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Severely enlarged left thyroid lobe Airtraq and FOB after failed intubation

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Awake morbidly obese with difficult airway

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Awake in an immobile neck

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Severe ankylosing spondylitis

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Giant Lipoma at the Nape

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Awake Plexiform neurofibroma of face

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Severe macrosomia. After failed awake nasotracheal FOB

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Spinal surgery reintubation in prone position

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7-year-old child with severe cervical burned sequels

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Thoraco-omphalopagus Twins

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3 month old child with occipital meningocele

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Child with Goldenhar syndrome, previously failed intubation

• Immediate glottis view without using any additional equipment.
• Perfect backup viewing solution

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Airtraq Laryngoscope vs Macintosh : a systematic review and meta – analysis

British Journal of Anaesthesia 2011. Y.Lu H. Jiang & Y.S. Zhu, Shanghai Jiao Tong University, China

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Comparison of video laryngoscopes vs. direct laryngoscopy for tracheal intubation: a meta-analysis of randomised trials

Yung-Cheng Su, European Journal of Aanaesthesiology · Sept 2011  

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Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq

British Journal of Anaesthesia S. K. Ndoko et Al. Jean Verdier Public University Hospital of Paris.

One hundred and six consecutive ASA I–III morbidly obese patients undergoing surgery were randomized to intubation with the Macintosh laryngoscope or the Airtraq.

In the Airtraq group, tracheal intubation was successfully carried out in all patients within 120 s. In the Macintosh laryngoscope group, six patients required intubation with the Airtraq laryngoscope.

The mean (SD) time taken for tracheal intubation was 24 (16) and 56 (23) s, respectively, with the Airtraq and Macintosh laryngoscopes, (P,0.001). SpO2 was better maintained in the Airtraq group than in the Macintosh laryngoscope group with one and nine patients, respectively, demonstrating drops of SpO2 to 92% or less (P,0.05).

Conclusions. In this study, the Airtraq laryngoscope shortened the duration of tracheal intubation and prevented reductions in arterial oxygen saturation in morbidly obese patients.

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Forces applied by the laryngoscope blade onto the tongue during intubation attempts: a comparison between MacIntosh, AirTraq and Pentax AWS in a mannequin study

European Journal of Anaesthesiology, T. Gaszynski. Medical University of Lodz, Poland

The objective of this study was to measure the pressure created by different intubation devices on the tongue during endotracheal intubation attempts in the mannequin model . Fourteen specialists and 20 anesthesiologists in training.

Pressure created on the tongue was highest when the Macintosh blade was used and was more than five times higher than with AirTraq and Pentax AWS (P<0.05). When comparing the Pentax AWS and AirTraq, there was no statistical difference (P>0.05).

Measurement of forces applied during Macintosh direct laryngoscopy compared with GlideScope videolaryngoscopy*

T. Russell, University of Toronto, Toronto, Canada

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Simulating face-to-face tracheal intubation of a trapped patient: a randomized comparison of the LMA Fastrach, the GlideScope, and the Airtraq laryngoscope

British Journal of Anaesthesia , R. Amathieu, Paris.

Thirty senior emergency medicine physicians were trained in the use of the LMA Fastrach, GlideScope, and Airtraq laryngoscope with a standard airway trainer manikin (control).

Participants were then asked to perform tracheal intubation in two difficult situations simulated on a difficult airway management manikin wearing a cervical collar. In Situation 1, the manikin was in the supine position with a difficult airway caused by stiffening the cervical spine. In Situation 2, the manikin was positioned to simulate face-to-face tracheal intubation. We measured intubation times, success rates for tracheal intubation, and the difficulty of tracheal intubation.

Conclusions. The Airtraq was superior to both the GlideScope and LMA Fastrach during simulated face-to-face difficult tracheal intubation.

Inverse intubation in entrapped trauma casualties: a simulator based, randomised cross-over comparison of direct, indirect and video laryngoscopy

Emerg Med J, Patrick Schober, VU University Medical Center Amsterdam, Holland

Background Airway management in entrapped casualties with restricted access to the head is challenging. If tracheal intubation is required and conventional laryngoscopy is not possible, intubation must be attempted in a face-to-face approach

Methods 24 anaesthesiologists direct laryngoscopy (Macintosh blade #3), Airtraq and McGrath).

