The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
I Hodzovic - One of the best experts on this subject based on the ideXlab platform.
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Rescue oxygenation success by cannula or scalpel-Bougie emergency front-of-neck access in an anaesthetised porcine model.
PloS one, 2020Co-Authors: Nejc Umek, I Hodzovic, Marija Damjanovska, Erika Cvetko, Jurij Zel, Alenka Seliškar, Tatjana Stopar PintaricAbstract:In the obese, the evidence for the choice of the optimal emergency front-of-neck access technique is very limited and conflicting. We compared cannula and scalpel-Bougie emergency front-of-neck access techniques in an anaesthetised porcine model with thick pretracheal tissue. Cannula and scalpel-Bougie cricothyroidotomy techniques were performed in 11 and 12 anaesthetised pigs, respectively. Following successful tracheal access, oxygenation was commenced and continued for 5 min using Rapid-O2 device for cannula and circle breathing system for scalpel-Bougie study groups. The primary outcome was a successful rescue oxygenation determined by maintenance of arterial oxygen saturation >90% 5 min after the beginning of oxygenation. Secondary outcomes included success rate of airway device placement, time to successful airway device placement, and trauma to the neck and airway. The success rate of rescue oxygenation was 18% after cannula, and 83% after scalpel-Bougie technique (P = 0.003). The success rate of airway device placement was 73% with cannula and 92% with scalpel-Bougie technique (P = 0.317). Median (inter-quartile-range) times to successful airway device placement were 108 (30-256) and 90 (63-188) seconds (P = 0.762) for cannula and scalpel-Bougie emergency front-of-neck access, respectively. Proportion of animals with iatrogenic trauma additional to the procedure itself was 27% for cannula and 75% for scalpel-Bougie technique (P = 0.039). Thus, in the porcine model of obesity, the scalpel-Bougie technique was more successful in establishing and maintaining rescue oxygenation than cannula-based technique; however, it was associated with a higher risk of severe trauma.
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Bougie related airway trauma dangers of the hold up sign
Anaesthesia, 2014Co-Authors: Ben A Marson, A R Wilkes, E A Anderson, I HodzovicAbstract:Summary The Bougie is a popular tool in difficult intubations. The hold-up sign is used to confirm tracheal placement of a Bougie. This study aimed to establish the potential for airway trauma when using this sign with an Eschmann re-usable Bougie or a Frova single-use Bougie. Airways were simulated using a manikin (hold-up force) and porcine lung model (airway perforation force). Mean (SD) hold-up force (for airway lengths over the range 25–45 cm) of 1.0 (0.4) and 5.2 (1.1) N were recorded with the Eschmann and Frova Bougies, respectively (p < 0.001). The mean (SD) force required to produce airway perforation was 0.9 (0.2) N with the Eschmann Bougie and 1.1 (0.3) N with the Frova Bougie (p = 0.11). It is possible to apply a force at least five times greater than the force required to produce significant trauma with a Frova single-use Bougie. We recommend that the hold-up sign should no longer be used with single-use Bougies. Clinicians should be cautious when eliciting this sign using the Eschmann re-usable Bougie.
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Bougie-related airway trauma: dangers of the hold-up sign.
Anaesthesia, 2014Co-Authors: Ben A Marson, A R Wilkes, E A Anderson, I HodzovicAbstract:Summary The Bougie is a popular tool in difficult intubations. The hold-up sign is used to confirm tracheal placement of a Bougie. This study aimed to establish the potential for airway trauma when using this sign with an Eschmann re-usable Bougie or a Frova single-use Bougie. Airways were simulated using a manikin (hold-up force) and porcine lung model (airway perforation force). Mean (SD) hold-up force (for airway lengths over the range 25–45 cm) of 1.0 (0.4) and 5.2 (1.1) N were recorded with the Eschmann and Frova Bougies, respectively (p
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Bougie‐assisted difficult airway management in a manikin – the effect of position held on placement and force exerted by the tip*
Anaesthesia, 2004Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:In a randomised cross-over study, 50 anaesthetists attempted to place a multiple-use Bougie in the trachea of a manikin, when holding it at either 20 cm or 30 cm from the tip. A grade 3 laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates when held at 20 and 30 cm distance from the tip were 68 and 62%, respectively (p = 0.55). In a separate experiment, multiple and single-use Bougies were held at four different positions and pressed onto a disc attached to a force transducer. The peak force exerted by the single-use Bougies was two to three times greater than that which could be exerted by the multiple-use Bougies (p < 0.0001). Holding the Bougie at either 20 or 30 cm distance from the tip is unlikely to influence Bougie placement. The single-use Bougie is much more likely to cause trauma to tissue during placement, particularly if held close to the tip.
