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Intubation Complication clinical trials

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NCT ID: NCT06401486 Not yet recruiting - Anesthesia Clinical Trials

DOuble-Lumen Intubation With VIdeolaryngoscopy

DoLVi
Start date: June 1, 2024
Phase: N/A
Study type: Interventional

Tracheal intubation (TI) is one of the fundamental and most recognized techniques in Anesthesiology, also essential in all units treating urgent pathology and critical patients. It involves advancing a tube through the vocal cords into the trachea to ventilate the patient. In thoracic surgery, it is often necessary to achieve lung isolation, ventilating only one lung while the operated lung remains collapsed and immobile. To achieve this, it is common to intubate the patient with a special tube: a double-lumen tube (DLT), larger than usual because it provides two ventilation channels, one for each lung. Tracheal intubation with a DLT presents some peculiarities: its larger size and stiffness make manipulation and orientation in the oropharynx difficult. It has a curve at its distal end (the bronchial lumen) designed to slide into the left or right main bronchus as needed. The fact that the DLT passes between the vocal cords does not ensure its proper placement and function. Therefore, DLT intubation requires practice and experience, both to slide it between the vocal cords and to position it properly. The classic technique for DLT intubation is "Direct Laryngoscopy" (DL). A traditional laryngoscope with a Macintosh blade is used to move the upper airway structures aside to allow direct visualization of the glottis. In recent years, to facilitate tracheal intubation, different videolaryngoscopes have appeared. A videolaryngoscope is a device similar to a traditional laryngoscope that allows, thanks to an image sensor located at its end, indirect visualization of the glottis on an integrated or external screen. There is strong evidence for the benefit of using a VL over traditional DL in single-tube intubation in adult patients. However, although the use of VL for DLT intubation is becoming more common, there are few studies with small sample sizes comparing VL to DL for DLT intubation, so the evidence of its advantages or disadvantages is of low quality. It could improve glottic exposure and the percentage of success on the first attempt, although there is a possibility of increased tube malposition incidence and delayed intubation. Therefore, Investigators propose a prospective, multicenter, randomized study comparing the traditional Macintosh blade laryngoscope (direct laryngoscopy) with the videolaryngoscope to facilitate orotracheal intubation with double-lumen tube in patients scheduled for thoracic surgery requiring lung isolation.

NCT ID: NCT06386757 Recruiting - Clinical trials for Intubation Complication

Comparison Between Nasal and Oropharyngeal Bleeding in Video Laryngoscopy and Direct Laryngoscopy for Nasal Intubation

Start date: March 1, 2024
Phase: N/A
Study type: Interventional

The objective of this study is to compare the effectiveness and safety of video laryngoscopy versus direct laryngoscopy for nasal intubation in patients with maxillofacial fractures regarding less bleeding to oral and nasal structures, quicker intubation times, increased success rates for first intubation attempts, fewer uses of the Magill forceps and the less need for cervical spine extension

NCT ID: NCT06360328 Recruiting - Intubation Clinical Trials

Success Rates of Video- vs. Direct Laryngoscopy for Endotracheal Intubation in Anesthesiology Residents: A Randomized Controlled Trial" (The JuniorDoc-VL-Trial)

JuniorDoc-VL
Start date: April 1, 2024
Phase: N/A
Study type: Interventional

Securing the airway through endotracheal intubation (ETI) is a fundamental skill for anaesthetists. It is used during surgery, in the intensive care unit, during periprocedural anaesthesia and in emergency medicine. The clinical relevance of airway management is demonstrated in particular by the fact that the main cause of serious anaesthesia-related complications lies in the area of airway management. increasing technological developments in recent years (e.g. video laryngoscopy [VL]) aim to reduce the complication rate in the area of airway management. however, there are currently a large number of VLs available, which differ massively in their application. Therefore, it is essential to systematically collect data and develop structured training in airway management, taking into account current technological developments.While endotracheal intubation is traditionally performed with a direct laryngoscope, indirect video laryngoscopy, with chip-based camera technology at its tip, has been introduced across the board in recent years and is now part of standard clinical and preclinical equipment. Doctors in advanced training are trained with a focus on direct laryngoscopy; the use of and training in indirect video laryngoscopy does not follow any standards; in addition, the decision as to which method of securing the airway is chosen has so far been the responsibility of the individual doctor in anaesthesiology, although there is a tendency for the VL to be associated with a higher success rate in the first intubation attempt, the so-called "first-pass success".The main aim of this clinical prospective, randomised controlled trial is to train anaesthetists in advanced training in conventional direct laryngoscopy on the one hand and indirect video laryngoscopy (VL) on the other, with a focus on tracking the progress of their skills after 200 intubations with regard to first-pass success.

NCT ID: NCT06327399 Recruiting - Dexmedetomidine Clinical Trials

Dexmedetomidine Infusion Dose Versus Rapid Bolus Dose Before Tracheal Intubation.

Start date: January 21, 2024
Phase: Phase 2
Study type: Interventional

Dexmedetomidine bolus dose may provide similar or less hemodynamic changes (less bradycardia and less hypertension) than infusion dose during induction of anaesthesia and tracheal intubation.

