Use of the GlideScope for Airway Management in Patients with Craniofacial Anomalies
Notice bibliographique
Résumé
Sir: An estimated 40 to 50 million anesthetics are administered each year in North America alone and as many again worldwide. In up to half of the cases, it is necessary to intubate the patient for airway management. This can be challenging and dangerous in the pediatric population, and even more so in the child with significant craniofacial anomalies. The standard laryngoscope blade, in conjunction with maneuvers performed by the laryngoscopist to improve their view, is not always adequate to visualize the epiglottis and/or vocal cords. In recent years, a number of airway devices have been introduced. Some of these devices offer a definite advantage when confronted with a difficult pediatric airway. The GlideScope videolaryngoscope (Saturn Biomedical Systems, Inc., British Columbia, Canada) is a relatively new device designed by a surgeon for management of the airway and, more specifically, the difficult airway (Fig. 1). It is essentially a lightweight laryngoscope that incorporates micro-video technology. The approximate weight of the handpiece is 0.12 kg. The 60-degree angle on the laryngoscope blade of the GlideScope enables visualization of the endotracheal tube in its trajectory toward the glottic opening. The laryngoscope blade includes an integrated camera with an antifogging mechanism and has been designed and developed to make the insertion of the endotracheal tube safe, reliable, and easy. The view from the camera in the handpiece is transferred to a small display monitor. The image of the airway structures provided is clear and sharp and is a significant improvement when compared with those obtained with direct laryngoscopy.Fig. 1.: Monitor, Glidescope videolaryngoscope handpiece, and carrying case.The Glidescope videolaryngoscope provides an unquestionable advantage in the airway management of children with craniofacial anomalies. Pediatric anesthesiologists can benefit from such a device, especially when they are presented with a challenging airway. In addition, clinicians who teach airway management skills will recognize that this device is an invaluable teaching tool, since both teacher and trainee are able to visualize the complex and variable airway anatomy. To date at our institution, the GlideScope videolaryngoscope has been used in numerous pediatric craniofacial cases and in even more routine pediatric cases, with excellent results. In our experience, anesthesia residents as well as other trainees to the device quickly acquire the skills necessary for visualizing the larynx and passage of the endotracheal tube with limited assistance from the attending anesthesiologist. While the time needed for intubation is certainly decreased, the possibility of trauma to the airway is also lessened. Concerns regarding this device might include a reliance on the technology to the point where clinicians lose the ability to perform direct laryngoscopy. Therefore, we recommend its use as a complement to, but not a replacement for, the traditional method of intubation. The laryngoscopist should remain proficient at intubating patients with the standard laryngoscope blade, but also be comfortable using this new technology. In addition, while the cost of the GlideScope videolaryngoscope is greater than that of the traditional laryngoscope, its use may save healthcare dollars when one considers the savings from possible patient morbidity or mortality related to the airway. Of note, the authors have no financial arrangement with the makers of the GlideScope videolaryngoscope. Peter J. Taub, M.D. Lester Silver, M.D. Division of Plastic and Reconstructive Surgery Cheryl K. Gooden, M.D. Department of Anesthesiology Mount Sinai Medical Center New York, N.Y.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».