Intubación traqueal de obesos mórbidos: estudio randomizado comparando el rendimiento de laringoscopios Macintosh y el Airtraq.
Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes.
Ndoko SK, Amathieu R, Tual L, Polliand C, Kamoun W, El Housseini L, Champault G, Dhonneur G.
Anaesthesia and Intensive Care Department, Jean Verdier Public University Hospital of Paris (APHP), 93143 Bondy, France.serge.ndoko@jvr.aphp.fr
Br J Anaesth. 2008 Feb;100(2):263-8.
Abstract
BACKGROUND: The Airtraq laryngoscope is designed to allow visualization of the glottis without alignment of the oral, pharyngeal, and laryngeal axes. We hypothesized that this new airway device would facilitate tracheal intubation of morbidly obese patients. We compared tracheal intubation performance of standard Macintosh laryngoscope with the Airtraq laryngoscope in morbidly obese patients. METHODS: One hundred and six consecutive ASA I-III morbidly obese patients undergoing surgery were randomized to intubation with the Macintosh laryngoscope or the Airtraq laryngoscope. Induction of anaesthesia was standardized. If tracheal intubation failed within 120 s with the Macintosh or Airtraq , laryngoscopes were switched. Success rate, SpO2, duration of tracheal intubation, and quality of airway management were evaluated and compared between the groups. RESULTS: Preoperative characteristics of the patients were similar in both groups. In the Airtraq group, tracheal intubation was successfully carried out in all patients within 120 s. In the Macintosh laryngoscope group, six patients required intubation with the Airtraq laryngoscope. The mean (SD) time taken for tracheal intubation was 24 (16) and 56 (23) s, respectively, with the Airtraq and Macintosh laryngoscopes, (P<0.001). SpO2 was better maintained in the Airtraq group than in the Macintosh laryngoscope group with one and nine patients, respectively, demonstrating drops of SpO2 to 92% or less (P<0.05). CONCLUSIONS: In this study, the Airtraq laryngoscope shortened the duration of tracheal intubation and prevented reductions in arterial oxygen saturation in morbidly obese patients.
http://bja.oxfordjournals.org/content/100/2/263.full.pdf
Intubación traqueal convencional versus intubación video asistida en obesos mórbidos
Video-assisted versus conventional tracheal intubation in morbidly obese patients.
Dhonneur G, Abdi W, Ndoko SK, Amathieu R, Risk N, El Housseini L, Polliand C, Champault G, Combes X, Tual L.
Anesthesiology and Intensive Care Medicine Department, Jean Verdier Public University Hospital of Paris (APHP), 93143, Bondy, France.gilles.dhonneur@jvr.aphp.fr
Obes Surg. 2009 Aug;19(8):1096-101. Epub 2008 Oct 4.
Abstract
BACKGROUND: We compared tracheal intubation characteristics and arterial oxygenation quality during airway management of morbidly obese patients whose trachea was intubated under video assistance with the LMA CTrach (SEBAC, Pantin, France) or the Airtraq laryngoscope (VYGON, Ecouen, France) with that of the conventional Macintosh laryngoscope. METHODS: After standardized induction of anesthesia, 318 morbidly obese patients scheduled for elective morbid obesity surgery received tracheal intubation with the LMA CTrach, the Airtraq laryngoscope, or the conventional Macintosh laryngoscope. Duration of apnea, time to tracheal intubation, and oxygenation quality during airway management were compared between the LMA CTrach and the laryngoscope groups. RESULTS: Patients' characteristics were similar in the three groups. The success rate for tracheal intubation was 100% with the LMA CTrach and the Airtraq laryngoscope. One patient of the Macintosh laryngoscope group received LMA CTrach intubation because of early arterial oxygen desaturation associated with unstable facemask ventilation. The duration of apnea was shorter with the LMA CTrach than that of the Airtraq laryngoscope and the Macintosh laryngoscope. The duration tracheal intubation was shorter with the Airtraq laryngoscope than with the Macintosh laryngoscopes and the LMA CTrach. During airway management, arterial oxygenation was of better quality with the LMA CTrach and the Airtraq laryngoscope than that of the Macintosh laryngoscope. CONCLUSION: Because LMA CTrach promoted short apnea time and the Airtraq laryngoscope allowed early definitive airway, both video-assisted tracheal intubation devices prevented most serious arterial oxygenation desaturation evidenced during tracheal intubation of morbidly obese patients with the conventional Macintosh laryngoscope.
http://www.springerlink.com/content/g1l21nr3828hj6t2/fulltext.pdf
Vía aérea difícil en obesidad mórbida
LUIS BRUNET L.
Rev Chil Anest, 2010; 39: 110-115
INTRODUCCIÓN
Una de las tareas más importantes de los anestesiólogos durante la anestesia, la cirugía y en el período postoperatorio inmediato, es asegurar la permeabilidad de la vía aérea y mantener la función respiratoria para lograr una oxigenación adecuada. La dificultad en el manejo de la vía aérea, incluidos los problemas de ventilación y de intubación traqueal, aunque poco frecuentes, constituye la primera causa de morbilidad y mortalidad anestésica.
http://www.sachile.cl/upfiles/revistas/4ce13fefaf59f_brunet.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes.
