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Title: Is retrograde intubation more successful than direct laryngoscopic technique in difficult endotracheal intubation?
Authors: Pitsucha Sanguanwit
Thavinee Trainarongsakul
Noppanan Kaewsawang
Kittisak Sawanyawisuth
Yuwares Sitthichanbuncha
Mahidol University
Khon Kaen University
Keywords: Medicine
Issue Date: 1-Dec-2016
Citation: American Journal of Emergency Medicine. Vol.34, No.12 (2016), 2384-2387
Abstract: © 2016 Elsevier Inc. Background Difficult airway intubation is an emergency condition both at the emergency department (ED) and in out-of-hospital situations. Retrograde intubation (RI) is another option for difficult airway management. There are limited data regarding the successful rate of RI compared with direct laryngoscopy (DL) intubation, the commonly used method in the ED. Methods This study was a randomized, controlled trial. Participants were randomly assigned to either the RI or the DL technique to attempt intubation on a difficult airway mannequin (Cormack and Lehane grades 3-4). First, all participants received the training on the RI or DL, and then attempted intubation. After the training, the participants had 2 chances to intubate. The outcomes of this study included numbers of participants who successfully intubated and times of successful intubation. Results There were 100 participants in this study, with 50 participants in each group (RI and DL). There was no significant difference between the groups in terms of experience at the ED or DL. The successful rate of intubation was significantly higher in the RI group than in the DL group (74% vs 12%; P =.001), as was the rate of successful intubation on the first attempt (34% vs 8%; P =.026). There were no statistical differences between physicians and medical students in any of the 3 outcomes in either the DL or RI group. Conclusions The RI technique had a higher success rate in difficult airway intubation than the DL technique, regardless of experience.
ISSN: 15328171
Appears in Collections:Scopus 2016-2017

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