A Randomised Controlled Trial Comparing Fibreoptic-Guided Tracheal Intubation through Two Supraglottic Devices: Ambu® Auragain™ Laryngeal Mask and LMA® Fastrach™

Preece, G; Ng, Irene; Lee, K; Mezzavia, Paul Mario; Krieser, Roni Benjamin; Di, Williams; Stewart, Orla; Segal, Reny

doi:10.1177/0310057x1804600508

Cited by 16 publications

(14 citation statements)

References 9 publications

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“…The mean time taken in the insertion of ILMA was significantly higher than that observed in group 2. Similar observations were observed in a previous case study in which Ambu Aura Gain LM and LMA FastrachTM were compared [7]. A previous case study comparing Ambu Aura-i and LMA Supreme showed no significant difference in the time of insertion of both the device [8].…”

Section: Discussionsupporting

confidence: 81%

Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

Mishra¹,

Bharadwaj²

2020

Cureus

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Background and aim The primary aim of the study was to compare the intubation characteristics and effectiveness of intubating laryngeal mask airway (ILMA) and Ambu® Aura-i™ as a conduit for facilitating fiberoptic-guided intubation. Methods Eighty patients were enrolled in the randomized-controlled hospital-based study. After inducing general anesthesia, an appropriately sized ILMA (group 1)/Ambu Aura-I (group 2) was placed. Fiberoptic assessment of the glottic view was done followed by fiberoptic-guided tracheal intubation. The time taken for the insertion of ILMA/Ambu Aura-i, glottic view grading, time taken for fiberoptic-guided intubation, ease of intubation, time taken for the removal of ILMA/Ambu Aura-i were recorded. Data analysis was done using the two-tailed independent t-test, paired t-test, and Fisher's exact probability test. Result Anthropometric and airway parameters were similar in both groups. The success rate of the insertion of both devices was 100%. In group 1, the mean time taken for the insertion was 20.53±1.91, and it was 13.98±2.4 in group 2 (P<0.001S). Fiberoptic assessment of the glottic view in group 1 (ILMA group) was grade 1 in 80% of the patients, whereas it was 92% in group 2 (Ambu Aura-i) (P=0.54). The mean time taken for fiberoptic-guided intubation was 14.95±1.85 in group 1 and 14.15±1.37 in group 2 (P>0.001). No significant difference was observed according to the number of attempts in intubating through ILMA/Ambu Aura-i. Seventy-five percent (75%) in group 1 and 87.5% in group 2 were successfully inserted on the first attempt (= 0.33). The time taken for the removal of the device was 11.87 +1.265 seconds in group 1 and 11.25±1.58 seconds in group 2 (P=0.054). Conclusion The Ambu Aura-i scores superiorly over ILMA in requiring less time for successful insertion on the basis of statistical analysis and hence appears to be a better independent ventilatory device.

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Section: Discussionsupporting

confidence: 81%

Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

Mishra¹,

Bharadwaj²

2020

Cureus

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“… Proporción del grado de facilidad de intubación orotraqueal. Usando la escala subjetiva de facilidad descrita por G. Preece y col. (6). Se trata de una escala de 0 a 10, en donde 0: extremadamente difícil y 10: extremadamente fácil.…”

Section: Medición De Resultadosunclassified

“…En la actualidad existen diferentes dispositivos supraglóticos disponibles para uso en pediatría; uno de ellos la máscara laríngea AuraGain, que por sus características de diseño permite la intubación orotraqueal guiada por fibrobroncoscopia (5), lo cual está respaldado por ensayos clínicos realizados en adultos (6)(7)(8), que reportan una porcentaje de intubación al primer intento del 91% al 100%, con un tiempo de intubación 21.4 a 127 segundos; además comparado con otros dispositivos supraglóticos tiene mejores porcentajes de visualización glótica y permite realizar una intubación traqueal más fácil y rápida. Sin embargo, en la población pediátrica este dispositivo no cuenta con estudios que evalúen su desempeño para ser usado como conductor en intubación con fibra óptica.…”

Section: Introductionunclassified

Intubación orotraqueal por medio de fibrobroncoscopio flexible sin conductor vs guiada con máscara laríngea AuraGain en simuladores pediátricos: Ensayo clínico cross over