The manikin was sitting with the neck immobilised and only accessible from the left anterolateral side.

All three techniques have a high success rate, but the usefulness of the McGrath is limited due to longer intubation duration. Inverse direct laryngoscopy showed reasonable intubation times.

Intubation was always successful and tended to be fastest with the Airtraq device, suggesting that this technique may be a promising alternative

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Airtraq Face to Face Intubation

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Airtraq Face to Face Intubation

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Airtraq Face to Face Intubation

Performance of the glottiscopes: a randomized comparative study on difficult intubation simulation manikin.

Ann Fr Anesth Reanim. Sudrial et Al.

Prospectively compared simulated-difficult tracheal intubation characteristics of four glottiscopes: Airtraq, GlideScope, McGrath, LMA CTrach with that of the conventional Macintosh laryngoscope.

Forty-two physicians, naïve to glottiscope More than 1600 supervised tracheal intubations were performed

Compared to the Macintosh laryngoscope, GlideScope, McGrath, tracheal intubation duration was shorter (p<0.05) with the Airtraq and longer (p<0.01) with the LMA CTrach.

Airtraq and Macintosh laryngoscope were respectively the simplest (p<0.01) and the most difficult (p<0.01) airway devices to manage a simulated difficult tracheal intubation.

Airtraq and the LMA CTrach both demonstrated remarkable advantage over GlideScope and McGrath for simulated difficult intubation management.

Comparison of the Glidescope, the McGrath, the Airtraq and the Macintosh laryngoscopes in simulated difficult airways

Anaesthesia, Savoldelli et Al. University of Geneva

Sixty anaesthesia providers (20 staff, 20 residents, and 20 nurses) were enrolled into this study. The volunteers intubated the trachea of a Laerdal SimMan manikin in three simulated difficult airway scenarios.

In all scenarios, indirect laryngoscopes provided better laryngeal exposure than the Macintosh blade and appeared to produce less dental trauma.

In the most difficult scenario (tongue oedema), the Macintosh blade was associated with a high rate of failure and prolonged intubation times whereas indirect laryngoscopes improved intubation time and rarely failed. Indirect laryngoscopes were judged easier to use than the Macintosh.

The Airtraq consistently provided the most rapid intubation. Laryngeal grade views were superior with the Airtraq and McGrath than with the Glidescope.

The learning curve for laryngoscopy: Airtraq versus Macintosh laryngoscopes

J Anesthesia, M. Baciarello, University of Parma, Italy

Purpose. This prospective study was designed to compare learning curves for laryngoscopy with the Airtraq or Macintosh laryngoscopes in patients under general anesthesia.

Methods. Ten medical students with no prior experience in airway management were recruited. Each student performed laryngoscopy with either device on ten consecutive patients.

Conclusion: Students achieved higher success rates using the Airtraq laryngoscope during early training on live patients.

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Teaching tracheal intubation: Airtraq is superior to Macintosh laryngoscope

BMC Medical Education, Hong Zhao, Peking University People’s Hospital, Beijing, China

Method: Twenty-six medical students in the 6th year participated in this trial. Each of the students intubated 3 patients with each laryngoscope respectively. Macintosh (n = 75) or Airtraq (n =74).

Results:

• Intubation success rate was significantly higher in Airtraq group (87.8% vs. 66.7%, P < 0.05).
• Duration of glottis exposure was significantly shorter in Airtraq group (50 ± 19 s vs. 81 ± 27 s, P < 0.001).
• A grade I Cormack and Lehane glottic view was obtained in 94.6% of patients in the Airtraq group versus 32% of patients in the Macintosh group (P <0.001).
• Duration of intubation in Airtraq group was significantly shorter (68 ± 21 s vs. 96 ± 22 s, P < 0.05).

CONCLUSION: Airtraq laryngoscope is easier to master for novice personnel with a higher intubation success rate and shorter intubation duration compared with the Macintosh laryngoscope.

