ABSTRACT
We compared the time taken to intubate the trachea of a manikin by fibreoptic-guided intubation through an intubating laryngeal mask airway (ILMA-FOS) with intubation through a laryngeal mask airway CTrach (LMA-CTrach). Forty-two anaesthetists participated in this randomised crossover study. Although the insertion time was similar, the time taken to intubate the trachea was significantly shorter with the LMA-CTrach as compared with the ILMA-FOS, with a mean time (SD) for ILMA-FOS and CTrach 84 (32) and 53 (21) s, respectively (p < 0.001). The mean difference in the total time between the two techniques was 31 s, with a 95% confidence interval of 22 to 39 s. Thirty (71%) anaesthetists preferred LMA-CTrach as compared with ILMA-FOS (p = 0.008). We conclude that LMA-CTrach is a suitable alternative to fibreoptic-guided intubation through ILMA for the management of unanticipated failed intubation.
Subject(s)
Fiber Optic Technology , Laryngeal Masks , Cross-Over Studies , Humans , Intubation, Intratracheal/methods , Manikins , Time FactorsABSTRACT
We compared times to intubate the trachea orally and success rates using two fibreoptically assisted techniques in 42 healthy patients with normal airways using (a) a 6.0-mm nasal RAE tracheal tube passed through a classic laryngeal mask airway (CLMA group) or (b) a 6.0-mm nasal RAE tracheal tube passed through a new disposable Portex Soft Seal laryngeal mask airway (PLMA group). The mean (SD) total intubation times were 82 (14) and 80 (17) s, respectively (p = 0.55). The success rates for intubation at the first attempt were similar (17/21 in the CLMA vs. 16/21 in the PLMA group; p = 0.50). We conclude that there is no clinically significant difference between the times to intubate the trachea or success rates using these two devices, but there may be other more subtle measures which might influence the choice of device in clinical practice. Finally, in the course of this study we developed a grading scale to describe the laryngeal views obtained when using a fibrescope passed through supraglottic airway devices.
Subject(s)
Disposable Equipment , Fiber Optic Technology/instrumentation , Laryngeal Masks , Adult , Anthropometry , Female , Humans , Intubation, Intratracheal/instrumentation , Intubation, Intratracheal/methods , Male , Time Factors , Treatment OutcomeABSTRACT
Among 155 medical admissions to the intensive care unit during the period 1989 to 1990, 16 patients had Guillain-'Barre' Syndrome (GBS), five of whom were HIV positive. Out of the five cases, three had manifested herpes zoster and one had TB. The impact of HIV infection o GBS is discussed.