Dataset Information

In which clinical scenario would awake fibreoptic nasal intubation be employed?

ABSTRACT:

Key clinical message

The routine way to access the uncomplicated airway is via direct laryngoscopy. When this is not possible, there are a number of other techniques to help visualization such as the video laryngoscopy. These require a degree of mouth opening. With almost complete trismus, the clinician should resort to awake fibreoptic nasal intubation to secure the airway.

SUBMITTER: Kassam K

PROVIDER: S-EPMC4184772 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

In which clinical scenario would awake fibreoptic nasal intubation be employed?

Kassam Karim K Rope Tasmin T

Clinical case reports 20140113 1

<h4>Key clinical message</h4>The routine way to access the uncomplicated airway is via direct laryngoscopy. When this is not possible, there are a number of other techniques to help visualization such as the video laryngoscopy. These require a degree of mouth opening. With almost complete trismus, the clinician should resort to awake fibreoptic nasal intubation to secure the airway. ...[more]

PMID: 25356235

Similar Datasets

Project description:BACKGROUND:The benefits of high-flow nasal cannula (HFNC) as primary intervention in patients with acute hypoxemic respiratory failure (AHRF) are still a matter in debate. Our objective was to compare HFNC therapy versus conventional oxygen therapy (COT) in the prevention of endotracheal intubation in this group of patients. METHODS:An open-label, controlled and single-centre clinical trial was conducted in patients with severe AHRF, defined by a PaO2/FIO2 ratio ?200, to compare HFNC with a control group (CG) treated by COT delivered through a face mask, with the need to perform intubation as the primary outcome. The secondary outcomes included tolerance of the HFNC device and to look for the predictive factors for intubation in these patients. RESULTS:A total of 46 patients were included (22 in the COT group and 24 in the HFNC group) 48% of whom needed intubation: 63% in the COT group and 33% in the HFNC group, with significant differences both in intention to treat [?2?=?4.2; p?=?0.04, relative risk (RR)?=?0.5; confidence interval (CI) 95%: 0.3-1.0] and also in treatment analysis (?2?=?4.7; p?=?0.03; RR?=?0.5; IC 95%: 0.3-0.9) We obtained a number needed to treat (NNT)?=?3 patients treated to avoid an intubation. Intubation occurred significantly later in the HFNC group. Estimated PaO2/FIO2, respiratory rate and dyspnea were significantly better in the HFNC group. Patients treated with HFNC who required intubation presented significant worsening after the first 8?h, as compared with non-intubated HFNC group patients. Mortality was 22% with no differences. The HFNC group patients were hospitalized for almost half of the time in the intensive care unit (ICU) and in the ward, with significantly less hospital length of stay. A total of 14 patients in the HFNC group (58%) complained of excessive heat and 17% of noise; 3 patients did not tolerate HFNC. CONCLUSION:Patients with severe acute hypoxemic respiratory failure who tolerate HFNC present a significantly lower need for endotracheal intubation compared with conventional oxygen therapy. CLINICAL TRIAL REGISTER:EUDRA CT number: 2012-001671-36The reviews of this paper are available via the supplemental material section.

Dataset Information

In which clinical scenario would awake fibreoptic nasal intubation be employed?

Key clinical message

Publications

In which clinical scenario would awake fibreoptic nasal intubation be employed?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets