Clinical Research and Airway Management

Head of the projects:
Prof. Dr. Robert Greif, MME, FERC
E-Mail

The Airway Management group:

  • Evaluates the performance of new techniques and devices in difficult airway situations;
  • Organizes annually the basic and the advanced hands-on workshop, Airway Management Simulation and the Train the Airway Trainer course indicated by EAMS (European Airway Management Society);
  • Promotes multicenter studies through its affiliated society DARC: Difficult Airway Research Collaboration (www.darc-airway.com).

Ongoing randomized controlled trials and projects

  1. Rigid fiberoptics (Bonfils, SensaScope) in the simulated difficult airway scenario
  2. Supraglottic airway devices: Prospective observational study of pediatric supraglottic airway devices
  3. Supraglottic airway devices: Blind Intubation through the pediatric supraglottic airway devices AirQ vs. Ambu Aura-i
  4. Swiss Video Intubation Trial SWIVIT part 1 and part 2: Comparing 9 video-laryngoscopes in simulated difficult airway in a total of 1200 patients. A multicenter trial with the cooperation of HUG Geneva (PD Dr. G. Savoldelli) and CHUV Lausanne (PD Dr. P Schoettker)
  5. Difficult Environment Video-Intubation and Laryngoscopy (DEVIL) Evaluation of video-laryngoscopes under extreme environmental conditions on a Swiss Glacier
  6. Impact of the Train the Airway Trainer course on the Airway Trainers' teaching performance.
  7. Validity of Airway Assessment and rating tools

Collaborators

Lead: L. Theiler

Substitute

M. Kleine-Brüggeney; S. Seiler; F. Stucki, S. Signer, Y. Berger, A. Gottfried, F. Sermann, A. Nicolet 

Other collaborators

S. Nabecker, Klinik Hirslanden
M. Kotarlic, University of Wittgen, Germany
P. Schoettker, CHUV Lausanne
G. Salvoldelli, HUG Lausanne
K. Arheart, University of Miami, FL, USA

Peer-Reviewed Grands (Supporting Societies) and Prizes

FLAVA; Bangerter-Rhyner-Stiftung
Swiss Society of Anaesthesiology and Resuscitation SGAR-SSAR
Foundation of Research in Anaesthesia, Bern

ABBOTT SGAR 2008 and 2010 Annual Best Publication Award
Difficult Airway Society DAS Award Best Oral Presentation

Publications

Theiler L, Kleine-Brueggeney M, Urwyler N, Luyet C, Kaiser D, Vogt A, Greif R. Crossover Comparison of the Laryngeal Mask Supreme and the i-gel in Simulated Difficult Airway Scenario in Anesthetized Patients. Anesthesiology 2009; 111(1): 55-62

Kleine-Brueggeney M, Theiler L, Luyet C, Greif R. Acute airway obstruction caused by the new single use Laryngeal Mask Supreme. Anesthesiology 2009; 110(1): 189-90

Greif R, Theiler L. The problem of cross-over design in airway studies. Anaesthesia 2009; 64(8): 919

Greif R, Kleine-Brueggeney M, Theiler L. Awake Tracheal Intubation using the S-Shaped Rigid Fiberoptic SensaScope in Thirteen Patients with Anticipated Difficult Airway. Anaesthesia 2010; 65(5): 525-8

Theiler L, Greif R. Insertion of the i-gel Airway Obstructed by the Tongue. Anesthesiology 2010; 112 (2): 501

Isono S, Greif R, Mort TC. Airway research: the current status and future directions. Anaesthesia. 2011 Dec;66 Suppl 2:3-10.

Greif R, Egger L, Basciani RM, Lockey A, Vogt A Emergency skill training--a randomized controlled study on the effectiveness of the 4-stage approach compared to traditional clinical teaching.. Resuscitation. 2010 Dec;81(12):1692-7.

Greif R, Theiler L. The use of supraglottic airway devices in pediatric laparoscopic surgery. Minerva Anestesiol 2010; 76(8): 575-6

Kleine-Brueggeney M, Greif R, Ross S, Eichenberger U, Moriggl B, Arnold A, Luyet C. Br J Ultrasound-guided percutaneous tracheal puncture: a computer-tomographic controlled study in cadavers. Anaesth. 2011 May;106(5):738-42

Fischer H, Hochbrugger E, Fast A, Hager H, Steinlechner B, Koinig H, Eisenburger P, Frantal S, Greif R. Performance of supraglottic airway devices and 12 month skill retention: a randomized controlled study with manikins. Resuscitation. 2011 Mar;82(3):326-31.