Alternative intubation techniques vs Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials

British Journal of Anaesthesia, 2015, 1–10, L. Suppan1Geneva University Hospitals,

Results: Twenty-four trials (1866 patients) met inclusion criteria.

Meta analyses could be performed for Airtraq, Airwayscope, C-Mac, Glidescope, and McGrath.

The Airtraq was associated with a statistically significant:

• a reduction of the risk of intubation failure at the first attempt,
• a higher rate of Cormack–Lehane grade 1,
• a reduction of time until successful intubation,
• a reduction of oropharyngeal complications.

Other devices were associated with improved glottis visualization but no statistically significant differences in intubation failure or time to intubation compared with conventional laryngoscopy.

Conclusions: In situations where the spine is immobilized, the Airtraq device reduces the risk of intubation failure. There is a lack of evidence for the usefulness of other intubation devices.

The use of the Airtraq for routine tracheal intubation in high-risk cardiosurgical patients

BMC Research Notes , Schälte, University Hospital Aachen, Germany

123 consecutive ASA III patients undergoing elective coronary artery bypass grafting were routinely intubated with the Airtraq.

In conclusion our results demonstrate that routine tracheal intubation with Airtraq is feasible, fast and save in high-risk cardiac patients. The use of the Airtraq allowed maintaining a stable hemodynamic situation.

A comparison of Airtraq & Macintosh in routine airway management: a randomized, controlled clinical trial

Anaesthesia,. Maharaj . Univ. Of Ireland, Galway

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Hemodynamic Response to Endotracheal Intubation Comparing the Airtraq® with Macintosh in Cardiac Surgical Patients

Aleksandra G. Brzanov, Sabah Al Ahmed Cardiac Center, Kuwait

Sixty patients who underwent elective coronary artery bypass graft surgery.

Results demonstrate that routine endotracheal intubation using Airtraq in patients undergoing routine CABG surgery can reduce hemodynamically changes and allow maintaining a stable hemodynamic situation, compared to the Macintosh laryngoscope.

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Airtraq: new device in patients at increased risk for difficult tracheal intubation

Critical Care S Tomasino, Alto Friuli, Tolmezzo, Udine, Italy

In this randomised, controlled, clinical trial authors enrolled 30 patients at increased risk for difficult tracheal intubation, undergoing surgical operations requiring tracheal intubation.

All patients, maintained in spontaneous breathing all through the procedure, received awake intubation performed by one of three anesthetists expert in difficult airway management. All patients received a topical airway anesthesia with 2% lidocaine and total intravenous anesthesia (TIVA) performed with propofol c.i. with an effecter site concentration of 1.5 μg/ml.

All patients were successfully intubated in both groups. In Airtraq group the authors assessed a short time and a small amount of attempts of intubation with a statistically significant difference between the two groups. No difference was noted between the two groups in hemodynamic setting, saturation, Ramsey score and airway-trauma-related side effects.

Conclusions: Our experience demonstrated that the Airtraq could be used during awake sedations and may be a promising alternative device for difficult airway management as a valid alternative to the traditional fiberoptic bronchoscope.

Airway topical anesthesia using the Airtraq in patients with difficult airways

Canadian Anesthesiologists Soc , F.S. Xue, , Chinese Academy of Medical Sciences

The authors describe our initial experience with a method of airway topical anesthesia for awake tracheal intubation in adult patients with difficult airways using a combination of an Airtraq laryngoscope and a MADgic laryngotracheal atomizer.

Once the distal end of the Airtraq laryngoscope was positioned in the vallecula with the glottis in the center of the viewfinder, the curved applicator portion of a MAD-LTA was advanced through the lateral channel of the Airtraq. By adjusting the distant position of the applicator portion under direct vision on the viewfinder, its tip was placed immediately superior to the glottis and the bilateral pyriform recess. Then, 3 mL of 2% lidocaine was sprayed in three aliquots onto these targeted areas with the MAD-LTA.

