scholarly journals Tracheal Intubation with Aura-i and aScope-2: How to Minimize Apnea Time in an Unpredicted Difficult Airway

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Vittorio Pavoni ◽  
Valentina Froio ◽  
Alessandra Nella ◽  
Martina Simonelli ◽  
Lara Gianesello ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Laryngeal Mask ◽  
Difficult Airway Management ◽  
Ventilation Technique ◽  
The Subject ◽  
Airway Devices ◽  
Entire Procedure

The supraglottic airway’s usefulness as a dedicated airway is the subject of continuing development. We report the case of an obese patient with unpredicted difficult airway management in which a new “continuous ventilation technique” was used with the Aura-i laryngeal mask and the aScope-2 devices. The aScope-2/Aura-i system implemented airway devices for the management of predictable/unpredictable difficult airway. The original technique required the disconnection of the mount catheter from Aura-i, the introduction of the aScope-2 into the laryngeal mask used as a conduit for video assisted intubation and then towards the trachea, followed by a railroading of the tracheal tube over the aScope-2. This variation in the technique guarantees mechanical ventilation during the entire procedure and could prevent the risk of hypoventilation and/or hypoxia.

scholarly journals An Algorithm for Difficult Airway Management, Modified for Modern Optical Devices (Airtraq Laryngoscope; LMA CTrach ™)

2011 ◽  
Vol 114 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Roland Amathieu ◽  
Xavier Combes ◽  
Widad Abdi ◽  
Loutfi El Housseini ◽  
Ahmed Rezzoug ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Macintosh Laryngoscope ◽  
Patient Characteristics ◽  
Routine Practice ◽  
Difficult Airway Management ◽  
Management Algorithm ◽  
Airway Devices ◽  
Risk Of Aspiration

Background Because algorithms for difficult airway management, including the use of new optical tracheal intubation devices, require prospective evaluation in routine practice, we prospectively assessed an algorithm for difficult airway management that included two new airway devices. Methods After 6 months of instruction, training, and clinical testing, 15 senior anesthesiologists were asked to use an established algorithm for difficult airway management in anesthetized and paralyzed patients. Abdominal, gynecologic, and thyroid surgery patients were enrolled. Emergency, obstetric, and patients considered at risk of aspiration were excluded. If tracheal intubation using a Macintosh laryngoscope was impossible, the Airtraq laryngoscope (VYGON, Ecouen, France) was recommended as a first step and the LMA CTrach™ (SEBAC, Pantin, France) as a second. A gum elastic bougie was advocated to facilitate tracheal access with the Macintosh and Airtraq laryngoscopes. If ventilation with a facemask was impossible, the LMA CTrach™ was to be used, followed, if necessary, by transtracheal oxygenation. Patient characteristics, adherence to the algorithm, efficacy, and early complications were recorded. Results Overall, 12,225 patients were included during 2 yr. Intubation was achieved using the Macintosh laryngoscope in 98% cases. In the remainder of the cases (236), a gum elastic bougie was used with the Macintosh laryngoscope in 207 (84%). The Airtraq laryngoscope success rate was 97% (27 of 28). The LMA CTrach™ allowed rescue ventilation (n = 2) and visually directed tracheal intubation (n = 3). In one patient, ventilation by facemask was impossible, and the LMA CTrach™ was used successfully. Conclusions Tracheal intubation can be achieved successfully in a large cohort of patients with a new management algorithm incorporating the use of gum elastic bougie, Airtraq, and LMA CTrach™ devices.

scholarly journals The retrograde tracheal intubation technique for difficult airway management

2019 ◽  
Vol 3 (2) ◽  
pp. e16 ◽  
Author(s):  
Vincenzo Marchello ◽  
Ruggero M. Corso ◽  
Emanuele Piraccini ◽  
Alfredo Del Gaudio ◽  
Giuseppe Mincolelli ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management ◽  
Intubation Technique

scholarly journals Pediatric Trainees Managing a Difficult Airway: Comparison of Laryngeal Mask Airway, Direct, and Video-Assisted Laryngoscopy

OTO Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. 2473974X1770791 ◽  
Author(s):  
Art Ambrosio ◽  
Kastley Marvin ◽  
Colleen Perez ◽  
Chelsie Byrnes ◽  
Cory Gaconnet ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Direct Laryngoscopy ◽  
Training Session ◽  
Laryngeal Mask ◽  
Normal Infant ◽  
Difficult Airway Management ◽  
Video Assisted ◽  
Advanced Airway

Objective Difficult airway management is a key skill required by all pediatric physicians, yet training on multiple modalities is lacking. The objective of this study was to compare the rate of, and time to, successful advanced infant airway placement with direct laryngoscopy, video-assisted laryngoscopy, and laryngeal mask airway (LMA) in a difficult airway simulator. This study is the first to compare the success with 3 methods for difficult airway management among pediatric trainees. Study Design Randomized crossover pilot study. Setting Tertiary academic medical center. Methods Twenty-two pediatric residents, interns, and medical students were tested. Participants were provided 1 training session by faculty using a normal infant manikin. Subjects then performed all 3 of the aforementioned advanced airway modalities in a randomized order on a difficult airway model of a Robin sequence. Success was defined as confirmed endotracheal intubation or correct LMA placement by the testing instructor in ≤120 seconds. Results Direct laryngoscopy demonstrated a significantly higher placement success rate (77.3%) than video-assisted laryngoscopy (36.4%, P = .0117) and LMA (31.8%, P = .0039). Video-assisted laryngoscopy required a significantly longer amount of time during successful intubations (84.8 seconds; 95% CI, 59.4-110.1) versus direct laryngoscopy (44.9 seconds; 95% CI, 33.8-55.9) and LMA placement (36.6 seconds; 95% CI, 24.7-48.4). Conclusions Pediatric trainees demonstrated significantly higher success using direct laryngoscopy in a difficult airway simulator model. However, given the potential lifesaving implications of advanced airway adjuncts, including video-assisted laryngoscopy and LMA placement, more extensive training on adjunctive airway management techniques may be useful for trainees.

scholarly journals Laryngeal Mask Airway for Pediatric/Difficult Airway Management

2011 ◽  
Vol 31 (7) ◽  
pp. 923-930
Author(s):  
Tetsuro KAGAWA ◽  
Aya YAMAMOTO ◽  
Akitsu MURAKAMI ◽  
Takeshi SUZUKI ◽  
Noriyuki IKEJIMA
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Laryngeal Mask ◽  
Difficult Airway Management
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