Comparison of tracheal intubation by the Macintosh laryngoscope and Pentax-AWS (Airway Scope) during chest compression: a manikin study

Abstract

To compare tracheal intubation with the Pentax Airway Scope (AWS) and the Macintosh laryngoscope (McL) during chest compression, 25 anesthesiologists (including 12 specialists having >5 years of experience and 13 trainees having <2 years of experience) performed tracheal intubation using either the McL or the AWS, with or without chest compression, on a manikin. Using the McL, both specialists and trainees took a significantly longer time (P < 0.01) to secure the airway with chest compression (17.3 +/- 3.7 and 22.5 +/- 8.0, respectively) and than without chest compression (11.3 +/- 2.9 and 13.9 +/- 4.4 s, respectively). No significant difference was observed in time needed to secure the airway using the AWS with or without chest compression in both groups. From the standpoint of experience, time to complete intubation for specialists using the McL during chest compression was significantly shorter than that for trainees. In contrast, the difference in time to complete intubation with the AWS during chest compression was not significantly different between the two groups. Based on these results, we conclude that the use of the AWS may reduce the time needed to secure the airway during chest compression.

Tracheal intubation during chest compressions using Pentax-AWS®, GlideScope®, and Macintosh laryngoscope: a randomized crossover trial using a mannequin

“…However, marked delays in intubation during chest compression have been reported in some studies with the Macintosh laryngoscope. 9 Moreover, overall success rates were significantly lower with the Macintosh laryngoscope than with the Pentax-AWS. 7,8,10 Success rates of 100% have been reported for the Pentax-AWS compared with success rates of 57.1%, 8 74.3%, 10 and 81.3% 7 reported for the Macintosh.…”

“…[7][8][9][10][14][15][16] The laryngoscopes employed in the majority of these previous studies were the conventional Macintosh laryngoscope and the Pentax-AWS. [7][8][9][10]14,15 While four studies [7][8][9][10] reported that the Pentax-AWS was more effective than the Macintosh laryngoscope, two studies 14,15 reported no significant difference.…”

“…Les donne´es suivantes ont e´te´mesure´es et enregistre´es : temps jusqu'a`intubation trache´ale re´ussie (crite`re d'e´valuation principal), taux de re´ussite global, temps jusqu'a`visualisation des cordes vocales, pourcentage d'ouverture glottique, compression dentaire et facilited 'intubation. Résultats Dans les cas de voies ae´riennes normales, les temps (moyenne [e´cart interquartile]) jusqu'a`intubation trache´ale e´taient plus courts avec le Pentax-AWS (12,1 [10,1-14,4] sec) et le GlideScope (14,3 [12,[4][5][6][7][8][9][10][11][12][13][14][15][16][17]6] sec) qu'avec le laryngoscope Macintosh (16,5 [13,,1] sec) (P \ 0,03 pour les deux). La diffe´rence de temps entre les deux vide´olaryngoscopes n'e´tait pas significative d'un point de vue statistique.…”

“…7 In other studies, it has been reported that the Pentax-AWS is a more effective device than the Macintosh laryngoscope for the performance of tracheal intubation during uninterrupted chest compressions. [8][9][10] The GlideScope Ò (Verathon Ò , Bothell, WA, USA) is another popular indirect laryngoscope developed for the management of difficult airways. Studies have demonstrated that the GlideScope may provide a better laryngoscopic view than direct laryngoscopy, 11 and it may be advantageous for tracheal intubation in patients with a difficult airway.…”

Comparison of Pentax-AWS Airwayscope video laryngoscope, Airtraq optic laryngoscope, and Macintosh laryngoscope during cardiopulmonary resuscitation under cervical stabilization: a manikin study

“…In simulation studies utilizing a manikin, we and others have previously reported that AWS more effectively secures the airway during chest compression simulation in a manikin than the Macintosh laryngoscope (McL) [10,11]. One group reported that AWS was superior to ATQ and McL [12].…”