Saldarriaga

Orozco

2021

Rev Esp Edu Med

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Antecedentes: La incidencia de intubación difícil en población pediátrica es de 2 a 11 casos por 1000 pacientes llevados a anestesia general, lo que conlleva riesgos potenciales como hipoxemia, parada cardíaca y muerte. Dentro de las estrategias para el manejo de la vía aérea difícil en los niños se encuentra el uso de fibroscopia flexible para guiar la intubación, que se puede combinar con un dispositivo supraglótico con la finalidad de facilitar su inserción, superar obstrucciones de la vía aérea superior y permitir una ventilación simultánea. El objetivo de este estudio fue comparar la intubación orotraqueal en simuladores pediátricos, utilizando fibrobroncoscopio flexible sin conductor versus el uso de la máscara laríngea AuraGain como conductor, con el fin de demostrar si el uso de dicho dispositivo supra glótico tiene alguna ventaja comparado con intubar sin conductor. Métodos: 41 anestesiólogos y residentes de anestesiología, fueron asignados al azar para realizar una intubación orotraqueal en un simulador pediátrico, utilizando fibrobroncoscopio flexible sin conductor o utilizando como guía la máscara laríngea AuraGain. Resultados: La intubación exitosa en el primer intento se consiguió en 38 de 41 intubaciones en el grupo de fibrobroncoscopia sin conductor y en 32 de 41 intubaciones en el grupo de fibrobroncoscopia con AuraGain, sin encontrar diferencias estadísticamente significativas. El grupo de fibrobroncoscopia sin conductor tuvo una mediana de tiempo de intubación significativamente más corta (41 segundos), comparado con el grupo de fibrobroncoscopia y AuraGain (67.5 segundos). Conclusiones: Usar el dispositivo AuraGain como conductor para intubar simuladores pediátricos con fibra óptica no mejora la intubación al primer intento, la intubación global, ni la visualización glótica, comparado con intubar solo con fibra óptica. Usar AuraGain aumenta los tiempos de intubación, sin embargo, dichos hallazgos deben ser confirmados en estudios con humanos. Background: The incidence of difficult intubation in pediatric population is 2 to 11 cases per 1000 patients brought to general anesthesia, which carries potential risks such as hypoxemia, cardiac arrest and death. Among the strategies for the management of difficult airway in children is the use of flexible fiberscopy to guide intubation, which can be combined with a supraglottic device in order to facilitate its insertion, overcome upper airway obstructions and allow simultaneous ventilation. The aim of this study was to compare orotracheal intubation in pediatric simulators, using a flexible fibrobronchoscope without driver versus using the AuraGain laryngeal mask as a driver, in order to demonstrate whether the use of such a supraglottic device has any advantage compared to intubating without a driver. Methods: 41 anesthesiologists and anesthesiology residents were randomly assigned to perform orotracheal intubation in a pediatric simulator using either a flexible fibrobronchoscope without a driver or the AuraGain laryngeal mask as a guide. Results: Successful intubation on the first attempt was achieved in 38 of 41 intubations in the driverless fibrobronchoscopy group and in 32 of 41 intubations in the fibrobronchoscopy with AuraGain group, with no statistically significant differences. The driverless fibrobronchoscopy group had a significantly shorter median intubation time (41 seconds) compared to the fibrobronchoscopy and AuraGain group (67.5 seconds). Conclusions: Using the AuraGain device as a driver to intubate pediatric simulators with fiberoptics does not improve first-attempt intubation, overall intubation, or glottic visualization compared with intubating with fiberoptics alone. Using AuraGain increases intubation times, however, such findings need to be confirmed in human studies.

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“…The ITLS-D2 is constructed for blind intubation but can also be combined with fibreoptic guided intubation through the ILTS-D. Undoubtedly, intubation endoscopy is the most reliable technique in this context, but it requires advanced skills and is, therefore, reserved for experienced airway management providers only [12]. However, the success rate using the ILTS-D2 was comparable with that of the FT-LM over all five attempts.…”

Section: Discussionmentioning

confidence: 99%

Does the revised intubating laryngeal tube (ILTS-D2) perform better than the intubating laryngeal mask (Fastrach)? – a randomised simulation research study

et al. 2020

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Background: The intubating laryngeal tube (ILTS-D™) and the intubating laryngeal mask (Fastrach™) are devices that facilitate both extraglottic application and blind tracheal intubation. A revised model of the iLTS-D (for scientific reasons called ILTS-D2) has been designed but not yet evaluated. Therefore, we compared the ILTS-D2 with the established Fastrach under controlled conditions in a prospective randomised controlled simulation research study. Methods: After ethical approval, we randomised 126 medical students into two groups. Each participant received either Fastrach or ILTS-D2 to perform five consecutive ventilation attempts in a manikin. The primary endpoint was the time to ventilation in the last attempt of using the devices as extraglottic devices. Secondary endpoints were the time to tracheal intubation and the success rates. Results: There was no relevant difference between the two devices in the time to ventilation in the last of five attempts (Fastrach: median 14 s [IQR: 12-15]; ILTS-D2: median 13 s [IQR: 12-15], p = 0.592). Secondary endpoints showed a 2 s faster blind tracheal intubation using the Fastrach than using the ILTS-D2 (Fastrach: median 14 s [IQR: 13-17]; ILTS-D2: median 16 s [IQR: 15-20] p < 0.001). For both devices, the success rates were 100% in the last attempt. Conclusions: Concerning extraglottic airway management, we could not detect a relevant difference between the revised ILTS-D2 and the Fastrach under laboratory conditions. We advocate for an evaluation of the ILTS-D2 in randomised controlled clinical trials.

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A Randomised Controlled Trial Comparing Fibreoptic-Guided Tracheal Intubation through Two Supraglottic Devices: Ambu® Auragain™ Laryngeal Mask and LMA® Fastrach™

Cited by 16 publications

References 9 publications

Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

Intubación orotraqueal por medio de fibrobroncoscopio flexible sin conductor vs guiada con máscara laríngea AuraGain en simuladores pediátricos: Ensayo clínico cross over

Does the revised intubating laryngeal tube (ILTS-D2) perform better than the intubating laryngeal mask (Fastrach)? – a randomised simulation research study

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