Initiation of Airway Code: the Role of the Airway Team in Unexpected Difficult Airways

NCT06448377 | Completed

• 1 other identifier: 2025-25
• Study Type: observational
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of our study is to observationally examine our unexpected difficult airway incidence and intervention times. In addition, it is aimed to discuss the clinical effect of a team specialized in airway intervention intervening in cases by call on the success of airway intervention. In this discussion, it is aimed to use the opinion-opposition method.

Conditions

Unexpected Difficult Airway; Intubation;Difficult; Airway Management

Keywords

airway management; anesthesia; intubation; difficult airway

Outcome Measures

Primary Outcomes (1)

• Successful endotracheal intubation rate in difficult airway

  The primary outcome of our study is the rate( in percent) of complication-free and successful endotracheal intubation performed by specialists or the airway team in unexpected difficult airway cases.

  During the intraoperative period of difficult intubation case

Secondary Outcomes (2)

• The response time of the airway team to the case and the tools they used

  During the intraoperative period of difficult intubation case

• airway intervention equipment

  During the intraoperative period of difficult intubation case

Study Arms (2)

Airway Team Group

In this group, the intervention time and methods used by the airway team will be evaluated in patients who have been called for airway assistance.

Procedure: Videolaryngoscopy; Procedure: FOB; Procedure: FOB+Aintree; Procedure: Classic intubation with laryngoscopy; Procedure: Others

Control Group

In this group, anesthesiologists' feedback on difficult airway cases will be received.

Procedure: Videolaryngoscopy; Procedure: FOB; Procedure: FOB+Aintree; Procedure: Classic intubation with laryngoscopy; Procedure: Others

Interventions

Videolaryngoscopy PROCEDURE

Situations in which the practitioner performs endotracheal intubation using a videolaryngoscope during airway intervention will be included in this group.

Airway Team Group; Control Group

FOB PROCEDURE

Situations in which the practitioner performs endotracheal intubation using a fiberoptic bronchoscope during airway intervention will be included in this group.

Also known as: endotracheal intubation with fiberoptic bronchoscope

Airway Team Group; Control Group

FOB+Aintree PROCEDURE

Situations in which the practitioner performs endotracheal intubation using a Fiberoptic intubation via LMA with aintree catheter during airway intervention will be included in this group.

Also known as: Fiberoptic intubation via LMA with aintree catheter

Airway Team Group; Control Group

Classic intubation with laryngoscopy PROCEDURE

Situations in which the practitioner performs endotracheal intubation using a macintosh laryngoscope during airway intervention will be included in this group.

Airway Team Group; Control Group

Others PROCEDURE

Cases in which intubation cannot be performed, those who are awakened from anesthesia, or those in whom a surgical method is used for airway access will be included in this group.

Airway Team Group; Control Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Unexpected difficult airway patients will be included in our study. These patients should need perioperative endotracheal intubation without signs of difficult airway in their airway evaluation scores, and the patients should be intervened by the anesthesiologists themselves or the airway team.

You may qualify if:

• Patients who will be operated under general anesthesia at Kocaeli City Hospital or who require perioperative endotracheal intubation will be included in our study.
• Operations performed within the study time period will be taken
• Patients whose anesthesiologists call for help for difficult airway will be included in the study.
• Patients between the ages of 18-65 will be included in the study.

You may not qualify if:

• \- 1. Expected difficult airway patients (mallampati 3-4) and other patients with high difficult airway scores will not be included in the study.
• \. Patients with difficult airway conditions but who will be awakened by giving up endotracheal intubation will not be included in the study.

Sponsors & Collaborators

• Kocaeli City Hospital: lead

Study Sites (1)

Kocaeli City Hospital

Kocaeli, Izmıt, 41100, Turkey (Türkiye)

Location

Related Publications (5)

• Pandian V, Ghazi TU, He MQ, Isak E, Saleem A, Semler LR, Capellari EC, Brenner MJ. Multidisciplinary Difficult Airway Team Characteristics, Airway Securement Success, and Clinical Outcomes: A Systematic Review. Ann Otol Rhinol Laryngol. 2023 Aug;132(8):938-954. doi: 10.1177/00034894221123124. Epub 2022 Oct 2.

  PMID: 36189709 BACKGROUND

• Karamchandani K, Wheelwright J, Yang AL, Westphal ND, Khanna AK, Myatra SN. Emergency Airway Management Outside the Operating Room: Current Evidence and Management Strategies. Anesth Analg. 2021 Sep 1;133(3):648-662. doi: 10.1213/ANE.0000000000005644.

  PMID: 34153007 BACKGROUND

• Penketh J, Nolan JP. Airway management during cardiac arrest. Curr Opin Crit Care. 2023 Jun 1;29(3):175-180. doi: 10.1097/MCC.0000000000001033. Epub 2023 Mar 28.

  PMID: 37078613 BACKGROUND

• Mark LJ, Herzer KR, Cover R, Pandian V, Bhatti NI, Berkow LC, Haut ER, Hillel AT, Miller CR, Feller-Kopman DJ, Schiavi AJ, Xie YJ, Lim C, Holzmueller C, Ahmad M, Thomas P, Flint PW, Mirski MA. Difficult airway response team: a novel quality improvement program for managing hospital-wide airway emergencies. Anesth Analg. 2015 Jul;121(1):127-139. doi: 10.1213/ANE.0000000000000691.

  PMID: 26086513 BACKGROUND

• Koh W, Kim H, Kim K, Ro YJ, Yang HS. Encountering unexpected difficult airway: relationship with the intubation difficulty scale. Korean J Anesthesiol. 2016 Jun;69(3):244-9. doi: 10.4097/kjae.2016.69.3.244. Epub 2016 Jun 1.

  PMID: 27274369 BACKGROUND

MeSH Terms

Interventions

Intubation, Intratracheal; Laryngoscopy; Bro protein, Drosophila

Intervention Hierarchy (Ancestors)

Airway Management; Therapeutics; Intubation; Investigative Techniques; Diagnostic Techniques, Respiratory System; Diagnostic Techniques and Procedures; Diagnosis; Endoscopy; Diagnostic Techniques, Surgical; Minimally Invasive Surgical Procedures; Surgical Procedures, Operative; Otorhinolaryngologic Surgical Procedures

Study Officials

• Ahmet YUKSEK, Md

  Kocaeli Cith Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 3, 2024
• First Posted: June 7, 2024
• Study Start: March 15, 2024
• Primary Completion: September 15, 2024
• Study Completion: October 15, 2024
• Last Updated: October 24, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)