Theiler L, Kleine-Brueggeney M, Lupold B, Stucki F, Seiler S, Urwyler N, Greif R / Performance of the Pediatric-sized i-gel Compared with the Ambu AuraOnce  Laryngeal Mask in Anesthetized and Ventilated Children. Anesthesiology 2011; 115(1): 102-10

Theiler L, Kleine-Brueggeney M, Urwyler N, Graf T, Luyet C, Greif  R. Randomized clinical trial of the i-gel and Magill trachea tube or single-use ILMA and ILMA tracheal tube for blind intubation in anaesthetized patients with a predicted difficult airway. British Journal of Anaesthesia 2011; 107(2): 243-50

Kleine-Brueggeney M, Theiler L, Urwyler N, Vogt A, Greif R. Randomized trial comparing the i-gel and Magill tracheal tube with the single-use ILMA and ILMA tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway. British Journal of Anaesthesia 2011; 107(2): 251-7

Theiler L, Gutzman M, Kleine-Brueggeney M, Urwyler N, Kämpfen B, Greif R. The i-gel™ Supraglottic Airway in Clinical Practice: Results from a Multicenter Prospective Observational Study in Switzerland including 2049 patients. British Journal of Anaesthesia 2012; 109(6): 990-5

Theiler L, Fischer H, Voelke N, Basciani R, Hasty F, Greif R. Survey on controversies in airway management among anaesthesiologists in the UK, Austria and Switzerland. Minerva Anestesiol 2012; 78(10): 1095-100

Theiler L, Hermann K, Schoettker P, Savoldelli G, Urwyler N, Kleine-Brueggeney M, Arheart KL, Greif R. SWIVIT - Swiss Video-Intubation Trial evaluating video-laryngoscopes in a simulated difficult airway scenario: study protocol for a multicenter prospective randomized controlled trial in Switzerland.Trials 2013; 4,14(1): 94

Theiler L, Greif R. The i-gel as a conduit for fiberoptic tracheal intubation. In: The i-gel Supraglottic Airway Device. Pavel Michalek and William Donaldson Ed. NOVA Science Biomedical, New York 2013

Theiler L, Greif R. Clinical evidence for the use of the i-gel in pediatric anesthesia. In: The i-gel Supraglottic Airway Device. Pavel Michalek and William Donaldson Ed. NOVA Science Biomedical, New York 2013

Michalek P, Donaldson W, Theiler L. The use of the i-gel in anaesthesia - facts and fiction in 2013. TACC 2013;3(5):246-51

Theiler L, Greif R, Supraglottic Airway Devices as intubation aides. British Journal of Anaesthesia 2014;112(2):387

Schaer A, Keel MJB, Dubach P, Greif R, Luyet C, Theiler L, Mucosal erosion of the cricoid cartilage following use of an i-gel Supraglottic Airway Device in a Patient with Diffuse Idiopathic Skeletal Hyperostosis [DISH]. Anesthesia & Analgesia Case Reports, 2014; in press

Head of Pharmacokinetics and -dynamics of Tetrahydrocannabinol (THC):
PD Dr. med. Lorenz Theiler, CAS
E-Mail

The THC pharmacology group:

  • Evaluates the efficacy of intravenously applied THC on postoperative nausea and vomiting
  • Analyzes the degradation of THC in relation to CYP2C9 single nucleotide polymorphisms
  • Works in collaboration with scientists from Lausanne CHUV, Munich Germany, Ft. Lauderdale, USA and Forensic Departments in Bern and Munich to optimize ressources and gather knowledge

Ongoing randomized controlled trials and projects

  1. What is the influence of THC on PONV?
  2. What model predicts the degradation of THC in relation to CYP2C9 and other predictors? Is there a relevant difference to earlier models?
  3. What is the relevance of those findings to forensic departments and researchers?
  4. Changes of pupillary dynamics in relation to THC
  5. Chemical stability of THC
  6. Influence of THC application on corticosteroids and endocannabinoids
  7. Influence of THC application on human adrenal glands

Collaborators

R. Greif, M. Kleine-Brüggeney, S. Suker and S. Mustafa

Other collaborators

W. Bernhard, Inst. Forensic Medicine, University of Bern
E. Gouzman, Dépt. des Laboratoires, Centre Hospitalier Universitaire Vaudois
H. Sachs, Forensic and Toxicologic Center, Munich
G. Schelling, University of Munich
W. R. Wolowich, NOVA Southeastern University, Ft. Lauderdale, FL, USA 

Peer-Reviewed Grants (Supporting Societies) and Prizes

Swiss Society of Anaesthesiology and Resuscitation SGAR-SSAR
Swiss Federal Office of Health BAG

Selected publications

Thieme U, Schelling G, Hauer D, Greif R, Dame T, Bernhard W, Thieme D, Campolongo P, Theiler L. Quantification of  Plasma Enocannabinoids to Examine Potential Influences of Tetrahydrocannabinol on the Endocannabinoid System in Humans. Drug Testing and Analysis 2014; 6(1-2):17-23