Several advantages appear to exist with this technique: the applicator portion of the MAD-LTA can well be adapted to the curved blade of the Airtraq / the MAD-LTA can be directed easily towards the different targeted airway structures / this approach can provide excellent airway topical anesthesia for awake orotracheal intubation / this technique is well tolerated by the awake, sedated patient / this technique is easy to perform.

Therefore, the authors believe this technique can provide a favourable alternative to a fiberoptic technique for the management of difficult airways.

Endotracheal intubation with Airtraq versus Storz videolaryngoscope in children younger than two years - a randomized pilot-study

BMC Anesthesiology, Martin K Soerensen, University Hospital, Rigshospitalet, Denmark

The aim of the study was to compare the Storz videolaryngoscope to the Airtraq Optical laryngoscope for tracheal intubation in children younger than two years of age who had a normal airway assessment. Our hypothesis was that the Storz would have a better success rate than Airtraq.

Ten children aged 2 years or younger scheduled for elective cleft lip/palate surgery were included. The anesthesia was standardized and a Cormack-Lehane (CL)-score was obtained using a Macintosh laryngoscope. After randomization CL-score and endotracheal tube positioning in front of the glottis was performed with one device, followed by the same procedure and intubation with the other device. The video-feed was recorded along with real-time audio. The primary endpoint was the success rate, defined as intubation in first attempt. Secondary endpoints were the time from start of laryngoscopy to CL-score, tube positioning in front of the glottis, and intubation.

No difference in the success rate of endotracheal intubation could be established in this ten patient sample of children younger than two years with a normal airway assessment scheduled for elective cleft lip/palate surgery. However, the Airtraq showed a number of time related advantages over the Storz videolaryngoscope.

A Comparitive Study of the Efficacy of Pediatric Airtraq with Conventional Laryngoscope in Children

Minerva Anestesiology , Dr Qazi Ehsan Ali, Nehru Medical College India

Method: Patients were allocated into two groups of 17 patients each using the paediatric Airtraq in one and a conventional laryngoscope in the other. The primary outcome measure was time needed for successful intubation whereas secondary outcome measures were number of attempts to intubate, POGO (percentage of glottis opening) scoring and complications like airway trauma and oesophageal intubation.

Results: It took significantly shorter time to intubate in Airtraq intubation group of patients as compared to Conventional intubation group of patients (P <0.05). Similarly the POGO scoring was significantly better in Airtraq intubation compared to Conventional intubation (P <0.001). Number of attempts to intubate and complications like airway trauma and oesophageal intubation using Airtraq was less frequent compared to conventional laryngoscopy but the difference was statistically insignificant.

CONCLUSION: Paediatric Airtraq provides better intubating conditions in children compared to conventional laryngoscope with less frequent complications.

Easy and difficult nasal intubation – a randomised comparison of Macintosh vs Airtraq laryngoscopes

Anaesthesia, St. Kliniken Essen-Mitte, Essen, Germany

The authors prospectively compared tracheal intubation efficiency of the Airtraq for nasotracheal intubation vs that of the Macintosh in 200 patients.

All easy intubations were succesfully performed with the respective technique.

In the expected difficult intubation group, the success rate was higher, the glottis view was better, mean (SD) intubation time was shorter and the number of optimising manoeuvres was reduced with the nasotracheal Airtraq compared with the Macintosh, respectively.

For difficult nasal intubations, the nasotracheal Airtraq is more effective than the Macintosh laryngoscope

Comparison of Airtraq with Conventional Laryngoscopy in 50 ENT Patients Undergoing Microlaryngoscopy

ASA 2009 Abstract Harald V. Genzwuerker,, Neckar-Odenwald-Kliniken , Buchen and Mosbach, Germany

Laryngoscopic view was obtained with a Macintosh blade by an anesthesia resident with 2 years of training in 50 adult patients before intubation was attempted with the Airtraq by the same operator. Cormack and Lehane score was used to compare glottic view.

Conclusion: In ENT patients presenting for microlaryngoscopical surgery, laryngoscopic view is improved with the Airtraq® when compared to conventional laryngoscopy with a Macintosh blade.

Better view may lead to less trauma and swelling at the glottic inlet caused by intubation, facilitating planned procedures.

