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| Clinical application and research progress of different intubation techniques in obese patients |
| Liu Miao, Wang Chang-song |
| Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin 150081, China |
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Abstract Obesity has become a health concern all over the world. The changes of airway anatomy and respiratory physiology associated with obesity may increase the difficulty of intubation. The choice of appropriate intubation technique and the rapid establishment of safe and effective airway are essential for obese patients. In recent years, visualization technology and new intubation technology have been gradually applied to obese patients. This paper describes the characteristics of different types of direct laryngoscopes, fiberoptic bronchoscope, optical stylet and light wand, and the effects of the above-mentioned intubation techniques and combined intubation techniques on tracheal intubation in obese patients. Combined with the studies at home and abroad, this paper provides reference for the selection of intubation techniques in obese patients.
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Corresponding Authors:
Wang Chang-song, E-mail: changsongwangicu@163.com
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| ［1］China Health and Nutrition Survey (CHNS)［DB/OL］. http://www.cpc.unc.edu/projects/china/data/datasets.
［2］Moon TS, Fox PE, Somasundaram A, et al. The influence of morbid obesity on difficult intubation and difficult mask ventilation［J］. J Anesth, 2019, 33(1): 96-102.
［3］Yumul R, Elvir-Lazo OL, White PF, et al. Comparison of three video laryngoscopy devices to direct laryngoscopy for intubating obesepatients: a randomized controlled trial［J］. J Clin Anesth, 2016, 31: 71-77.
［4］Langeron O, Birenbaum A, Le Saché F, et al. Airway management in obese patient［J］. Minerva Anestesiol, 2014, 80(3): 382-392.
［5］Riad W, Vaez MN, Raveendran R, et al. Neck circumference as a predictor of difficult intubation and difficult mask ventilation in morbidly obese patients: a prospective observational study［J］. Eur J Anaesthesiol, 2016, 33(4): 244-249.
［6］Cook TM, Woodall N, Frerk C, et al. Major complications of airway management in the UK: results of the fourth national audit project of the royal college of anaesthetists and the difficult airway society. part 1: anaesthesia［J］. Br J Anaesth, 2011, 106(5): 617-631.
［7］Szarpak L. Laryngoscopes for difficult airway scenarios: a comparison of the available devices［J］. Expert Rev Med Devices, 2018, 15(9): 631-643.
［8］Deguchi S, Komasawa N, Morimoto K, et al. Difficult airway management using the Pentax-AWS airwayscope with a thin intlock and bronchofiberscope in a patient with coffin-lowry syndrome［J］. J Clin Anesth, 2016, 29: 1-2.
［9］Kim J, Im KS, Lee JM, et al. Relevance of radiological and clinical measurements in predicting difficult intubation using light wand (Surch-liteTM) in adult patients［J］. J Int Med Res, 2016, 44(1): 136-146.
［10］Meitzen SE, Benumof JL. Video laryngoscopy: positives, negatives, and defining the difficult intubation［J］. Anesth Analg, 2019, 128(3): 399-401.
［11］薛富善，王强，程怡. 视频喉镜在气道管理中的应用现况［J］. 国际麻醉学与复苏杂志， 2012， 33(12): 795-797，818.
［12］Ander F, Magnuson A, Berggren L, et al. Time-to-intubation in obese patients. A randomized study comparing direct laryngoscopy and videolaryngoscopy in experienced anesthetists［J］. Minerva Anestesiol, 2017, 83(9): 906-913.
［13］Maassen R, Lee R, Hermans B, et al. A comparison of three videolaryngoscopes: the macintosh laryngoscope blade reduces, but does not replace, routine stylet use for intubation in morbidly obese patients［J］. Anesth Analg, 2009, 109(5): 1560-1565.
［14］Hoshijima H, Denawa Y, Tominaga A, et al. Videolaryngoscope versus macintosh laryngoscope for tracheal intubation in adults with obesity: a systematic review and meta-analysis［J］. J Clin Anesth, 2018, 44:69-75.
［15］Abdallah R, Galway U, You J, et al. A randomized comparison between the Pentax AWS video laryngoscope and the macintosh laryngoscope in morbidly obese patients［J］. Anesth Analg, 2011, 113(5): 1082-1087.
［16］Andersen LH, Rovsing L, Olsen KS. GlideScope videolaryngoscope vs. macintosh direct laryngoscope for intubation of morbidly obese patients: a randomized trial［J］. Acta Anaesthesiol Scand, 2011, 55(9): 1090-1097.
［17］Wasinwong W, Pukdeetanakul V, Kanchanawanitkul O, et al. Comparison of intubation time with glidescope and mcintosh laryngoscope in obese patients［J］. J Med Assoc Thai, 2017, 100(3): 306-312.
［18］Abdelmalak BB, Bernstein E, Egan C, et al. GlideScope vs. flexible fibreoptic scope for elective intubation in obese patients［J］. Anaesthesia, 2011, 66(7): 550-555.
［19］Abdellatif AA, Ali MA. GlideScope videolaryngoscope versus flexible fiberoptic bronchoscope for awake intubation of morbidly obese patient with predicted difficult intubation［J］. Middle East J Anaesthesiol, 2014, 22(4): 385-392.
［20］裴淼，华丽，魏江涛，等. McCoy喉镜、UE可视喉镜与纤维支气管镜在肥胖患者气管插管中的应用对比［J］. 医学理论与实践， 2018， 31(14): 2067-2069.
［21］Gaszynski T, Pietrzyk M, Szewczyk T, et al. A comparison of performance of endotracheal intubation using the Levitan FPS optical stylet or Lary-Flex videolaryngoscope in morbidly obese patients［J］. Sci World J, 2014, 2014: 207 591.
［22］李文波，陈树斌，张云红. 视可尼可视喉镜用于肥胖患者气管插管的临床观察［J］. 当代医学， 2011， 17(31): 141-142.
［23］龚洁，张雪卫，沈浩，等. 正中入路可视硬性喉镜辅助气管插管在肥胖患者中的应用［J］. 解放军医学院学报， 2018， 39(2): 126-129.
［24］杨虎，宋付民，王波，等. 慢诱导麻醉下光棒用于过度肥胖患者困难气管插管的临床探讨［J］. 农垦医学， 2016， 38(3): 203-205.
［25］贺志勇. 不同气管插管方式在肥胖患者手术全麻中的应用分析［J］. 中国民族民间医药， 2015， 24(10): 151-152.
［26］Gaszynski T. A combination of airtraq and truflex for intubation in morbidly obese patient［J］. J Clin Anesth, 2018, 44: 32-33.
［27］Chung MY, Park B, Seo J, et al. Successful airway management with combined use of McGrath MAC video laryngoscope and fiberoptic bronchoscope in a severe obese patient with huge goiter -a case report［J］. Korean J Anesthesiol, 2018, 71(3): 232-236.
［28］余淑珍，郭永清，张玮玮. 光棒联合喉镜在肥胖患者气管插管中的应用［J］. 山西医药杂志， 2014， 43(6): 661-663.
［29］黄佳洋，刘会长. 气管插管型喉罩在肥胖患者前路颈椎手术中的应用效果［J］.实用临床医药杂志， 2016， 20(1): 91-93.
［30］夏瑞，尹泓，徐伟，等. I-gel喉罩辅助明视插管软镜在肥胖患者中的临床应用［J］. 长江大学学报（自科版）， 2016， 13(12): 31-33，50. |
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