BACKGROUND: Double-lumen tube (DLT) intubation in lateral decubitus position is rarely reported. We designed this study to evaluate the feasibility of VivaSight double-lumen tube (VDLT) intubation assisted by video laryngoscope in lateral decubitus patients.
METHODS: Patients undergoing elective video-assisted thoracoscopic surgery (VATS) for lung lobectomy were assessed for eligibility between January 2022 and December, 2022. Eligible patients were randomly allocated into supine intubation group (group S) and lateral intubation group (group L) by a computer-generated table of random numbers. The prime objective was to observe whether the success rate of VDLT intubation in lateral position with the aid of video laryngoscope was not inferior to that in supine position.
RESULTS: A total of 116 patients were assessed, and 88 eligible patients were randomly divided into group L (n = 44) and group S (n = 44). The success rate of the first attempt intubation in the L group was 90.5%, lower than that of S group (97.7%), but there was no statistical difference (p > 0.05). Patients in both groups were intubated with VDLT for no more than 2 attempts. The mean intubation time was 91.98 ± 26.70 s in L group, and 81.39 ± 34.35 s in S group (p > 0.05). The incidence of the capsular malposition in the group L was 4.8%, less than 36.4% of group S (p < 0.001). After 24 h of follow-up, it showed a higher incidence of sore throat in group S, compared to that in group L (p = 0.009).
CONCLUSIONS: Our study shows the comprehensive success rate of intubation in lateral decubitus position with VDLT assisted by video laryngoscope is not inferior to that in supine position, with less risk of intraoperative tube malposition and postoperative sore throat.
BACKGROUND: Chinese Clinical Trail Register (ChiCTR2200062989).

OBJECTIVE: To retrospectively analyze the influence of nursing cooperation on complications and quality of life (QoL) in patients with video laryngoscope-guided orotracheal intubation in a lateral decubitus position (LDP).
METHODS: A total of 130 patients with orotracheal intubation under general anesthesia in LDP from January 2020 to December 2021 were included and grouped based on the nursing model they received, with 65 patients receiving routine nursing cooperation during operation being included in a control group (the Con), and 65 patients receiving comprehensive nursing cooperation on the basis of the Con being included in an observation group (the Obs). The effect of the two nursing intervention models on acute pressure ulcer degree, complications, doctor-patient satisfaction, duration and area of pressure injury, nursing costs, and QoL were compared.
RESULTS: The incidence of intraoperative acute pressure injury differed significantly between the Obs (3.08%) and the Con (21.54%) (P<0.05). The Obs also showed lower incidences of complications such as pressure injury, limb swelling, limb numbness and muscle soreness than the Con did (P<0.05). The satisfaction of nurses, patients, anesthesiologists and surgeons in the Obs group were all 100.00%, which was higher than those in the Con (93.85%, 89.23%, 92.31% and 90.77%, respectively). Patients in the Obs had shorter duration of pressure injury, smaller pressure injury area and less nursing cost (P<0.05). After nursing, the scores of social/physical functioning, vitality, role-emotional/physical, mental health, and bodily pain were all better in the Obs than in the Con (P<0.05).
CONCLUSIONS: The implementation of comprehensive nursing cooperation for patients with video laryngoscope-guided orotracheal intubation in LDP can reduce the incidence of complications, lower the degree of acute pressure injury, improve doctor-patient satisfaction, and enhance the QoL of patients.

Visualization techniques and artificial intelligence (AI) are currently used for intubation device. By providing airway visualization during tracheal intubation, the technologies provide safe and accurate access to the trachea. The ability of AI to automatically identify airways from images of intubation device makes it attractive for use in intubation devices. The purpose of this review is to introduce the state of application of visualization techniques and AI in certain intubation devices. We reviewed the evidence of clinical implications of the use of video-assisted intubation device in the intubation time, first attempt success rate, and intubation of the difficult airway. Especially, VivaSight single-lumen tube with an incorporated optics allows direct viewing of the airway. VivaSight single-lumen tube has more advantages in tracheal intubation. AI has been applied to fiberoptic bronchoscopy (FOB) and video laryngoscope with automatic airway image recognition, and has achieved certain accomplishment. Further, we discussed the possibility of applying AI to the VivaSight single-lumen tube and proposed future directions of research and application.

