BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practi...BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.展开更多
Endotracheal intubation-related complications are common in clinical,and there are currently no effective strategies to address these matters.Inspired by the biological characteristics of human airway mucus(HAM),an ar...Endotracheal intubation-related complications are common in clinical,and there are currently no effective strategies to address these matters.Inspired by the biological characteristics of human airway mucus(HAM),an artificial airway mucus(ARM)coating is straightforwardly constructed by combining carboxymethyl chitosan with methyl cellulose.The ARM coating exhibited excellent lubricity(coefficient of friction(Co F)=0.05)and hydrophilicity(water contact angle(WCA)=21.3°),and was capable of coating both the internal and external surfaces of the endotracheal tube(ETT).In vitro experiments demonstrated that the ARM coating not only showed good broad-spectrum antibacterial activity,but also significantly reduced nonspecific protein adhesion.Through an in vivo intubation cynomolgus monkey model,ARM-coated ETT potently mitigated airway injury and inflammation,and was highly potential to prevent bacterial infection and catheter blockage.This work offers a promising avenue for the development of airway-friendly invasive devices.展开更多
Endotracheal intubation has broad application prospects in the biomedical field.At present,visual intubation tools are mainly used to judge the catheter position.However,when patients suffer from pains in the neck,thr...Endotracheal intubation has broad application prospects in the biomedical field.At present,visual intubation tools are mainly used to judge the catheter position.However,when patients suffer from pains in the neck,throat,and trachea and other diseases or other conditions,if the exposure of the glottic area is not ideal,there are difficult airways.For difficult airways,this visual intubation tool has great limitations.Studying the new guidance method of endotracheal intubation and providing a reference or solution for difficult airway intubation is a crucial problem in the biomedical clinical field.In this paper,an endotracheal intubation method is proposed based on end-tidal carbon dioxide(ETCO_(2))perception.The simulation model verifies the feasibility of this method for endotracheal intubation guidance.Then,four micro-cavity tubes are used as a gas collection tube,and a set of endotracheal tube guidance systems based on ETCO_(2) perception is designed and developed to collect and process the CO_(2) concentration information in the pharyngeal cavity.The experimental results show that this guidance system can be used for intubation guidance in the simulated pharyngeal cavity without vision.展开更多
基金National Natural Science Foundation of China(U24A20714 to XMF and 82102238 to PC)。
文摘BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.
基金supported by the National Natural Science Foundation of China(Nos.52203046 and 82171219)Sichuan Science and Technology Program(No.2023NSFSC1944)+3 种基金West China Nursing Discipline Development Special Fund ProjectSichuan University(No.HXHL21007)the China Postdoctoral Science Foundation(No.2023M742483)the National Natural Science Foundation of Guangdong(No.2024A1515012881)。
文摘Endotracheal intubation-related complications are common in clinical,and there are currently no effective strategies to address these matters.Inspired by the biological characteristics of human airway mucus(HAM),an artificial airway mucus(ARM)coating is straightforwardly constructed by combining carboxymethyl chitosan with methyl cellulose.The ARM coating exhibited excellent lubricity(coefficient of friction(Co F)=0.05)and hydrophilicity(water contact angle(WCA)=21.3°),and was capable of coating both the internal and external surfaces of the endotracheal tube(ETT).In vitro experiments demonstrated that the ARM coating not only showed good broad-spectrum antibacterial activity,but also significantly reduced nonspecific protein adhesion.Through an in vivo intubation cynomolgus monkey model,ARM-coated ETT potently mitigated airway injury and inflammation,and was highly potential to prevent bacterial infection and catheter blockage.This work offers a promising avenue for the development of airway-friendly invasive devices.
基金the Science and Technology Commission of Shanghai Municipality(No.18441904600)the Cross Research Fund for Translational Medicine of Shanghai Jiao Tong University(No.ZH2018ZDA14)。
文摘Endotracheal intubation has broad application prospects in the biomedical field.At present,visual intubation tools are mainly used to judge the catheter position.However,when patients suffer from pains in the neck,throat,and trachea and other diseases or other conditions,if the exposure of the glottic area is not ideal,there are difficult airways.For difficult airways,this visual intubation tool has great limitations.Studying the new guidance method of endotracheal intubation and providing a reference or solution for difficult airway intubation is a crucial problem in the biomedical clinical field.In this paper,an endotracheal intubation method is proposed based on end-tidal carbon dioxide(ETCO_(2))perception.The simulation model verifies the feasibility of this method for endotracheal intubation guidance.Then,four micro-cavity tubes are used as a gas collection tube,and a set of endotracheal tube guidance systems based on ETCO_(2) perception is designed and developed to collect and process the CO_(2) concentration information in the pharyngeal cavity.The experimental results show that this guidance system can be used for intubation guidance in the simulated pharyngeal cavity without vision.
