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Uso de introductores para intubación a través de dispositivos supraglóticos para facilitar la intubación traqueal; revisión corta
Use of intubation introducers through a supraglottic airway to facilitate tracheal intubation: a brief review.
Wong DT, Yang JJ, Mak HY, Jagannathan N.
Department of Anesthesia, Toronto Western Hospital, University of Toronto, ON, Canada. david.wong@uhn.ca
Can J Anaesth. 2012 Jul;59(7):704-15. doi: 10.1007/s12630-012-9714-8.
Abstract
PURPOSE: This article is a narrative review regarding the usage and effectiveness of introducers or catheters to facilitate tracheal intubation through a supraglottic airway (SGA) as an alternative intubation technique in normal and difficult airway management. SOURCES:
Relevant articles were obtained through Medline (1948-July 2011). The articles were subsequently cross-referenced for additional literature, and only articles published in English were included. PRINCIPAL FINDINGS: In this review, we consider 32 reports using the LMA Classic™, LMA Unique™, LMA ProSeal™, LMA Supreme™, AuraOnce™, and i-gel™ as SGA conduits for intubation. In 13 articles, the use of an Aintree Intubation Catheter was described as an intubation introducer and resulted in high success rates in both elective and emergent situations. Eight studies used a guidewire exchange catheter technique. Although blind intubation using a guidewire resulted in a high failure rate, these studies found that using a bronchoscope improved successful intubation. Ten studies showed that insertion of a gum elastic bougie with a bronchoscope as an intubation introducer has high success rates compared with blind bougie insertion. One article described the use of a small endotracheal tube as an intermediary for tracheal intubation. CONCLUSIONS: In failed intubation scenarios, supraglottic airways, such as the LMA Classic™ or LMA ProSeal™ can serve as a conduit for tracheal intubation. A number of techniques using introducers or catheters can facilitate the insertion of an adequately sized endotracheal tube, particularly guided by a bronchoscope. Usage of introducers or catheters through a supraglottic airway may be a useful alternative intubation technique in difficult airway management
http://link.springer.com/content/pdf/10.1007%2Fs12630-012-9714-8
Revisión breve: disposistivo supraglótico ML Supreme
Brief review: The LMA Supreme™ supraglottic airway.
Wong DT, Yang JJ, Jagannathan N.
Department of Anesthesia, Toronto Western Hospital, University of Toronto, MC2-405, 399 Bathurst Street, Toronto, Ontario, Canada.david.wong@uhn.ca
Can J Anaesth. 2012 May;59(5):483-93. doi: 10.1007/s12630-012-9673-0. Epub 2012 Feb 9
Abstract
PURPOSE: This article is a review of the efficacy and safety of the Laryngeal Mask Airway (LMA) Supreme™ as a stand-alone supraglottic airway during general anesthesia and as a conduit for tracheal intubation. Relevant articles were obtained using MEDLINE (1948-July 2011) and EMBASE (1980-July 2011). Only original studies with adult human patients and published in English were selected. PRINCIPAL FINDINGS: The LMA Supreme was found to be comparable with the LMA Proseal™ with regard to success rate, insertion time, and complications. However, in three studies, oropharyngeal leak pressure was higher with the LMA Proseal than with the LMA Supreme. The LMA Supreme was superior to the LMA Classic™ with regard to insertion time and oropharyngeal seal pressure. The LMA Supreme was also used successfully in two difficult airway cases, and it has been used as a conduit for tracheal intubation by utilizing an intubation introducer (gum elastic bougie) and subsequently railroading an endotracheal tube over the bougie into the trachea. Techniques for achieving tracheal intubation include the use of the Aintree Intubation Catheter®, a guidewire-exchange catheter, a gum elastic bougie, and a small (<6.0 mm internal diameter) endotracheal tube.
CONCLUSION: The LMA Supreme has been shown to be a safe and efficacious device as a stand-alone supraglottic airway and may also be used as a conduit for tracheal intubation. Further trials are needed to determine the efficacy of the LMA Supreme compared with other supraglottic airways in both elective and emergent airway management situations.
http://link.springer.com/content/pdf/10.1007%2Fs12630-012-9673-0
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Use of intubation introducers through a supraglottic airway to facilitate tracheal intubation: a brief review.