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Bougie assisted difficult airway management in a manikin the effect of position held on placement and force exerted by the tip
Anaesthesia, 2004Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:In a randomised cross-over study, 50 anaesthetists attempted to place a multiple-use Bougie in the trachea of a manikin, when holding it at either 20 cm or 30 cm from the tip. A grade 3 laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates when held at 20 and 30 cm distance from the tip were 68 and 62%, respectively (p = 0.55). In a separate experiment, multiple and single-use Bougies were held at four different positions and pressed onto a disc attached to a force transducer. The peak force exerted by the single-use Bougies was two to three times greater than that which could be exerted by the multiple-use Bougies (p < 0.0001). Holding the Bougie at either 20 or 30 cm distance from the tip is unlikely to influence Bougie placement. The single-use Bougie is much more likely to cause trauma to tissue during placement, particularly if held close to the tip.
I P Latto - One of the best experts on this subject based on the ideXlab platform.
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Bougie‐assisted difficult airway management in a manikin – the effect of position held on placement and force exerted by the tip*
Anaesthesia, 2004Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:In a randomised cross-over study, 50 anaesthetists attempted to place a multiple-use Bougie in the trachea of a manikin, when holding it at either 20 cm or 30 cm from the tip. A grade 3 laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates when held at 20 and 30 cm distance from the tip were 68 and 62%, respectively (p = 0.55). In a separate experiment, multiple and single-use Bougies were held at four different positions and pressed onto a disc attached to a force transducer. The peak force exerted by the single-use Bougies was two to three times greater than that which could be exerted by the multiple-use Bougies (p < 0.0001). Holding the Bougie at either 20 or 30 cm distance from the tip is unlikely to influence Bougie placement. The single-use Bougie is much more likely to cause trauma to tissue during placement, particularly if held close to the tip.
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Bougie assisted difficult airway management in a manikin the effect of position held on placement and force exerted by the tip
Anaesthesia, 2004Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:In a randomised cross-over study, 50 anaesthetists attempted to place a multiple-use Bougie in the trachea of a manikin, when holding it at either 20 cm or 30 cm from the tip. A grade 3 laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates when held at 20 and 30 cm distance from the tip were 68 and 62%, respectively (p = 0.55). In a separate experiment, multiple and single-use Bougies were held at four different positions and pressed onto a disc attached to a force transducer. The peak force exerted by the single-use Bougies was two to three times greater than that which could be exerted by the multiple-use Bougies (p < 0.0001). Holding the Bougie at either 20 or 30 cm distance from the tip is unlikely to influence Bougie placement. The single-use Bougie is much more likely to cause trauma to tissue during placement, particularly if held close to the tip.
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to shape or not to shape simulated Bougie assisted difficult intubation in a manikin
Anaesthesia, 2003Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:Summary Thirty anaesthetists attempted to place a derived ‘optimal’ curve Bougie or a straight Bougie in the trachea of a manikin, in a randomised cross-over study. A Grade 3 Cormack and Lehane laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates with the curved and straight Bougies were 83 and 7%, respectively, giving a difference (95% confidence interval) of 77% (54–87%) between the two Bougies (p < 0.0001). On a separate occasion, under identical laboratory conditions, 30 anaesthetists attempted to place a straight coude (angled)-tipped Bougie or a straight straight-tipped Bougie in the trachea of a manikin. The success rates with the coude- and straight-tipped Bougies were 43 and 0%, respectively, giving a difference (95% confidence interval) of 43% (21–61%) between the two Bougies (p < 0.001). These results suggest that Bougies used to facilitate difficult intubation should be curved and have a coude tip.
