[Faster double-lumen tube intubation with the videolaryngoscope than with a standard laryngoscope]. / Le vidéolaryngoscope permet une intubation avec un tube à double lumière plus rapide que le laryngoscope standard.

PURPOSE: This study was designed to compare videolaryngoscopy with direct laryngoscopy with respect to ease of intubation when inserting a double lumen tube (DLT). METHODS: In this prospective randomized study 68 patients American Society of Anesthesiologists (ASA) physical status I and II were included. Patients with criteria indicating possible difficult intubation were excluded. The patients were randomized into two groups, depending on the tool used to facilitate intubation: videolaryngoscope (VL group) or direct laryngoscopy (DL group). The time required for intubation was the primary endpoint. Cormack and Lehane glottic visualization (CL) scores, the need for external laryngeal maneuvers and the number of attempts were measured. RESULTS: Glottic visualization was better in the VL group than in the DL group. The CL scores were I, II and III in 24, eight and two patients, respectively, in the VL group compared with 13, 11 and eight in the DL group (P = 0.025). Patients in the VL group required fewer attempts than the DL group (P = 0.019). Intubation time was 39.9 ± 4.4 sec in the VL group and 47.9 ± 5.4 sec in the DL group (P < 0.001). No intubation failure was noted in group VL compared with two in the DL group (not significant). CONCLUSION: The use of a videolaryngoscope reduces the time required for intubation with a DLT compared with the direct laryngoscopy in elective thoracic surgery.

[Fatal evolution of a left brachio-cephalic vein perforation by a catheter for hemodialysis]. / Évolution fatale d'une perforation du tronc veineux brachio-céphalique gauche par un cathéter d'hémodialyse.

Central venous catheterisation is a common procedure in intensive care and hemodialysis units. Tunnelled catheters of hemodialysis are a great contribution for patients for whom an arteriovenous fistula is not feasible, especially for prolonged use. However, multiple complications have been described from their practice. Through a case of perforation of the left brachio-cephalic vein with a venous catheter for dialysis and a review of the literature, the authors discuss the mechanisms and ways to prevent this complication.