Ndoko SK, Amathieu R, Tual L, Polliand C, Kamoun W, El Housseini L, Champault G, Dhonneur G.
Anaesthesia and Intensive Care Department, Jean Verdier Public University Hospital of Paris (APHP), 93143 Bondy, France.serge.ndoko@jvr.aphp.fr
Br J Anaesth. 2008 Feb;100(2):263-8.
Abstract
BACKGROUND: The Airtraq laryngoscope is designed to allow visualization of the glottis without alignment of the oral, pharyngeal, and laryngeal axes. We hypothesized that this new airway device would facilitate tracheal intubation of morbidly obese patients. We compared tracheal intubation performance of standard Macintosh laryngoscope with the Airtraq laryngoscope in morbidly obese patients. METHODS: One hundred and six consecutive ASA I-III morbidly obese patients undergoing surgery were randomized to intubation with the Macintosh laryngoscope or the Airtraq laryngoscope. Induction of anaesthesia was standardized. If tracheal intubation failed within 120 s with the Macintosh or Airtraq , laryngoscopes were switched. Success rate, SpO2, duration of tracheal intubation, and quality of airway management were evaluated and compared between the groups. RESULTS: Preoperative characteristics of the patients were similar in both groups. In the Airtraq group, tracheal intubation was successfully carried out in all patients within 120 s. In the Macintosh laryngoscope group, six patients required intubation with the Airtraq laryngoscope. The mean (SD) time taken for tracheal intubation was 24 (16) and 56 (23) s, respectively, with the Airtraq and Macintosh laryngoscopes, (P<0.001). SpO2 was better maintained in the Airtraq group than in the Macintosh laryngoscope group with one and nine patients, respectively, demonstrating drops of SpO2 to 92% or less (P<0.05). CONCLUSIONS: In this study, the Airtraq laryngoscope shortened the duration of tracheal intubation and prevented reductions in arterial oxygen saturation in morbidly obese patients.
http://bja.oxfordjournals.org/content/100/2/263.full.pdf
Intubación traqueal convencional versus intubación video asistida en obesos mórbidos
Video-assisted versus conventional tracheal intubation in morbidly obese patients.
Dhonneur G, Abdi W, Ndoko SK, Amathieu R, Risk N, El Housseini L, Polliand C, Champault G, Combes X, Tual L.
Anesthesiology and Intensive Care Medicine Department, Jean Verdier Public University Hospital of Paris (APHP), 93143, Bondy, France.gilles.dhonneur@jvr.aphp.fr
Obes Surg. 2009 Aug;19(8):1096-101. Epub 2008 Oct 4.
Abstract
BACKGROUND: We compared tracheal intubation characteristics and arterial oxygenation quality during airway management of morbidly obese patients whose trachea was intubated under video assistance with the LMA CTrach (SEBAC, Pantin, France) or the Airtraq laryngoscope (VYGON, Ecouen, France) with that of the conventional Macintosh laryngoscope. METHODS: After standardized induction of anesthesia, 318 morbidly obese patients scheduled for elective morbid obesity surgery received tracheal intubation with the LMA CTrach, the Airtraq laryngoscope, or the conventional Macintosh laryngoscope. Duration of apnea, time to tracheal intubation, and oxygenation quality during airway management were compared between the LMA CTrach and the laryngoscope groups. RESULTS: Patients' characteristics were similar in the three groups. The success rate for tracheal intubation was 100% with the LMA CTrach and the Airtraq laryngoscope. One patient of the Macintosh laryngoscope group received LMA CTrach intubation because of early arterial oxygen desaturation associated with unstable facemask ventilation. The duration of apnea was shorter with the LMA CTrach than that of the Airtraq laryngoscope and the Macintosh laryngoscope. The duration tracheal intubation was shorter with the Airtraq laryngoscope than with the Macintosh laryngoscopes and the LMA CTrach. During airway management, arterial oxygenation was of better quality with the LMA CTrach and the Airtraq laryngoscope than that of the Macintosh laryngoscope. CONCLUSION: Because LMA CTrach promoted short apnea time and the Airtraq laryngoscope allowed early definitive airway, both video-assisted tracheal intubation devices prevented most serious arterial oxygenation desaturation evidenced during tracheal intubation of morbidly obese patients with the conventional Macintosh laryngoscope.
http://www.springerlink.com/content/g1l21nr3828hj6t2/fulltext.pdf
Vía aérea difícil en obesidad mórbida
LUIS BRUNET L.
Rev Chil Anest, 2010; 39: 110-115
INTRODUCCIÓN
Una de las tareas más importantes de los anestesiólogos durante la anestesia, la cirugía y en el período postoperatorio inmediato, es asegurar la permeabilidad de la vía aérea y mantener la función respiratoria para lograr una oxigenación adecuada. La dificultad en el manejo de la vía aérea, incluidos los problemas de ventilación y de intubación traqueal, aunque poco frecuentes, constituye la primera causa de morbilidad y mortalidad anestésica.
http://www.sachile.cl/upfiles/revistas/4ce13fefaf59f_brunet.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
No hay comentarios:
Publicar un comentario