A randomised crossover trial comparing the Airtraq® NT, McGrath® MAC and Macintosh laryngoscopes for nasotracheal intubation of simulated easy and difficult airways in a manikin

Gómez-Ríos, Manuel Ángel; Pinegger, S.; Mantilla, María de Carrillo; Vizcaino, Lucia; Barreto-Calvo, Purísima; Paech, Michael J.; Gómez-Ríos, D.; López‐Calviño, Beatriz

doi:10.1016/j.bjane.2014.10.009

Cited by 10 publications

(11 citation statements)

References 31 publications

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“…Rendeki et al [24] indicated that Airtraq was superior to the Macintosh laryngoscope in difficult airway intubation performed by novice users. This finding is in line with studies by other researchers [25,26].…”

Section: Discussionsupporting

confidence: 94%

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

Maslanka¹,

Smereka

Czyżewski

et al. 2020

Disaster Emerg Med J

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INTRODUCTION: The aim of this study was to evaluate intubation performance by paramedics using Macintosh laryngoscope and VieScope ® laryngoscope under simulated difficult airway conditions. METHODS: In a randomized, single-blinded, cross-over simulation trial, 42 paramedics performed endotracheal intubation using VieScope ® and Macintosh (MAC) laryngoscopes in two difficult airway scenarios: (A) tongue edema, (B) manual cervical inline stabilization. The order of participants and intubation methods was random. Time to ventilation constituted the primary outcome, and the secondary outcomes were the success rate of first intubation attempt, overall intubation success rate, Cormack and Lehane grade, and ease of use. RESULTS: In scenario A, the median overall intubation time was 55s (46-109) in the MAC group and 30.5s (26-35) in the VieScope ® group (p < 0.001). The efficacy of the first intubation attempt with MAC and VieScope ® varied and amounted to 64.3% vs. 95.2% (p < 0.001). During scenario B, VieScope ® offered better intubation conditions than MAC (p < 0.001), including shorter intubation time, higher first attempt and overall intubation success rates, as well as better glottic view. CONCLUSIONS: In this simulation trial, we found that VieScope ® could be successfully used for intubation in difficult airways by paramedics with little simulation experience with this device. VieScope ® was associated with shorter time and higher success rates of intubation attempt compared with MAC. Nevertheless, we recommend that the performance of VieScope ® and MAC should be further evaluated in the clinical setting to confirm our results.

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Section: Discussionsupporting

confidence: 94%

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

Maslanka¹,

Smereka

Czyżewski

et al. 2020

Disaster Emerg Med J

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“…Gomez et al (19) reported that anesthesia residents needed the external laryngeal pressure maneuver in 32% of difficult nasotracheal intubation of a manikin with the Airtraq NT. In addition, they had to use Magill forceps, stylet, or operator change in some difficult cases.…”

Section: Discussionmentioning

confidence: 99%

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

Arslan¹,

Türkyılmaz²

2019

Turk J Med Sci

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Background and aim: Nasotracheal Airtraq, is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. Materials and methods: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18-70 years of age undergoing elective maxillofascial, oral and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomised into the right and left nostril groups. Results: Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (p<0.001). 90 anti-clockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (p<0.001 vs p=0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. Conclusion: Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90 anti-clockwise rotation, external laryngeal pressure and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand; cuff inflation maneuver also must be kept in mind. Keywords: Airtraq, nasotracheal, right nostril, 90 degree anticlockwise, cricoid pressure, head flexion

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“…0 = none of the glottis opening is seen, 100 = full visualization of larynx from the interarytenoid notch to anterior commissure of the vocal cords Visual analog scale (VAS) for field of view: 0–10-point scale. 0 = poor, 10 = excellent[ 2 13 ] Time to best view (TTBV): Time interval between blade entry past the lips and the laryngoscopist's verbal declaration that the best view for endotracheal intubation is achieved Tube at glottis (TAG): Time interval between blade entry past the lips and the tube passed the vocal cords Time to intubation (TTI): Time interval between blade entry past the lips and the appearance of first upstroke of the end-tidal CO 2 tracing Visual analog scale (VAS) for ease of use: 0–10-point scale. 0 = poor, 10 = excellent.…”

Section: Methodsmentioning

confidence: 99%

An observational study of feasibility of tracheal intubation using Airtraq in pediatric population

Thakare

Malde

2017

J Anaesthesiol Clin Pharmacol

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Background and Aim:There is a paucity of observational studies for the use of Airtraq (AT) in children, especially infants. We undertook a prospective observational study to compare ease of use of infant (size 0), pediatric (size 1), and small (size 2) AT.Material and Methods:AT was used for endotracheal intubation in healthy pediatric patients of 3 months to 18 years age. The primary outcome was success of intubation which was noted as number (%) and analyzed using Fisher's exact test. The secondary outcomes were percentage of glottis opening (POGO) score, visual analog scale (VAS) for field of view, time to best view (TTBV), time to intubation (TTI), and VAS for ease of use and were presented as median (interquartile range) in each subgroup of sizes and analyzed using Kruskal–Wallis test.Results:Overall POGO score was 100 (100, 100 [50–100]) %, VAS field of view was 10 (10, 10 [5–10]), and TTBV was 6 (4, 10 [1.5–24]) s. There was no statistically significant difference in any of the subgroups. The success rate of intubation with AT was 100% with AT size 1 and 2, whereas 45% with AT 0, P < 0.001. VAS for ease of use was 5 (4, 10 [3-10]) with AT 0 compared to 10 (10, 10 [9–10]) with AT 1 and 10 (10, 10 [6–10]) with AT 2 (P < 0.001). TTI was 28 (20, 36 [11.8-59]) s in those who could be successfully intubated.Conclusions:All sizes of AT provide quick, easy, and excellent glottic visualization. However, failure rate for intubation with infant (size 0) is high compared to nil with pediatric (size 1) and small (size 2).

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A randomised crossover trial comparing the Airtraq® NT, McGrath® MAC and Macintosh laryngoscopes for nasotracheal intubation of simulated easy and difficult airways in a manikin

Cited by 10 publications

References 31 publications

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

An observational study of feasibility of tracheal intubation using Airtraq in pediatric population

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