BACKGROUND: To verify a test prototype of a novel flexible video laryngoscope in a difficult airway management simulator and to compare the efficacy of the flexible video laryngoscope with that of a conventional video laryngoscope.
METHODS: Fifteen clinical anesthesiologists performed endotracheal intubation with a flexible video laryngoscope and a conventional video laryngoscope in a difficult airway management simulator in the neutral position with intermediate and difficult mouth opening. The rate of intubation success, intubation time, and classification of glottic exposure were recorded. After endotracheal intubation, participants were asked to assess the difficulty of intubation of the two laryngoscopes.
RESULTS: The success rate of endotracheal intubation with flexible video laryngoscope was significantly higher than that with video laryngoscope in neutral positions with both intermediate (P = 0.025) and difficult (P = 0.005) mouth opening. The Cormack Lehane score of the flexible video laryngoscope was significantly lower than that of the video laryngoscope in the neutral position with intermediate mouth opening (P < 0.001) and difficult mouth opening (P < 0.001). There was no significant difference in intubation time in the neutral position with intermediate mouth opening (P = 0.460) or difficult mouth opening (P = 0.078). The difficulty score of endotracheal intubations with the flexible video laryngoscope was also significantly lower than that of the video laryngoscope in the neutral position with intermediate mouth opening (P = 0.001) and difficult mouth opening (P = 0.001).
CONCLUSIONS: Compared with conventional video laryngoscopy, flexible video laryngoscopy can provide superior glottic exposure and improve the success rate of intubation in a difficult airway management simulator.

OBJECTIVE: The objective of this work was to anatomically locate the urethral orifice in female minipigs and describe the use of video laryngoscopes in urethral catheterization.
METHODS: Urethral catheterization guided by a video laryngoscope was attempted in 16 adult female Bama minipigs. The anatomical location of urethral orifices, operating time and complications (mucosal edema and bleeding in the vaginal vestibule, and the numbers of red blood cells (RBCs) and white blood cells (WBCs) in mid-stream urine samples) were recorded.
RESULTS: The anatomical location of the urethral orifice: the depth of the urethral orifice in female Bama minipigs was 4.2 ± 1.2 cm; all the urethral orifices were covered by mucosal folds of the vaginal vestibule. In the supine position, the orifice of the urethra at 9-12 and 1-3 o\'clock accounted for 6.25%, 6.25%, 18.75%, 50%, 12.5%, 6.25% and 6.25%, respectively. All animals were successfully catheterized and the operating time was 9.0 (6.0-12.8) min. Complications: no bleeding in the vaginal vestibule was observed; the incidence of mucosal edema was 12.5%, all of which were mild; of urine samples collected 1 h after catheterization, 12.5% were found to contain RBCs and no RBCs were detected 6 h after catheterization; no WBCs were detected 1 h or 6 h after catheterization.
CONCLUSIONS: The urethral orifice of female minipigs was located deep in the vagina at variable clock directions and was unexceptionally covered by mucosal folds. Applying a video laryngoscope in urethral catheterization allowed quick and accurate exposure of the urethral orifice and minimal operational injury in female minipigs.

Although video laryngoscopy solves the problem of glottis exposure, it is difficult to deliver the tube to the glottic opening when the tracheal tube is unevenly shaped. This study aimed to compare the effects of different tube shapes on the first-pass success (FPS) rate in patients undergoing video laryngoscopy-assisted tracheal intubation. Three hundred patients above 18 years of age who underwent general anaesthesia and required endotracheal intubation were included in the study. The participants were randomly allocated to three groups with 100 participants in each group as follows: Group A, video laryngoscopes with a self-equipped stylet are used for tube preshaping; Group B: curvature of the video laryngoscope blade is modelled for tube preshaping; Group C: tube preshaping angle is consistent with the video laryngoscope blade, and the bending point is set 1 cm above the tracheal tube cuff. The primary outcome was FPS rates. The secondary outcomes included time to tracheal intubation, haemodynamic responses and adverse events. No significant differences in patient characteristics or airway assessments were noted (P > 0.05). Compared with Groups A, Group B and Group C exhibited a higher FPS rate (68% vs. 86% vs. 92%; P < 0.001). However, there is no significant difference in FPS rate between Group B and Group C (P > 0.05). And the time to tracheal intubation in Group C was significantly less than that in Group A and Group B (22.21 ± 4.01 vs. 19.92 ± 4.11 vs. 17.71 ± 3.47; P < 0.001). The straight-to-cuff stylet preshape angulation of curvature of the blade could provide a higher FPS rate and shorter time to tracheal intubation during video laryngoscopy-assisted endotracheal intubation. Trial registration: Chinese Clinical Trial Registry, ChiCTR1900026019.

