{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:18:54Z","timestamp":1768285134293,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Fire risk during laser airway surgery is well\u2010documented, but there is limited information regarding this risk with the novel TruBlue laser. This study evaluates its safety under different experimental conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using a cadaveric porcine larynx and lungs model, we conducted trials with laser\u2010safe endotracheal tubes (LSETTs), high\u2010flow ventilation (HFV), and jet ventilation. We varied distance, FiO\n                      <jats:sub>2<\/jats:sub>\n                      levels, and laser power settings to observe the occurrence of uncontrolled fires, brief flames, and sparks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LSETT trials showed no fire events. Pledget fires were the only uncontrolled fires in HFV, at 100%, 70%, and 50% FiO\n                      <jats:sub>2<\/jats:sub>\n                      . Brief flames occurred only with 4\u2009W continuous settings at 100% FiO\n                      <jats:sub>2<\/jats:sub>\n                      . Innocuous spark ignition rates were significantly increased by increased wattage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In jet ventilation trials, brief flames appeared across a wider range of FiO\n                      <jats:sub>2<\/jats:sub>\n                      levels and settings. HFV and jet ventilation groups showed a greater frequency and earlier occurrence of sparks and brief flames, in contrast to the event\u2010free LSETT group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Using the TruBlue laser with a fully inflated LSETT cuff positioned at least 0.3\u2009cm below the operating area while delivering 100% oxygen was consistently safe in our trials. Uncontrolled fires occurred only when targeting a pledget under HFV, confirming extrinsic fuel as the main risk and highlighting the safety of the TruBlue laser with HFV and jet ventilation in its absence. Compared to HFV, jet ventilation trials showed a higher frequency of brief flames and sparks. A 60\u2010s continuous application of the laser at 100% FiO\n                      <jats:sub>2<\/jats:sub>\n                      is safe.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>NA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32444","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T12:08:46Z","timestamp":1752754126000},"page":"4815-4822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Redefining Safe Practices in Airway\n                    <scp>TruBlue<\/scp>\n                    Laser Surgery\u2014A Systematic Evaluation"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5080-0522","authenticated-orcid":false,"given":"Ariel","family":"Roitman","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion\u2014Israel Institute of Technology  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Bowen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristopher M.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan L.","family":"Thibeault","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery School of Medicine and Public Health, University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3299-3014","authenticated-orcid":false,"given":"Seth H.","family":"Dailey","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery School of Medicine and Public Health, 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