Laryngoscope and a New Tracheal Tube Assist Lightwand Intubation in Difficult Airways Due to Unstable Cervical Spine

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Mar 25

PMID 25803435

Citations 12

Authors

Cai-Neng Wu

Wu-Hua Ma

Jian-Qi Wei

Hua-Feng Wei

Qing-yun Cen

Qing-xiang Cai

Ying Cao

Affiliations

Soon will be listed here.

Abstract

Purpose: The WEI Jet Endotracheal Tube (WEI JET) is a new tracheal tube that facilitates both oxygenation and ventilation during the process of intubation and assists tracheal intubation in patients with difficult airway. We evaluated the effectiveness and usefulness of the WEI JET in combination with lightwand under direct laryngoscopy in difficult tracheal intubation due to unstable cervical spine.

Methods: Ninety patients with unstable cervical spine disorders (ASA I-III) with general anaesthesia were included and randomly assigned to three groups, based on the device used for intubation: lightwand only, lightwand under direct laryngoscopy, lightwand with WEI JET under direct laryngoscopy.

Results: No statistically significant differences were detected among three groups with respect to demographic characteristics and C/L grade. There were statistically significant differences between three groups for overall intubation success rate (p = 0.015) and first attempt success rate (p = 0.000). The intubation time was significantly longer in the WEI group (110.8±18.3 s) than in the LW group (63.3±27.5 s, p = 0.000) and DL group (66.7±29.4 s, p = 0.000), but the lowest SpO2 in WEI group was significantly higher than other two groups (p<0.01). The WEI JET significantly reduced successful tracheal intubation attempts compared to the LW group (p = 0.043). The severity of sore throat was similar in three groups (p = 0.185).

Conclusions: The combined use of WEI JET under direct laryngoscopy helps to assist tracheal intubation and improves oxygenation during intubation in patients with difficult airway secondary to unstable spine disorders.

Trial Registration: Chinese Clinical Trial Registry ChiCTR-TRC-14005141.

Citing Articles

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Hong K, Lee J, Hwang H, Sim W, Park H, Lee J In Vivo. 2023; 38(1):490-495.

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Yang M, Wei H, Hou Q, Wang B, Cheng Q Med Sci Monit. 2023; 29:e938602.

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References

Wei H . A new tracheal tube and methods to facilitate ventilation and placement in emergency airway management. Resuscitation. 2006; 70(3):438-44. DOI: 10.1016/j.resuscitation.2006.01.021. View

Davis L, Cook-Sather S, Schreiner M . Lighted stylet tracheal intubation: a review. Anesth Analg. 2000; 90(3):745-56. DOI: 10.1097/00000539-200003000-00044. View

Fan K, Hung O, Agro F . A comparative study of tracheal intubation using an intubating laryngeal mask (Fastrach) alone or together with a lightwand (Trachlight). J Clin Anesth. 2001; 12(8):581-5. DOI: 10.1016/s0952-8180(00)00219-1. View

Agro F, Hung O, Cataldo R, Carassiti M, Gherardi S . Lightwand intubation using the Trachlight: a brief review of current knowledge. Can J Anaesth. 2001; 48(6):592-9. DOI: 10.1007/BF03016838. View

Agro F, Benumof J, Carassiti M, Cataldo R, Gherardi S, Barzoi G . Efficacy of a combined technique using the Trachlight together with direct laryngoscopy under simulated difficult airway conditions in 350 anesthetized patients. Can J Anaesth. 2002; 49(5):525-6. DOI: 10.1007/BF03017937. View

Sener E, Sarihasan B, Ustun E, Kocamanoglu S, Kelsaka E, Tur A . Awake tracheal intubation through the intubating laryngeal mask airway in a patient with halo traction. Can J Anaesth. 2002; 49(6):610-3. DOI: 10.1007/BF03017390. View

Crosby E . Airway management after upper cervical spine injury: what have we learned?. Can J Anaesth. 2002; 49(7):733-44. DOI: 10.1007/BF03017455. View

Heath K . The effect of laryngoscopy of different cervical spine immobilisation techniques. Anaesthesia. 1994; 49(10):843-5. DOI: 10.1111/j.1365-2044.1994.tb04254.x. View

Hung O, Pytka S, Morris I, Murphy M, Launcelott G, Stevens S . Clinical trial of a new lightwand device (Trachlight) to intubate the trachea. Anesthesiology. 1995; 83(3):509-14. DOI: 10.1097/00000542-199509000-00009. View

10.

Biehl J, Bourke D . Use of the lighted stylet to aid direct laryngoscopy. Anesthesiology. 1997; 86(4):1012. DOI: 10.1097/00000542-199704000-00041. View

11.

Huang W, Huang C, Chung Y . Clinical comparisons between GlideScope video laryngoscope and Trachlight in simulated cervical spine instability. J Clin Anesth. 2007; 19(2):110-4. DOI: 10.1016/j.jclinane.2006.06.004. View

12.

Fisher Q, Tunkel D . Lightwand intubation of infants and children. J Clin Anesth. 1997; 9(4):275-9. DOI: 10.1016/s0952-8180(97)00013-5. View

13.

Xue F, Liu H, Liao X, Xiong J . Use of a Trachlight to facilitate the insertion of Proseal laryngeal mask airway in children. Paediatr Anaesth. 2009; 19(7):704-6. DOI: 10.1111/j.1460-9592.2009.03019.x. View

14.

Lin C, Su C, Lin W, Jan J, Jeng C, Lin F . Modified lightwand intubation in a child with spondyloepiphyseal dysplasia congenita. Acta Anaesthesiol Taiwan. 2011; 49(2):66-8. DOI: 10.1016/j.aat.2011.05.003. View

15.

Han J, Cho S, Jeon W, Yeom J, Shin W, Shim J . The optimal effect-site concentration of remifentanil for lightwand tracheal intubation during propofol induction without muscle relaxation. J Clin Anesth. 2011; 23(5):379-83. DOI: 10.1016/j.jclinane.2010.12.012. View

16.

Jeon Y, Lim Y, Na H, Park S, Oh A, Hwang J . A double bending lightwand can provide more successful endotracheal intubation in patients with a short thyromental distance: a prospective randomised study. Eur J Anaesthesiol. 2011; 28(9):651-4. DOI: 10.1097/EJA.0b013e328349a017. View

17.

Prasarn M, Conrad B, Rubery P, Wendling A, Aydog T, Horodyski M . Comparison of 4 airway devices on cervical spine alignment in a cadaver model with global ligamentous instability at C5-C6. Spine (Phila Pa 1976). 2011; 37(6):476-81. DOI: 10.1097/BRS.0b013e31822419fe. View

18.

Rosenstock C, Thogersen B, Afshari A, Christensen A, Eriksen C, Gatke M . Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management: a randomized clinical trial. Anesthesiology. 2012; 116(6):1210-6. DOI: 10.1097/ALN.0b013e318254d085. View

19.

Peng J, Ye J, Zhao Y, Liang J, Huang H, Wei H . Supraglottic jet ventilation in difficult airway management. J Emerg Med. 2012; 43(2):382-90. DOI: 10.1016/j.jemermed.2011.06.145. View

20.

Chen J, Luo W, Wang E, Lu K . Optimal bent length of lightwand for intubation in adults: a randomized, prospective, comparative study. J Int Med Res. 2012; 40(4):1519-31. DOI: 10.1177/147323001204000432. View