NCT ID: NCT06322719 Recruiting - Clinical trials for Acute Respiratory Failure

Hyperangulated vs Macintosh Blades for Intubation With Videolaryngoscopy in ICU

INVIBLADE
Start date: May 1, 2024
Phase: N/A
Study type: Interventional

Tracheal intubation in the intensive care unit (ICU) is associated with high incidence of difficult intubation and complications. Videolaryngoscopes (VLs) devices have been proposed to improve airway management, and the use of VLs are recommended as first-line or after a first-attempt failure using direct laryngoscopy in ICU airway management algorithms. Although until relatively few years ago there were doubts about whether videolaryngoscopes had advantages over direct laryngoscopy for endotracheal intubation (ETI) in critically ill patients, two recent studies (DEVICE (1), INTUBATE (2)), and a Cochrane review (3) have confirmed that videolaryn should be used?, and what is the best blade? . There are two types of blades commonly used with videolaryngoscopes: the "Macintosh" blade with a slight curvature, and hyperangulated blades. The "Macintosh" blades have a lower angle of vision, but they have the advantage of being similar to the blades commonly used in direct laryngoscopy, making them easy to use for the person performing the ETI. Hyperangulated blades have a greater angle of vision, improving glottic visualization, especially in patients with an anterior glottis. However, the need to overcome this angulation could potentially hinder the passage of the endotracheal tube to the vocal cords. It is unknown if either blade has any advantage for intubating critically ill patients.

NCT ID: NCT06297720 Not yet recruiting - Anesthesia Clinical Trials

Early Oral Hydration After Thoracoscopic Surgery

Start date: March 1, 2024
Phase: N/A
Study type: Interventional

The goal of this clinical trial is to learn about the safety and feasibility of early oral hydration in patients receiving video-assisted thoracoscopic surgery after general anesthesia. The main questions aims to answer: - the safety and feasibility of oral hydration supplementation in the recovery room following general anesthesia. - the degree of improvement in sore throat and dry mouth after oral hydration. - the side effects and risks of oral hydration supplementation, such as the incidence of postoperative nausea and vomiting. - the impact of oral hydration supplementation in the recovery room following general anesthesia on hemodynamics. - patient satisfaction with oral hydration supplementation in the recovery room following general anesthesia. Participants will receive a series of oral hydration from swab moistening, and ice cube hydration to water hydration in the recovery room. Researchers will compare with the standard, no-hydration group to see if it is safe and feasible to hydrate patients in the recovery room.

NCT ID: NCT06247969 Completed - Clinical trials for Intubation Complication

Cone Beam Computed Tomography For Appropriate Nostril Selection for Nasotracheal Intubation

Start date: December 19, 2023
Phase:
Study type: Observational

Design: Nasotracheal intubation is a standard blind procedure associated with various complications. Selection of the appropriate nostril is crucial in preventing most of these complications. The investigators aimed to evaluate the contribution of CBCT findings in selecting the proper nostril for nasotracheal intubation. Methods: This prospective observational study outlines the protocol for research conducted at the Selçuk University Faculty of Dentistry. Scope of the Research: The study encompasses patients undergoing dental surgery under general anesthesia at the Selçuk University Faculty of Dentistry. 1. Participant Selection: ASA I-II patients will be included in the study. Patients with structural abnormalities in the maxillo-mandibular anatomy, limited mouth opening, comorbidities such as rheumatoid arthritis, and a history of epistaxis will be excluded from the study. 2. Anesthesia Method: General anesthesia induction will be performed with intravenous (IV) propofol, IV rocuronium bromide, and IV fentanyl. Transition to nasotracheal intubation will follow adequate mask ventilation, and the preferred nostril will be determined through a simple occlusion test. 3. Data Collection: Demographic data, accompanying illnesses, medications used, and various parameters related to nasotracheal intubation will be recorded. The anesthetist performing nasotracheal intubation will be blinded to CBCT data, and the evaluation of data will be conducted jointly by the anesthetist and Radiology specialist after data collection from all patients is complete. 4. Exclusion Criteria: Unsuccessful nasotracheal intubation, difficult mask, and/or difficult intubation. 5. Implementation and Evaluation: Anesthesia procedures and CBCT evaluations will be carried out by experienced specialists. 6. The objective of this study is to evaluate the use of preoperative measurements of the nasal cavity from CBCT images in selecting the appropriate nostril for nasotracheal intubation under general anesthesia. The statistical tests to be employed are the chi-squared test and independent samples t-test.

NCT ID: NCT06232837 Not yet recruiting - Clinical trials for Intubation Complication

Macintosh Blade Size for Endotracheal Intubation in Operative Rooms

MacSize_OR
Start date: February 1, 2024
Phase:
Study type: Observational

Endotracheal intubation is a frequent procedure in the operating room but optimal Macintosh blade size remains unknown to date.

NCT ID: NCT06210867 Not yet recruiting - Clinical trials for Intubation Complication

Factors Associated With Occluding the Upper Esophagus by Paratracheal Force

Start date: February 27, 2024
Phase:
Study type: Observational

We aim to identify anatomical factors that affect upper esophageal occlusion during the application of paratracheal pressure.

NCT ID: NCT06139809 Recruiting - Clinical trials for Intubation Complication

Noninvasive Positive Pressure Ventilation During Neonatal Nasal Intubation

IntubAID
Start date: March 31, 2024
Phase: N/A
Study type: Interventional

The goal of this study is to perform a quality control assessment of our local intubation protocol in any newborn infant requiring endotracheal intubation in the delivery room or neonatal intensive care unit at the Department of Neonatology of the University Hospital Zurich. The primary aims are: - Successful nasal intubation at the first attempt without physiological instability. - Comparison of infants with successful intubation at the first attempt without physiological instability to the infants in the SHINE-Trial in Australia. Participants will be intubated according to our standard intubation procedure using non-invasive ventilation (NIV) delivered through a nasopharyngeal tube.