Successful intubation of a child with Goldenhar syndrome, who previously failed intubation, using an Airtraq

Abstract

The technique of inverting a stylet designed for a larger ETT worked very well in this case, but we do not routinely recommend it because of the theoretical risk of having the end of the stylet advance too far into the endotracheal tube such that it becomes difficult to remove.In summary, we have used a novel supraglottic airway device, the AirQ Ò ILA, as a conduit for fiberoptic intubation in two difficult intubation scenarios. We are currently evaluating its use in pediatric patients, both as a primary supraglottic airway and as a conduit for intubation.

A randomised, controlled trial comparing the Airtraq™ optical laryngoscope with conventional laryngoscopy in infants and children*

“…Reports in adults show improved ease of tracheal intubation [4,5,24], improved laryngeal view [7,[25][26][27], less movement of the cervical spine and fewer alterations in heart rate [4][5][6]28]. The paediatric Airtraq (in infant and child sizes) has not been formally evaluated in children with difficult airways and information is limited to a few case reports, not all of which resulted in successful intubation [11][12][13][14]22]. The aim of this study was to provide data on the use of the paediatric Airtraq in routine, rather than difficult, airway situations.…”

“…The paediatric Airtraq became available in the UK in May 2008 and is available in two sizes: infant (tracheal tube size 2.5-3.5 mm ID) and child (tracheal tube size 4.0-5.5 mm ID). To date, evidence for the safety and efficacy of the paediatric Airtraq is limited to case reports and an evaluation of its use in 100 children in Japan [8][9][10][11][12][13]. We aimed to compare the Airtraq with conventional laryngoscopy in a randomised, controlled trial during routine anaesthesia in children.…”

A simple measure to facilitate use of a preformed oral tube for tracheal intubation using the Airtraq® laryngoscope in children

“…A simple measure to facilitate use of a preformed oral tube for tracheal intubation using the Airtraq Ò laryngoscope in children doi:10.1111/j.1460-9592.2010.03435.x SIR IR-The Airtraq Ò laryngoscope (ATQ) (Prodol Meditec S.A., Vizcaya, Spain) is a new disposable optical laryngoscope with ability to provide a full view of the glottis without the necessity to align oral, pharyngeal, and laryngeal axes. This device has been successfully used for orotracheal intubation in pediatric patients with normal and difficult airways (1)(2)(3)(4)(5). Preformed oral tubes (POT) are commonly selected for orotracheal intubation in children undergoing the oral cavity, middle and upper face surgery because they are easy to secure, provide convenient surgical access, and help to reduce the risk of unintended extubation (6).…”

“…The intubation times, defined as the period from initial insertion of the ATQ to start of ventilation through the tube, were 12.5 ± 6.8 s. In our practice, first positioning the ATQ in the airway and then advancing the tube via the tube conduit have now become routine parts of orotracheal intubation with the POT and ATQ in children. (1). Ultrasound-guided saphenous nerve block was not included as it has not been reported in pediatric patients.…”

An observational study of feasibility of tracheal intubation using Airtraq in pediatric population

“…Initially, few cases were reported describing successful use of AT in syndromic children with difficult airway. [ 3 4 5 ] Many pediatric manikin-based simulation studies compared AT with direct laryngoscopy. [ 6 7 8 ] However, the results of the manikin studies cannot be extrapolated to live human beings.…”