Nasotracheal fibreoptic intubation: a randomised controlled trial comparing the GlideRite® (Parker‐Flex® Tip) nasal tracheal tube with a standard pre‐rotated nasal RAETM tracheal tube

Lomax, Suzi; Johnston, Kelly; Marfin, A. G.; Yentis, S. M.; Kathawaroo, S.; Popat, M.

doi:10.1111/j.1365-2044.2011.06621.x

Cited by 13 publications

(16 citation statements)

References 30 publications

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“…Using the smallest appropriate external diameter tracheal tube is advisable, as this may reduce the incidence of impingement (Grade B). Positioning the bevel of the tracheal tube posteriorly is recommended (Grade A). For ATI:VL, tracheal tube selection is similar to that in an asleep patient and is influenced by the VL selected.…”

Section: Procedural Setupmentioning

confidence: 99%

“…This should factor in size (internal and external diameter), shape, length, tip design and material. For ATI:FB, reinforced, Parker Flex-Tip TM (Bridgewater, CN, USA) and intubating laryngeal mask airway tubes (LMA â Fastrach TM ETT, Teleflex, Beaconsfield, UK) have been shown to be superior to standard polyvinylchloride (PVC) tracheal tubes in terms of ease of tracheal intubation, railroading (advancing the tracheal tube over the flexible bronchoscope) and decreasing laryngeal impingement[78][79][80][81][82][83][84][85][86]. Therefore, the use of a standard PVC tracheal tube is not recommended (Grade A).…”

mentioning

confidence: 99%

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Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

et al. 2019

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Summary Awake tracheal intubation has a high success rate and a favourable safety profile but is underused in cases of anticipated difficult airway management. These guidelines are a comprehensive document to support decision making, preparation and practical performance of awake tracheal intubation. We performed a systematic review of the literature seeking all of the available evidence for each element of awake tracheal intubation in order to make recommendations. In the absence of high‐quality evidence, expert consensus and a Delphi study were used to formulate recommendations. We highlight key areas of awake tracheal intubation in which specific recommendations were made, which included: indications; procedural setup; checklists; oxygenation; airway topicalisation; sedation; verification of tracheal tube position; complications; management of unsuccessful awake tracheal intubation; post‐tracheal intubation management; consent; and training. We recognise that there are a range of techniques and regimens that may be effective and one such example technique is included. Breaking down the key practical elements of awake tracheal intubation into sedation, topicalisation, oxygenation and performance might help practitioners to plan, perform and address complications. These guidelines aim to support clinical practice and help lower the threshold for performing awake tracheal intubation when indicated.

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Section: Procedural Setupmentioning

confidence: 99%

mentioning

confidence: 99%

Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

et al. 2019

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“…Nasotracheal intubation time is the time elapsing from the device entering the oral cavity until the visualization of the tube entering through the vocal cords. When a resistance was felt during the tube adjustment, the maneuvers included 90° counterclockwise rotation maneuver (6,12), external laryngeal pressure (3,13), cuff inflation (14,15), head flexion, changing the operator, use of Magill forceps were applied (10) in random order. Total nasotracheal intubation time is the time elapsing from the device entering the oral cavity until the confirmation of intubation from the capnograph.…”

Section: Methodsmentioning

confidence: 99%

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

Arslan¹,

Türkyılmaz²

2019

Turk J Med Sci

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Background and aim: Nasotracheal Airtraq, is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. Materials and methods: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18-70 years of age undergoing elective maxillofascial, oral and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomised into the right and left nostril groups. Results: Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (p<0.001). 90 anti-clockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (p<0.001 vs p=0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. Conclusion: Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90 anti-clockwise rotation, external laryngeal pressure and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand; cuff inflation maneuver also must be kept in mind. Keywords: Airtraq, nasotracheal, right nostril, 90 degree anticlockwise, cricoid pressure, head flexion

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“…Les mandrins articulés Parker (Flex-It TM ) ou stylet directionnel type Schroeder [43] sont des mandrins en plastique à usage unique, insérés directement dans le TET. La courbure distale du tube est ensuite modifiée directement pendant l'intubation, en exerçant une pression spécifique avec le pouce sur un ressaut du mandrin [44,45]. Aucune étude n'a démontré la supériorité de ces stylets à ce jour et le développement continu d'outils et de techniques améliorant l'intubation ont conduit à l'abandon de ces stylets.…”

Section: Les Mandrins Non Métalliquesunclassified

Comment préférez-vous votre guide ou mandrin pour intuber ? Long ou court, plein ou creux, dur ou mou, droit ou béquillé ?

Schoettker

Grape

2016

Le Praticien en Anesthésie Réanimation

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But.-Les guides et mandrins sont des dispositifs régulièrement utilisés pour la gestion des voies aériennes difficiles dans différents scénarios. Leur utilisation en première intention est proposée par un grand nombre d'algorithmes. Leur forme et techniques d'utilisation évoluent régulièrement. Notre but est de fournir au clinicien une mise à jour concernant les caractéristiques, indications, techniques d'utilisation et les dangers des différents guides et mandrins utilisés comme aides à l'intubation. Méthode.-Nous avons effectué une recherche systématique de la littérature jusqu'en mai 2015, sans restrictions de langue. Les deux auteurs ont retiré, de façon indépendante, toutes les études, rapports de cas et séries avec les mots clés « bougie », « gum elastic bougie », « stylet », « airway management », « tracheal tube introducer », « intubation aid », « extubation catheter », « bougie élastique », « mandrin », « stylet d'intubation », « management des voies aériennes », « introducteur », « aide à l'intubation » et « mandrin d'extubation ». Résultats.-Nous avons trouvé principalement des études observationnelles et rétrospectives avec au total un petit nombre de sujets. Ces données ont été synthétisées dans une revue narrative. Conclusion.-À ce jour, de nombreux guides et mandrins existent pour assister à la gestion de la voie aérienne difficile. Chacun d'entre eux possède des indications différentes, avec une

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Nasotracheal fibreoptic intubation: a randomised controlled trial comparing the GlideRite^® (Parker‐Flex^® Tip) nasal tracheal tube with a standard pre‐rotated nasal RAE^TM tracheal tube

Cited by 13 publications

References 30 publications

Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults

Which nostril should be used for nasotracheal intubation with Airtraq NT?: the right or left? A randomized clinical trial

Comment préférez-vous votre guide ou mandrin pour intuber ? Long ou court, plein ou creux, dur ou mou, droit ou béquillé ?

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