UNASSIGNED: Up-to-date technology has been increasingly useful for learning resuscitation skills in the emergency and resuscitation settings. It improves the learning curve of the learners and helps them to avoid making mistakes on real patients. This study aimed to evaluate the educational efficiency for tracheal intubation by comparing Macintosh (direct) laryngoscope (DL) and video laryngoscope (VL) learning in novices.
UNASSIGNED: This prospective randomized controlled study was conducted in an emergency department between 2013 and 2014. Fifth- and sixth-year medical students were enrolled and assigned to normal airway and difficult airway groups, respectively. They were then further randomized into using a VL or DL for tracheal intubation learning. Participants had three practices before proceeding to the post-course assessment. Our primary outcome was post-course assessment performance, which included intubation success rate, total intubation time and best glottic view. The secondary outcome was the sum of total intubation learning times during the three practices.
UNASSIGNED: We recruited 177 undergraduate students. Of these, 97 were assigned to the normal airway group (49 VL and 48 DL) and 80 were placed in the difficult airway group (40 each for VL and DL). VL significantly quickened the intubation learning time in both the normal airway and difficult airway groups (140 s vs. 158 s, 141 s vs. 221.5 s; both p < 0.05). The learning curve was much improved with VL when compared using time-to-event analysis (p < 0.001). VL also improved the glottic view performance during post-course assessments.
UNASSIGNED: VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.

OBJECTIVE: This study was designed to explore the clinical application of video laryngoscopy in the diagnosis and treatment of throat foreign bodies (FBs).
METHODS: In total, 1572 patients diagnosed with throat FBs at the Department of Otolaryngology of Nanjing Drum Tower Hospital were retrospectively analysed. The covariables collected were the time from FB ingestion to admission, age, sex, duration of admission, and site of impaction.
RESULTS: The most common FBs were fish bones, which accounted for 1446 (91.98%) of 1572 FBs. Among all 1572 FBs, 1004 (63.87%) were successfully removed by video laryngoscopy without complications. A shorter duration of admission was associated with a higher diagnostic rate under video laryngoscopy. The diagnostic rate of sharp FBs was significantly higher than that of non-sharp FBs. The most common sites of throat FBs were the tongue root (42.29%), epiglottic vallecula (19.40%), tonsil (18.21%), and piriform fossa (10.65%).
CONCLUSIONS: Video laryngoscopy is a powerful tool for the diagnosis and treatment of throat FBs, allowing for identification of rare locations of FBs as well as refractory FBs.

暂无摘要。

OBJECTIVE: To determine whether there is a clinically relevant difference between the circulatory responses to double-lumen tube intubation (DLTI) with the GlideScope video laryngoscope versus the Macintosh direct laryngoscope.
METHODS: Eighty adult patients requiring double-lumen tubes for thoracic surgery were randomly and equally allocated to either a Macintosh direct laryngoscope group (DL group, n = 40) or a Glide Scope video laryngoscope group (GS group, n = 40). DLTI was performed after airway evaluations and induction of anesthesia. Systolic blood pressure (SBP) and heart rate (HR) were recorded before induction (baseline values), immediately before intubation (post-induction values), at intubation and after intubation. Rate-pressure-product (RPP), and the areas under SBP- and HR-time curves were calculated. All data obtained by the two devices were compared.
RESULTS: After laryngoscope insertion, SBP of DL and GS groups changed significantly differently (13.1% vs. 4.6%, P< 0.001), while HR changed similarly (17.2% vs. 14.6%, P = 0.074). One minute after intubation, both SBP and HR significantly increased in both groups (SBP: 11.6% vs. 11.9%; HR: 18.4% vs. 10.8%), but there were no significant differences between the two groups. RPP significantly increased in both groups after laryngoscope insertion (32.6%, P=0.001; 18.2%, P=0.002), and there was a significant difference between the two groups (P =0.001). Throughout intubation, the areas under SBP-time curves had a significant difference between the two groups (P = 0.042), while those under HR-time curves did not differ significantly (P=0.06).
CONCLUSIONS: The intubation response was most significant upon laryngoscope insertion during the whole intubation process. The GlideScope video laryngoscope induced milder circulatory fluctuations than the Macintosh direct laryngoscope did, suggesting that DLTI using video laryngoscopy can help reduce the cardiovascular response to intubation.