Clinical Medicine Research

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Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients

Received: 17 June 2018    Accepted: 29 August 2018    Published: 28 September 2018
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Abstract

Background: Emergency airway management outside operating room (OR) is associated with a higher incidence of difficult intubations. The Shikani optical stylet (SOS) has been shown to improve first-attempt success rates compared with the classic Macintosh laryngoscope (ML) in patients with difficult airway inside the operating room (OR). Objective: In this randomized controlled clinical trial, the effectiveness of using a SOS as the primary intubation device was assessed during urgent endotracheal intubations (UEI) in conscious, critically ill patients outside the OR. Method: Sixty conscious critically ill patients from May 2018 to March 2018 were randomly assigned to undergoing intubation guided by the SOS (group S, n = 30) or the Macintosh laryngoscope (group M, n = 30) in ChanCheng Center Hospital,. After application of airway topical anesthesia and intravenous sedatives, endotracheal intubations were performed. The primary measured outcome was first-attempt intubation success rate. Secondary outcomes included ultimate success, the number of attempts, the duration of intubation, and the adverse effects or complications of intubation. Result: The rate of successful intubation at the first-attempt was superior with the SOS as compared with the ML (93.3% vs 63.3%, P = 0.005), the average number of attempts required for successful tracheal intubation (1.0 ± 0.3 vs 1.5 ± 0.8, P = 0.004), the duration of intubation (18.8 ± 11.9 vs 26.8 ± 15.6, P = 0.028), and the incidences of hemorrhage in the oropharyngeal mucosa (0 vs 28.6%, P = 0.006) were all improved significantly with use of the SOS compared with the ML. Conclusion: This study suggested SOS could be used as the effective device when UEIs are performed by experienced operators in conscious, critically ill patients outside the operating room.

DOI 10.11648/j.cmr.20180704.11
Published in Clinical Medicine Research (Volume 7, Issue 4, July 2018)
Page(s) 84-91
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Airway Management, Intubation, Intratracheal, Critical Illness, Laryngoscope, Optical Stylet

References
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Author Information
  • Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China

  • Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China

  • Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China

  • Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China

Cite This Article
  • APA Style

    Zhipeng Li, Meirong Wang, Qiong Wang, Chuiliang Liu. (2018). Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients. Clinical Medicine Research, 7(4), 84-91. https://doi.org/10.11648/j.cmr.20180704.11

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    ACS Style

    Zhipeng Li; Meirong Wang; Qiong Wang; Chuiliang Liu. Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients. Clin. Med. Res. 2018, 7(4), 84-91. doi: 10.11648/j.cmr.20180704.11

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    AMA Style

    Zhipeng Li, Meirong Wang, Qiong Wang, Chuiliang Liu. Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients. Clin Med Res. 2018;7(4):84-91. doi: 10.11648/j.cmr.20180704.11

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  • @article{10.11648/j.cmr.20180704.11,
      author = {Zhipeng Li and Meirong Wang and Qiong Wang and Chuiliang Liu},
      title = {Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients},
      journal = {Clinical Medicine Research},
      volume = {7},
      number = {4},
      pages = {84-91},
      doi = {10.11648/j.cmr.20180704.11},
      url = {https://doi.org/10.11648/j.cmr.20180704.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cmr.20180704.11},
      abstract = {Background: Emergency airway management outside operating room (OR) is associated with a higher incidence of difficult intubations. The Shikani optical stylet (SOS) has been shown to improve first-attempt success rates compared with the classic Macintosh laryngoscope (ML) in patients with difficult airway inside the operating room (OR). Objective: In this randomized controlled clinical trial, the effectiveness of using a SOS as the primary intubation device was assessed during urgent endotracheal intubations (UEI) in conscious, critically ill patients outside the OR. Method: Sixty conscious critically ill patients from May 2018 to March 2018 were randomly assigned to undergoing intubation guided by the SOS (group S, n = 30) or the Macintosh laryngoscope (group M, n = 30) in ChanCheng Center Hospital,. After application of airway topical anesthesia and intravenous sedatives, endotracheal intubations were performed. The primary measured outcome was first-attempt intubation success rate. Secondary outcomes included ultimate success, the number of attempts, the duration of intubation, and the adverse effects or complications of intubation. Result: The rate of successful intubation at the first-attempt was superior with the SOS as compared with the ML (93.3% vs 63.3%, P = 0.005), the average number of attempts required for successful tracheal intubation (1.0 ± 0.3 vs 1.5 ± 0.8, P = 0.004), the duration of intubation (18.8 ± 11.9 vs 26.8 ± 15.6, P = 0.028), and the incidences of hemorrhage in the oropharyngeal mucosa (0 vs 28.6%, P = 0.006) were all improved significantly with use of the SOS compared with the ML. Conclusion: This study suggested SOS could be used as the effective device when UEIs are performed by experienced operators in conscious, critically ill patients outside the operating room.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients
    AU  - Zhipeng Li
    AU  - Meirong Wang
    AU  - Qiong Wang
    AU  - Chuiliang Liu
    Y1  - 2018/09/28
    PY  - 2018
    N1  - https://doi.org/10.11648/j.cmr.20180704.11
    DO  - 10.11648/j.cmr.20180704.11
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 84
    EP  - 91
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20180704.11
    AB  - Background: Emergency airway management outside operating room (OR) is associated with a higher incidence of difficult intubations. The Shikani optical stylet (SOS) has been shown to improve first-attempt success rates compared with the classic Macintosh laryngoscope (ML) in patients with difficult airway inside the operating room (OR). Objective: In this randomized controlled clinical trial, the effectiveness of using a SOS as the primary intubation device was assessed during urgent endotracheal intubations (UEI) in conscious, critically ill patients outside the OR. Method: Sixty conscious critically ill patients from May 2018 to March 2018 were randomly assigned to undergoing intubation guided by the SOS (group S, n = 30) or the Macintosh laryngoscope (group M, n = 30) in ChanCheng Center Hospital,. After application of airway topical anesthesia and intravenous sedatives, endotracheal intubations were performed. The primary measured outcome was first-attempt intubation success rate. Secondary outcomes included ultimate success, the number of attempts, the duration of intubation, and the adverse effects or complications of intubation. Result: The rate of successful intubation at the first-attempt was superior with the SOS as compared with the ML (93.3% vs 63.3%, P = 0.005), the average number of attempts required for successful tracheal intubation (1.0 ± 0.3 vs 1.5 ± 0.8, P = 0.004), the duration of intubation (18.8 ± 11.9 vs 26.8 ± 15.6, P = 0.028), and the incidences of hemorrhage in the oropharyngeal mucosa (0 vs 28.6%, P = 0.006) were all improved significantly with use of the SOS compared with the ML. Conclusion: This study suggested SOS could be used as the effective device when UEIs are performed by experienced operators in conscious, critically ill patients outside the operating room.
    VL  - 7
    IS  - 4
    ER  - 

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