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To shape or not to shape... Simulated Bougie-assisted difficult intubation in a manikin
Anaesthesia, 2003Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:Summary Thirty anaesthetists attempted to place a derived ‘optimal’ curve Bougie or a straight Bougie in the trachea of a manikin, in a randomised cross-over study. A Grade 3 Cormack and Lehane laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates with the curved and straight Bougies were 83 and 7%, respectively, giving a difference (95% confidence interval) of 77% (54–87%) between the two Bougies (p
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Survey of the use of the gum elastic Bougie in clinical practice
Anaesthesia, 2002Co-Authors: I P Latto, M. Stacey, J. S. Mecklenburgh, R. S. VaughanAbstract:Data were collected prospectively on the use of the gum elastic Bougie in 200 patients. The Bougie was successfully inserted into the trachea and tracheal intubation was accomplished in 199 cases. The Bougie was inserted into the trachea at the first attempt in 178 cases. In nine cases (4.5%) a second, more experienced, clinician was required. In 173 cases, the grades of view were recorded before and after the application of laryngeal pressure; pressure improved the view in 80 cases (46%), had no effect in 89 (51%) and worsened the view in four cases (2%). Various recommendations for optimal external laryngeal pressure and use of the Bougie were not followed on 15-64% of occasions. There is a need for better education in these techniques.
A R Wilkes - One of the best experts on this subject based on the ideXlab platform.
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Bougie related airway trauma dangers of the hold up sign
Anaesthesia, 2014Co-Authors: Ben A Marson, A R Wilkes, E A Anderson, I HodzovicAbstract:Summary The Bougie is a popular tool in difficult intubations. The hold-up sign is used to confirm tracheal placement of a Bougie. This study aimed to establish the potential for airway trauma when using this sign with an Eschmann re-usable Bougie or a Frova single-use Bougie. Airways were simulated using a manikin (hold-up force) and porcine lung model (airway perforation force). Mean (SD) hold-up force (for airway lengths over the range 25–45 cm) of 1.0 (0.4) and 5.2 (1.1) N were recorded with the Eschmann and Frova Bougies, respectively (p < 0.001). The mean (SD) force required to produce airway perforation was 0.9 (0.2) N with the Eschmann Bougie and 1.1 (0.3) N with the Frova Bougie (p = 0.11). It is possible to apply a force at least five times greater than the force required to produce significant trauma with a Frova single-use Bougie. We recommend that the hold-up sign should no longer be used with single-use Bougies. Clinicians should be cautious when eliciting this sign using the Eschmann re-usable Bougie.
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Bougie-related airway trauma: dangers of the hold-up sign.
Anaesthesia, 2014Co-Authors: Ben A Marson, A R Wilkes, E A Anderson, I HodzovicAbstract:Summary The Bougie is a popular tool in difficult intubations. The hold-up sign is used to confirm tracheal placement of a Bougie. This study aimed to establish the potential for airway trauma when using this sign with an Eschmann re-usable Bougie or a Frova single-use Bougie. Airways were simulated using a manikin (hold-up force) and porcine lung model (airway perforation force). Mean (SD) hold-up force (for airway lengths over the range 25–45 cm) of 1.0 (0.4) and 5.2 (1.1) N were recorded with the Eschmann and Frova Bougies, respectively (p
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Bougie‐assisted difficult airway management in a manikin – the effect of position held on placement and force exerted by the tip*
Anaesthesia, 2004Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:In a randomised cross-over study, 50 anaesthetists attempted to place a multiple-use Bougie in the trachea of a manikin, when holding it at either 20 cm or 30 cm from the tip. A grade 3 laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates when held at 20 and 30 cm distance from the tip were 68 and 62%, respectively (p = 0.55). In a separate experiment, multiple and single-use Bougies were held at four different positions and pressed onto a disc attached to a force transducer. The peak force exerted by the single-use Bougies was two to three times greater than that which could be exerted by the multiple-use Bougies (p < 0.0001). Holding the Bougie at either 20 or 30 cm distance from the tip is unlikely to influence Bougie placement. The single-use Bougie is much more likely to cause trauma to tissue during placement, particularly if held close to the tip.
