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YEAR IN REVIEW
Chiumello D. 1, Allegri M. 2, Cavaliere F. 3, De Cosmo G. 3, Iohom G. 4, Langeron O. 5, Apan A. 6, Spieth P. 7, Capogna G. 8
1 Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del dolore, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italia;
2 Dipartimento di Diagnosi Clinica Chirurgica e Scienze Pediatriche, Servizio di Terapia del Dolore, Università di Pavia-Fondazione IRCCS Policlinico San Matteo, Pavia, Italia;
3 Istituto di Anestesia e Rianimazione, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli”, Roma, Italia;
4 Department of Anesthesia and Intensive Care Medicine, Cork University Hospital and University College Cork, Wilton, Cork, Ireland;
5 Department of Anesthesiology and Intensive Care, Hôpital de la Pitié-Salpètrière, Paris, France;
6 Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Giresum University, Giresum, Turkey;
7 Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Therapy, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany;
8 Dipartimento di Anestesia, Casa di Cura Città di Roma, Roma, Italia
Background: We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices.
Methods: The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressurewas railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were successful in both groups, with patients in each group being equally satisfied with the procedures.
Conclusion: This study highlights the importance of a structured FOI training program, demonstrating that it is possible to learn to perform FOI proficiently by practicing on dummies.