tube in nontrained professionals.

Background And Objective: EasyTube (EZT), ProSeal laryngeal mask airway (PLMA), and Laryngeal tube S II (LTS II) have recently been introduced as supraglottic airway devices and have been proposed as emergency airway alternatives. The purpose of this study was to compare the performance of the three devices, if used by anaesthesiologists without extensive hands-on training, with the endotracheal tube during routine surgical procedures.

Methods: After informed consent, 88 ASA I-II patients scheduled for routine minor surgery were randomly allocated to EZT (n=22), PLMA (n=22), and LTS II (n=22) groups and the endotracheal tube (n=22) group, respectively.

Cerebral effects of three resuscitation protocols in uncontrolled haemorrhagic shock: a randomised controlled experimental study.

Background: To compare haemodynamic and cerebral variables during aggressive fluid resuscitation vs. administration of a hypertonic starch solution (HS) combined with either noradrenaline [norepinephrine] or arginine vasopressin in an animal model of uncontrolled haemorrhagic shock.

Methods: After Animal Investigational Committee approval, 24 anaesthetised pigs underwent a liver trauma.

Neurochemical monitoring using intracerebral microdialysis during systemic haemorrhage.

Background: Intracerebral microdialysis is a sensitive tool to analyse tissue biochemistry, but the value of this technique to monitor cerebral metabolism during systemic haemorrhage is unknown. The present study was designed to assess changes of intracerebral microdialysis parameters both during systemic haemorrhage and after initiation of therapy.

Methods: Following approval of the Animal Investigational Committee, 18 healthy pigs underwent a penetrating liver trauma.

The reliability of pulse contour-derived cardiac output during hemorrhage and after vasopressor administration.

Background: Reliable measurement of cardiac output (CO) is important in the critically ill. Pulse contour-derived CO (PCCO) has been evaluated during stable hemodynamics, but is sensitive to changes in vascular tone and has not been validated under conditions of changing hemodynamics. Furthermore, PCCO requires calibration for the individual vascular impedance by transpulmonary thermodilution CO (TPCO), and the required frequency of recalibration to maintain accurate measurements, especially during changing conditions, has not been confirmed.

Comparison of LMA Unique, Ambu laryngeal mask and Soft Seal laryngeal mask during routine surgical procedures.

Background And Objective: This study was performed to compare three disposable airway devices, the LMA Unique (LMA-U), the Ambu laryngeal mask (Ambu LM) and the Soft Seal laryngeal mask (Soft Seal LM) for elective general anaesthesia during controlled ventilation in non-paralysed patients.

Methods: One hundred and twenty ASA I-III patients scheduled for routine minor obstetric surgery were randomly allocated to the LMA-U (n = 40), Ambu LM (n = 40) or Soft Seal LM (n = 40) groups, respectively. Patients were comparable with respect to weight and airway characteristics.

Heart rate variability-guided prophylactic treatment of severe hypotension after subarachnoid block for elective cesarean delivery.

Background: Baseline low-to-high frequency ratio (LF/HF) of heart rate variability predicted hypotension after subarachnoid block (SAB). LF/HF-guided treatment of hypotension with vasopressors or colloids was investigated.

Methods: In 80 women scheduled to undergo cesarean delivery during SAB, LF/HF and systolic blood pressure (SBP) were analyzed.

A comparison of transcranial Doppler with near infrared spectroscopy and indocyanine green during hemorrhagic shock: a prospective experimental study.

Introduction: The present study was designed to compare cerebral hemodynamics assessed using the blood flow index (BFI) derived from the kinetics of the tracer dye indocyanine green (ICG) with transcranial Doppler ultrasound (TCD) in an established model of hemorrhagic shock.

Methods: After approval from the Animal Investigational Committee, 20 healthy pigs underwent a simulated penetrating liver trauma. Following hemodynamic decompensation, all animals received a hypertonic-isooncotic hydroxyethyl starch solution and either arginine vasopressin or norepinephrine, and bleeding was subsequently controlled.

Smaller tidal volumes during cardiopulmonary resuscitation: comparison of adult and paediatric self-inflatable bags with three different ventilatory devices.

Gastric inflation and subsequent regurgitation of stomach contents is a major hazard of bag-valve-face mask ventilation during the basic life support phase of cardiopulmonary resuscitation (CPR). Recent investigations suggested that use of a paediatric self-inflating bag may reduce stomach inflation while ensuring sufficient lung ventilation. The purpose of our study was to examine whether use of a paediatric self-inflating bag in association with laryngeal mask airway, combitube, and bag-valve-face mask may provide adequate lung ventilation, while reducing the risk of gastric inflation in a bench model simulating the initial phase of CPR.

A comparison of the cuffed oropharyngeal airway (COPA) with the laryngeal mask airway (LMA) during manually controlled positive pressure ventilation.

Study Objective: To examine the cuffed oropharyngeal airway (COPA) during positive pressure ventilation (PPV) and to compare its reliability and efficacy with the laryngeal mask airway (LMA).

Design: Prospective, randomized, controlled trial.

Setting: University Hospital.

Airway management during cardiopulmonary resuscitation--a comparative study of bag-valve-mask, laryngeal mask airway and combitube in a bench model.

Gastric inflation and subsequent regurgitation are a potential risk of ventilation during cardiopulmonary resuscitation (CPR). In respect of recent investigations, principal respiratory components such as respiratory system compliance, resistance and lower esophageal sphincter pressure were adapted according to CPR situations. The purpose of our study was to assess lung ventilation and gastric inflation when performing ventilation with bag-valve-mask, laryngeal mask airway, and combitube in a bench model simulating an unintubated cardiac arrest patient.