Airway management equipment

Cook, Tim

doi:10.1016/b978-0-7020-3094-9.00001-2

Cited by 5 publications

(3 citation statements)

References 114 publications

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“…When using the palpation technique (P), the operator palpates the pilot balloon to estimate the pressure within it, using this as an approximation of the pressure within the cuff, as both are connected and inflate concurrently by design. 18 The minimum occlusive volume technique (MOV) requires the operator to inflate the ETC until the point of loss of audible air leakage around the cuff, during the inspiratory phase of ventilation. If ventilation is performed manually then there is a recommendation to maintain an airway pressure of 20–30 cmH 2 O.…”

Section: Introductionmentioning

confidence: 99%

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

White

Makara

Martínez-Taboada

2019

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to compare four inflation techniques on endotracheal tube cuff (ETC) pressure using a feline airway simulator. Methods Ten participants used four different endotracheal cuff inflation techniques to inflate the cuff of a low-pressure, high-volume endotracheal tube within a feline airway simulator. The simulator replicated an average-sized feline trachea, intubated with a 4.5 mm endotracheal tube, connected to a circle breathing system and pressure-controlled ventilation with oxygen and medical air. Participants inflated the ETC: by pilot balloon palpation (P); by instilling the minimum occlusive volume (MOV) required for loss of airway leaks during mechanical ventilation; until a passive release of pressure with use of a loss-of-resistance syringe (LOR); and with use of a syringe with a digital pressure reader (D) specifically designed for endotracheal cuff inflation. Intracuff pressure was measured by a manometer obscured to participants. The ideal pressure was considered to be between 20 and 30 cmH2O. Data were analysed by Shapiro–Wilk, Kruskal–Wallis and χ2 tests, as appropriate. Results Participants were eight veterinarians and two veterinary nurses with additional training in anaesthesia. Measured median intracuff pressures for P, MOV, LOR and D, respectively, were 25 cmH2O (range 4–74 cmH2O), 41 cmH2O (range 4–70 cmH2O), 31 cmH2O (range 18–64 cmH2O) and 22 cmH2O (range 20–30 cmH2O). D performed significantly better ( P <0.001) than all other techniques, with no difference between the other techniques. Conclusions and relevance Use of D for cuff inflation achieved optimal cuff pressures. There may be high operator-dependent variability in the cuff pressures achieved with the use of P, MOV or LOR inflation techniques. As such, a cuff manometer is recommended when using any of these techniques.

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Section: Introductionmentioning

confidence: 99%

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

White

Makara

Martínez-Taboada

2019

Journal of Feline Medicine and Surgery

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“…Tracheal intubation with an endotracheal tube (ETT) is recommended during general anaesthesia, as it allows protection of the airway, delivery of oxygen and inhalational anaesthetics, elimination of waste gases and provision of manual or mechanical ventilation. [3][4][5] Although rare, adverse events such as ETT breakage, ingestion and aspiration had been reported in various domestic animals including dogs, [6][7][8][9][10] cats, 11 horses, 12 sheep 13 and rabbits, 14 and in people. 15,16 Complications involving the use of ETT in zoo animals have not been reported.…”

Section: Introductionmentioning

confidence: 99%

Management of endotracheal tube breakage during extubation in a lion (Panthera leo)

Wong,

Le Souef,

Haitjema

et al. 2023

Vet Record Case Reports

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Endotracheal tube breakage during extubation is a rare complication previously reported in domestic animals, but not in zoo animals. A 9‐year‐old, male lion was anaesthetised to investigate lethargy and inappetence. Following anaesthesia, the lion was transported to its night quarter, a dedicated enclosed area for recovery. The lion was secured within the night quarter, with all personnel separated from the lion by a metal mesh fence. The lion was positioned adjacent to the fence, allowing distant monitoring and access for extubation through the fence. The silicone endotracheal tube broke during extubation. No immediate signs of airway obstruction were observed. The lion was re‐anaesthetised within the night quarter with intramuscular medetomidine and tiletamine/zolazepam administered using a pole syringe. Radiographs confirmed the presence of the broken distal endotracheal tube in the oesophagus, which was then manually retrieved with a mouth gag in place. The lion subsequently recovered with no complications.

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“…I-gel is a novel supraglottic airway device (SAD) that is designed to seal the airway without an inflatable cuff. [1] Since it is believed that i-gel cuff moulds to body temperature to fit the supraglottic region, a pre-warmed i-gel may seal faster, provide better ventilation and superior leak pressure. There are very few randomized controlled trials done on pre-warming of i-gel and findings are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Does prewarming of i-gel improve insertion and ventilation in anaesthetised and paralysed patients? A prospective, randomised, control trial

et al. 2019

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Context: I-gel are supraglottic airway devices with non-inflatable gel-like cuff that is believed to mould to body temperature, to seal the airway. Hence a pre-warmed i-gel may seal faster, provide better ventilation and superior leak pressure. Aims: To determine if pre-warming i-gel to 40°C improves insertion and efficacy of ventilation. Methods and Materials: A prospective, randomised, controlled trial was done on 64 patients requiring anaesthesia with muscle relaxation for short duration. For those in group W, i-gel warmed to 40°C for 15 minutes before insertion was used, whereas for those in group C, i-gel kept at room temperature (approximately 23°C) was used. The airway sealing pressure over time, number of attempts and time taken for a successful insertion were noted. Statistical Analysis: Mean sealing pressure between two groups was compared using independent sample t -test. Repeated Measures ANOVA was used to analyse mean sealing pressure at 0, 15 and 30 min. P value ≤0.05 was considered statistically significant. Results: Sealing pressure improves over time in both the groups but the mean sealing pressure was higher in group C when compared to group W at all points of time, however this was clinically and statistically insignificant. Ease of insertion, time for successful insertion, insertion attempts, intra-operative manoeuvres were all comparable between the groups with no adverse effects. Conclusions: Pre-warming of i-gel to 40°C does not improve the success rate of insertion or provide a higher sealing pressure in anaesthetised and paralysed patients when compared to i-gel at room temperature.

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Airway management equipment

Cited by 5 publications

References 114 publications

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator

Management of endotracheal tube breakage during extubation in a lion (Panthera leo)

Does prewarming of i-gel improve insertion and ventilation in anaesthetised and paralysed patients? A prospective, randomised, control trial

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