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Bougie assisted difficult airway management in a manikin the effect of position held on placement and force exerted by the tip
Anaesthesia, 2004Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:In a randomised cross-over study, 50 anaesthetists attempted to place a multiple-use Bougie in the trachea of a manikin, when holding it at either 20 cm or 30 cm from the tip. A grade 3 laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates when held at 20 and 30 cm distance from the tip were 68 and 62%, respectively (p = 0.55). In a separate experiment, multiple and single-use Bougies were held at four different positions and pressed onto a disc attached to a force transducer. The peak force exerted by the single-use Bougies was two to three times greater than that which could be exerted by the multiple-use Bougies (p < 0.0001). Holding the Bougie at either 20 or 30 cm distance from the tip is unlikely to influence Bougie placement. The single-use Bougie is much more likely to cause trauma to tissue during placement, particularly if held close to the tip.
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to shape or not to shape simulated Bougie assisted difficult intubation in a manikin
Anaesthesia, 2003Co-Authors: I Hodzovic, A R Wilkes, I P LattoAbstract:Summary Thirty anaesthetists attempted to place a derived ‘optimal’ curve Bougie or a straight Bougie in the trachea of a manikin, in a randomised cross-over study. A Grade 3 Cormack and Lehane laryngoscopic view was simulated. The anaesthetists were blinded to success (tracheal placement) or failure (oesophageal placement). The success rates with the curved and straight Bougies were 83 and 7%, respectively, giving a difference (95% confidence interval) of 77% (54–87%) between the two Bougies (p < 0.0001). On a separate occasion, under identical laboratory conditions, 30 anaesthetists attempted to place a straight coude (angled)-tipped Bougie or a straight straight-tipped Bougie in the trachea of a manikin. The success rates with the coude- and straight-tipped Bougies were 43 and 0%, respectively, giving a difference (95% confidence interval) of 43% (21–61%) between the two Bougies (p < 0.001). These results suggest that Bougies used to facilitate difficult intubation should be curved and have a coude tip.
Judith Elizabeth Hall - One of the best experts on this subject based on the ideXlab platform.
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A comparison of the Seeing Optical Stylet and the gum elastic Bougie in simulated difficult tracheal intubation: a manikin study
Anaesthesia, 2006Co-Authors: A. Evans, S. Morris, J. Petterson, Judith Elizabeth HallAbstract:Management of the difficult airway is one of the major challenges that anaesthetists face. The flexible fibreoptic scope is widely available but its use requires a level of skill, training and continued practice that is not universally found in all anaesthetists, particularly trainees. The Seeing Optical Stylet is a new, semirigid fibreoptic stylet 'scope. We compared the Seeing Optical Stylet with a gum elastic Bougie in a simulated Cormack and Lehane Grade 3 laryngoscopy in a manikin. Forty-four anaesthetists were timed while intubating the manikin's trachea with both devices. The mean (SD) time taken with the Seeing Optical Stylet was 20.8 (9.3) s and with the Bougie 30 (19.8) s (p = 0.001). Oesophageal intubation occurred six times with the Bougie but did not occur with the Seeing Optical Stylet (p = 0.011). We conclude that the Seeing Optical Stylet may be superior to the Bougie in difficult tracheal intubation. We feel that the results of this manikin trial are sufficiently encouraging to proceed to a clinical trial in patients.
M.e. Wilson - One of the best experts on this subject based on the ideXlab platform.
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An evaluation of the gum elastic Bougie. Intubation times and incidence of sore throat.
Anaesthesia, 1992Co-Authors: Jerry P. Nolan, M.e. WilsonAbstract:This study was designed to evaluate the routine use of a gum elastic Bougie for tracheal intubation. The median time to intubation with the gum elastic Bougie while simulating an 'epiglottis only' view was only 10 s longer than the time taken during conventional intubation with an optimum view. Three of the patients required a gum elastic Bougie-assisted intubation after attempts at conventional visual intubation had failed. There was no significant difference in the incidence of postoperative sore throat and hoarseness between the two groups. We recommend that anaesthetists should use the gum elastic Bougie whenever a good view of the glottis is not immediately obtained.