Romanian Journal of Medical Practice (Jun 2020)
Updated protocol proposed following an endoscopic study on intubation of the „pathological larynx“. Applications
Abstract
The anaesthesia and ICU doctor is confronted daily with the oro-tracheal intubation maneuver. We tried to identify by video-endoscopic means lesions or primary laryngeal dysfunctions on which the success and quality of general intubation / anesthesia as well as the prevention of secondary laryngeal and laryngotracheal lesions depend. We performed a prospective, observational, analytical and statistical study based on laryngeal and anatomical perimeter video-endoscopy, a study that included 1,031 orotracheal intubations (OTI) from which we selected 52 clinical cases relevant to the context of difficult intubation on pathological larynx. We used in a proportion of 64% fiber-optic as a technological means of exposing the larynx for oro-tracheal intubation (OTI) to prevent a difficult oro-tracheal intubation (IOT) or to complete it. An updated protocol was proposed in order to identify the pathological larynx, the lesions secondary to the intubation maneuver, the emergencies.
Keywords