Wong DT, Yang JJ, Mak HY, Jagannathan N.
Department of Anesthesia, Toronto Western Hospital, University of Toronto, ON, Canada. david.wong@uhn.ca
Can J Anaesth. 2012 Jul;59(7):704-15. doi: 10.1007/s12630-012-9714-8.
Abstract
PURPOSE: This article is a narrative review regarding the usage and effectiveness of introducers or catheters to facilitate tracheal intubation through a supraglottic airway (SGA) as an alternative intubation technique in normal and difficult airway management. SOURCES:
Relevant articles were obtained through Medline (1948-July 2011). The articles were subsequently cross-referenced for additional literature, and only articles published in English were included. PRINCIPAL FINDINGS: In this review, we consider 32 reports using the LMA Classic™, LMA Unique™, LMA ProSeal™, LMA Supreme™, AuraOnce™, and i-gel™ as SGA conduits for intubation. In 13 articles, the use of an Aintree Intubation Catheter was described as an intubation introducer and resulted in high success rates in both elective and emergent situations. Eight studies used a guidewire exchange catheter technique. Although blind intubation using a guidewire resulted in a high failure rate, these studies found that using a bronchoscope improved successful intubation. Ten studies showed that insertion of a gum elastic bougie with a bronchoscope as an intubation introducer has high success rates compared with blind bougie insertion. One article described the use of a small endotracheal tube as an intermediary for tracheal intubation. CONCLUSIONS: In failed intubation scenarios, supraglottic airways, such as the LMA Classic™ or LMA ProSeal™ can serve as a conduit for tracheal intubation. A number of techniques using introducers or catheters can facilitate the insertion of an adequately sized endotracheal tube, particularly guided by a bronchoscope. Usage of introducers or catheters through a supraglottic airway may be a useful alternative intubation technique in difficult airway management
http://link.springer.com/content/pdf/10.1007%2Fs12630-012-9714-8
Revisión breve: disposistivo supraglótico ML Supreme
Brief review: The LMA Supreme™ supraglottic airway.
Wong DT, Yang JJ, Jagannathan N.
Department of Anesthesia, Toronto Western Hospital, University of Toronto, MC2-405, 399 Bathurst Street, Toronto, Ontario, Canada.david.wong@uhn.ca
Can J Anaesth. 2012 May;59(5):483-93. doi: 10.1007/s12630-012-9673-0. Epub 2012 Feb 9
Abstract
PURPOSE: This article is a review of the efficacy and safety of the Laryngeal Mask Airway (LMA) Supreme™ as a stand-alone supraglottic airway during general anesthesia and as a conduit for tracheal intubation. Relevant articles were obtained using MEDLINE (1948-July 2011) and EMBASE (1980-July 2011). Only original studies with adult human patients and published in English were selected. PRINCIPAL FINDINGS: The LMA Supreme was found to be comparable with the LMA Proseal™ with regard to success rate, insertion time, and complications. However, in three studies, oropharyngeal leak pressure was higher with the LMA Proseal than with the LMA Supreme. The LMA Supreme was superior to the LMA Classic™ with regard to insertion time and oropharyngeal seal pressure. The LMA Supreme was also used successfully in two difficult airway cases, and it has been used as a conduit for tracheal intubation by utilizing an intubation introducer (gum elastic bougie) and subsequently railroading an endotracheal tube over the bougie into the trachea. Techniques for achieving tracheal intubation include the use of the Aintree Intubation Catheter®, a guidewire-exchange catheter, a gum elastic bougie, and a small (<6.0 mm internal diameter) endotracheal tube.
CONCLUSION: The LMA Supreme has been shown to be a safe and efficacious device as a stand-alone supraglottic airway and may also be used as a conduit for tracheal intubation. Further trials are needed to determine the efficacy of the LMA Supreme compared with other supraglottic airways in both elective and emergent airway management situations.
http://link.springer.com/content/pdf/10.1007%2Fs12630-012-9673-0
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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