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Comparison of Intubation Success Rate and Times Required for Intubation by Glottic Exposure Methods with Glidescope(R)
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Hyung Seo Jang, Jun Bum Park, Jae Hoon Oh, Chang Sun Kim, Hyuk Joong Choi, Bo Seung Kang, Tae Ho Lim, Hyung Goo Kang
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Korean J Crit Care Med. 2013;28(4):241-246.
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DOI: https://doi.org/10.4266/kjccm.2013.28.4.241
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 Abstract
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- BACKGROUND
The glottis can be exposed by a Glidescope(R) during endotracheal intubation using either the epiglottis or valleculae elevation method. We compared the epiglottis and valleculae elevation methods for endotracheal intubations performed with a Glidescope(R) using differences in success rate, time spent for tracheal intubation and percent of glottic opening.
METHODS
Forty medical students without experience using a Glidescope(R) participated in this prospective, randomized study in which they intubated a tracheal tube into a manikin. All participants performed tracheal intubation using the 2 forementioned methods. Twenty students exposed the vocal cord by placing the blade tip in the valleculae (valleculae elevation method; VEM). The other 20 students directly elevated the epiglottis with the blade (epiglottis elevation method; EEM). We separated intubating time into 3 parts: turnaround time to exposing the vocal cord, tube passing time and first ventilating time.
RESULTS
The success rate of tracheal intubation using VEM (86.7%, 104/120) was higher than that using EEM (65.8%, 79/120) (p < 0.001). VEM resulted in a lower total intubation time (VEM vs. EEM, 23.5 +/- 5.3 vs. 29.0 +/- 8.7, p = 0.001). The key factor of this difference was the tube passing time (VEM vs. EEM, 7.4 +/- 2.5 vs. 12.8 +/- 7.4, p < 0.001).
CONCLUSIONS
Exposing the vocal cord by using VEM during tracheal intubation with a Glidescope(R) can increase the success rate of tracheal intubation and shorten the time of endotracheal intubation in novices.
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Severe Hypernatremia with Craniopharyngioma - A Case Report -
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Jun Bum Park, Se Hun Park, Eun Hui Seo, Hyun Seok Park, Jin Kyu Jeong
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Korean J Crit Care Med. 2013;28(1):46-50.
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DOI: https://doi.org/10.4266/kjccm.2013.28.1.46
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Abstract
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- Hypernatremia, defined as a rise in the serum sodium concentration to a value exceeding 145 mM/L, is a common electrolyte disorder. Diabetes insipidus is a common cause of hypernatremia, caused by impaired production or reduced responses to vasopressin. The resultant morbidity may be inconsequential, serious, or even life-threatening. However, hypernatremia rarely occurs during anesthesia and surgery. A 45-year-old female patient with craniopharyngioma was scheduled for tumor resection. Hypernatremia (serum sodium, 170 mM/L) occurred suddenly at the end of the surgery. To treat hypernatremia, 0.45% normal saline was used. Although serum sodium concentration was reduced faster than expected, the patient did not have any complications.
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