Airtraq vs GlideScope for double-lumen tube intubation in patients with predicted normal airways: a prospective randomized trial

BMC Anesthesiology (2015), DOI 10.1186/s12871-015-0037-5

Seventy ASA physical status I and II patients with predicted normal airway were scheduled for thoracic surgeries with double-lumen tube intubation. They were randomly assigned to one of two groups and intubated with either the Airtraq laryngoscope (group A, n = 35) or the GlideScope (group G, n = 35).

The mean arterial pressure and heart rate rose to higher levels during intubation with the GlideScope than with the Airtraq laryngoscope. The success of the first intubation attempt and the intubation difficulty scales were comparable between the two groups. The numbers of patients who experienced postoperative sore throat were similar (6 vs. 8) in the two groups.

Conclusions: Compared with the GlideScope, the specially designed Airtraq laryngoscope might be more suitable for double-lumen tube intubations in patients with predicted normal airway.

A Comparison of 3 Videolaryngoscopes for Double-Lumen Tube Intubation in Humans by Users With Mixed Experience: A Randomized Controlled

Journal of Cardiothoracic Anesthesia, 2017

Participants: The study comprised 133 patients undergoing elective thoracic surgery Interventions. Patients were randomly allocated into the following 4 groups of DLTs: Macintosh (n 32), GlideScope (n 34), Airtraq (n 35),or King VL (n 32).

Conclusions: Use of the Airtraq for endobronchial intubation was of clinical importance because it was associated with
- a significantly shorter time to endobronchial intubation (–63.5%)
- a lower intubation difficulty score (–54.2%)
- and required fewer frequent optimizing maneuvers (–45.3%)
than that of the GlideScope.

In addition, when compared with the GlideScope and KVL laryngoscopes, the Airtraq required less time to confirmation of endobronchial intubation (40.4% and 26.9%, respectively). In addition, in the present study, there was no cuff rupture in the Airtraq group.

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Contenuto

• Nozioni fondamentali di controllo delle vie aeree
• Introduzione al dispositivo
• Perché l'intubazione video guidata
• Opzioni di visualizzazione

Obiettivo

• Acquisire una conoscenza di base relativa alla modalità di intubazione con Airtraq
• Individuare i potenziali problemi durante l'utilizzo iniziale e proporre soluzioni

Tempo richiesto

• 30 minuti

Contenuto

• Scelta della misura dell'Airtraq
• Preparazione - Airtraq SP
• Preparazione - Airtraq Avant
• Tenere in mano l'Airtraq
• Inserimento dell'Airtraq
• Individuazione delle strutture della glottide
• Inserimento dell'ETT
• Gonfiamento del manicotto e rimozione dell'Airtraq
• Smaltimento dell'Airtraq SP
• Smaltimento dell'Airtraq Avant
• Intubazione naso tracheale
• Intubazione con doppio lume
• Intubazione pediatrica

Obiettivo

• Acquisire una conoscenza di base relativa alla modalità di intubazione con Airtraq
• Individuare i potenziali problemi durante l'utilizzo iniziale e suggerire soluzioni

Tempo richiesto

• da 30 a 45 minuti

Contenuto

• Confronto tra laringoscopia generale e diretta
• Vie aeree difficili
• Obesità e ostetricia
• Pazienti coscienti
• Pazienti traumatizzati
• Ambiente pre-ospedaliero e militare
• Procedure speciali
• Pediatria
• Naso tracheale
• Doppio lume
• Tecniche avanzate
• Curva di apprendimento
• Rispetto ad altri laringoscopi video

Obiettivo

• Acquisire una conoscenza base degli Studi clinici eseguiti con Airtraq e come trovare

Tempo richiesto

• 15 minuti

Contenuto

• Airtraq SP e Avant (caratteristiche comuni)
• Airtraq SP
• Airtraq Avant
• Videocamera Wi-Fi
• Adattatore per telefono

Objective

• Acquisire una conoscenza dettagliata delle diverse caratteristiche dei prodotti Airtraq

Tempo richiesto

• da 60 a 90 minuti

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