Evaluation of the Pentax-AWS® and the Macintosh laryngoscope in difficult intubation: a manikin study

Kariya, Takayuki; Inagawa, Gaku; Nakamura, Kyota; Fujimoto, Junichi; Aoi, Yoshihiro; Morita, Satoshi; Goto, Takahisa

doi:10.1111/j.1399-6576.2010.02363.x

Cited by 13 publications

(11 citation statements)

References 22 publications

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“…We included 22 manikin studies (42 trials) . The Pentax AWS was more effective than the Macintosh laryngoscope for all outcomes except the rate of audible dental clicks or significant dental compression (equivalent to oral or pharyngeal injury in human studies, Table ).…”

Section: Resultsmentioning

confidence: 99%

Pentax Airway Scope^® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

et al. 2014

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SummaryThe Pentax Airway Scope â is a single-use optical videolaryngoscope designed to assist with difficult tracheal intubation. We systematically reviewed the efficacy of the Pentax Airway Scope with that of a conventional laryngoscope for tracheal intubation in adults with 'normal' and 'difficult' airways. We included 17 randomised controlled trials with a total of 1801 participants. We used the DerSimonian and Laird random-effects model to calculate pooled relative risk or weighted mean differences. The relative risk (95%

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Section: Resultsmentioning

confidence: 99%

Pentax Airway Scope^® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

et al. 2014

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“…It must be underlined that our experimental manikin study has been conducted with a non-difficult airway head, and results cannot be expanded in cases of difficult ETI. Experimental and clinical studies have previously shown, however, that AWS-ETI could be a reliable technique in different difficult airways such as pharyngeal obstruction, cervical spine rigidity, tongue edema [26, 33] and limited mouth opening (≈20 mm) [34]. AWS can also be used according to a multimodal approach combining a flexible stylet or a fiberoptic bronchoscope, particularly if nasal ETI is required [35].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

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Bubenheim

Gelinotte

et al. 2016

Ann. Intensive Care

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BackgroundDifferent video-laryngoscopes (VDLs) for endotracheal intubation (ETI) have recently been developed. We compared the performance of the VDL Airway Scope (AWS) with the direct laryngoscopy by Macintosh (DLM) for ETI success, time and learning.Methods We performed an experimental manikin controlled study. Twenty experienced (experts) and 40 inexperienced operators (novices) for DLM-ETI were enrolled. None of them had experience with the use of AWS-VDL. Novices were assigned to start learning with DLM or AWS, and two sub-groups of 20 novices were formed. Experts group constituted the control group. Each participant performed 10 ETI attempts with each device on the same standard manikin. The primary endpoint was the ETI success probability. Secondary endpoints were ETI time, technical validity and qualitative evaluation for each technique. We also assessed the learning order and the successive attempts effects for these parameters.ResultsOverall, 1200 ETI attempts were performed. ETI success probability was higher with the AWS than with the DLM for all operators (98 vs. 81 %; p < 0.0001) and for experts compared to novices using devices in the same order (97 vs. 83 %; p = 0.0002). Overall ETI time was shorter with the AWS than with the DLM (13 vs. 20 s; p < 0.0001) and for experts compared to novices using devices in the same order (11 vs. 21 s; p < 0.0001). Among novices, those starting learning with AWS had higher ETI success probability (89 vs. 83 %; p = 0.03) and shorter ETI time (18 vs. 21 s; p = 0.02). Technical validity was found better with the AWS than DLM for all operators. Novices expressed global satisfaction and device preference for the AWS, whereas experts were indifferent.ConclusionsAWS-VDL permits faster, easier and more reliable ETI compared to the DLM whatever the previous airway ETI experience and could be a useful device for DLM-ETI learning.

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“…[ 12 – 14 ] Furthermore, videolaryngoscopes were reported to have more advantage in difficult airway management than conventional techniques in manikin and clinical studies. [ 12 – 15 ] Although there have been no case reports regarding emergency airway rescue with videolaryngoscopes for accidental extubation in the prone position, we hypothesized that tracheal intubation with a videolaryngoscope would allow effective airway rescue in this situation. Therefore, in the present study, we compared airway rescue performances of the 2 types of videolaryngoscopes—the channeled and the nonchanneled types, with that of SGAs in a prone manikin simulating accidental extubation in the prone position of a patient with a fixed flexed neck during neurosurgical procedures performed on the cervical spine and posterior fossa lesions.…”

Section: Introductionmentioning

confidence: 99%

Supraglottic airway device versus a channeled or non-channeled blade-type videolaryngoscope for accidental extubation in the prone position

et al. 2018

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Background:It is very rare but challenging to perform emergency airway management for accidental extubation in a patient whose head and neck are fixed in the prone position when urgently turning the patient to the supine position would be unsafe. The authors hypothesized that tracheal intubation with a videolaryngoscope would allow effective airway rescue in this situation compared with a supraglottic airway device and designed a randomized crossover manikin study to test this hypothesis.Methods:The authors compared airway rescue performances of the 3 devices—the ProSeal laryngeal mask airway (PLMA; Teleflex Medical, Westmeath, Ireland) as a reference; the Pentax AWS (AWS; Nihon Kohden, Tokyo, Japan) as a channeled blade-type videolaryngoscope; and the McGRATH videolaryngoscope (McGRATH; Medtronic, Minneapolis, MN) as a nonchanneled blade type in a manikin fixed to the operating table in the prone position. Twenty-one anesthesiologists performed airway management on the prone manikin with the 3 devices, and the time required for intubation/ventilation and the success rates were recorded.Results:The median (range) intubation/ventilation times with the PLMA, AWS, and McGRATH were 24.5 (13.5–89.5) s, 29.9 (17.1–79.8) s, and 46.7 (21.9–211.7) s, respectively. There was no significant difference in intubation/ventilation times between the PLMA and AWS. The AWS permitted significantly faster tracheal intubation than did the McGRATH (P = 0.006). The success rates with the PLMA (100%) and AWS (100%) were significantly greater than that with the McGRATH (71.4%). Airway management performance of the PLMA and AWS was comparable between devices and better than that of the McGRATH in the prone position.Conclusions:Considering that tracheal intubation can provide a more secure airway and more stable ventilation than the PLMA, re-intubation with a channeled blade-type videolaryngoscope such as the AWS may be a useful method of airway rescue for accidental extubation in patients in the prone position.

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Evaluation of the Pentax-AWS® and the Macintosh laryngoscope in difficult intubation: a manikin study

Abstract: The AWS(®) has an advantage over the Macintosh laryngoscope in simulated tongue edema and tongue edema with pharyngeal obstruction. Further studies in a clinical setting are necessary to confirm these findings.

Cited by 13 publications

References 22 publications

Pentax Airway Scope^® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

Pentax Airway Scope^® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

Supraglottic airway device versus a channeled or non-channeled blade-type videolaryngoscope for accidental extubation in the prone position

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Evaluation of the Pentax-AWS® and the Macintosh laryngoscope in difficult intubation: a manikin study

Abstract: The AWS(®) has an advantage over the Macintosh laryngoscope in simulated tongue edema and tongue edema with pharyngeal obstruction. Further studies in a clinical setting are necessary to confirm these findings.

Cited by 13 publications

References 22 publications

Pentax Airway Scope® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

Pentax Airway Scope® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study

Supraglottic airway device versus a channeled or non-channeled blade-type videolaryngoscope for accidental extubation in the prone position

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Product

Resources

About

Pentax Airway Scope^® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis

Pentax Airway Scope^® vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta‐analysis