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Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike
BACKGROUND: Efficient airway management to facilitate tracheal intubation encompasses essential skills in anaesthesiologic and intensive care. The application of flexible fibreoptic intubation in patients with difficult airways has been identified as the recommended method in various international g...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430093/ https://www.ncbi.nlm.nih.gov/pubmed/32807106 http://dx.doi.org/10.1186/s12871-020-01127-2 |
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author | Ruemmler, Robert Ziebart, Alexander Ott, Thomas Dirvonskis, Dagmar Hartmann, Erik Kristoffer |
author_facet | Ruemmler, Robert Ziebart, Alexander Ott, Thomas Dirvonskis, Dagmar Hartmann, Erik Kristoffer |
author_sort | Ruemmler, Robert |
collection | PubMed |
description | BACKGROUND: Efficient airway management to facilitate tracheal intubation encompasses essential skills in anaesthesiologic and intensive care. The application of flexible fibreoptic intubation in patients with difficult airways has been identified as the recommended method in various international guidelines. However, providing the opportunity to adequately train residents can be challenging. Using large animals for practice during ongoing studies could help to improve this situation, but there is no recent data on fibreoptic intubation in swine available. METHODS: Thirty male German landrace pigs were anesthetized, instrumented and randomized into two groups. The animals were either intubated conventionally using direct laryngoscopy or a single-use flexible video-endoscope. The intervention was carried out by providers with 3 months experience in conventional intubation of pigs and a brief introduction into endoscopy. Intubation attempts were supervised and aborted, when SpO2 dropped below 93%. After three failed attempts, an experienced supervisor intervened and performed the intubation. Intubation times and attempts were recorded and analysed. RESULTS: Flexible fibreoptic intubation showed a significantly higher success rate in first attempt endotracheal tube placement (75% vs. 47%) with less attempts overall (1.3 ± 0.6 vs. 2.1 ± 1.3, P = 0.043). Conventional intubation was faster (42 s ± 6 s vs. 67 s ± 10s, P < 0.001), but showed a higher complication rate and more desaturation episodes during the trial. CONCLUSIONS: Flexible fibreoptic intubation in swine is feasible and appears to be a safer and more accessible method for inexperienced users to learn. This could not only improve resident training options in hospitals with animal research facilities but might also prevent airway complications and needless animal suffering. |
format | Online Article Text |
id | pubmed-7430093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74300932020-08-17 Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike Ruemmler, Robert Ziebart, Alexander Ott, Thomas Dirvonskis, Dagmar Hartmann, Erik Kristoffer BMC Anesthesiol Research Article BACKGROUND: Efficient airway management to facilitate tracheal intubation encompasses essential skills in anaesthesiologic and intensive care. The application of flexible fibreoptic intubation in patients with difficult airways has been identified as the recommended method in various international guidelines. However, providing the opportunity to adequately train residents can be challenging. Using large animals for practice during ongoing studies could help to improve this situation, but there is no recent data on fibreoptic intubation in swine available. METHODS: Thirty male German landrace pigs were anesthetized, instrumented and randomized into two groups. The animals were either intubated conventionally using direct laryngoscopy or a single-use flexible video-endoscope. The intervention was carried out by providers with 3 months experience in conventional intubation of pigs and a brief introduction into endoscopy. Intubation attempts were supervised and aborted, when SpO2 dropped below 93%. After three failed attempts, an experienced supervisor intervened and performed the intubation. Intubation times and attempts were recorded and analysed. RESULTS: Flexible fibreoptic intubation showed a significantly higher success rate in first attempt endotracheal tube placement (75% vs. 47%) with less attempts overall (1.3 ± 0.6 vs. 2.1 ± 1.3, P = 0.043). Conventional intubation was faster (42 s ± 6 s vs. 67 s ± 10s, P < 0.001), but showed a higher complication rate and more desaturation episodes during the trial. CONCLUSIONS: Flexible fibreoptic intubation in swine is feasible and appears to be a safer and more accessible method for inexperienced users to learn. This could not only improve resident training options in hospitals with animal research facilities but might also prevent airway complications and needless animal suffering. BioMed Central 2020-08-17 /pmc/articles/PMC7430093/ /pubmed/32807106 http://dx.doi.org/10.1186/s12871-020-01127-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Ruemmler, Robert Ziebart, Alexander Ott, Thomas Dirvonskis, Dagmar Hartmann, Erik Kristoffer Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
title | Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
title_full | Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
title_fullStr | Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
title_full_unstemmed | Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
title_short | Flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
title_sort | flexible fibreoptic intubation in swine – improvement for resident training and animal safety alike |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430093/ https://www.ncbi.nlm.nih.gov/pubmed/32807106 http://dx.doi.org/10.1186/s12871-020-01127-2 |
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