Intubating Laryngeal Mask Airway

To compare the characteristics, causative factors, outcomes, prevention, and suggested preventive strategies of difficult intubation between university (U) and general community (non-U) hospitals. One thousand nine hundred and ninety-six reports were reviewed from Thai anesthesia incident monitoring study (Thai AIMS) conducted in 51 hospitals nationwide between January and June 2007. Thirty-four cases ofDI were reported from U hospitals and 69 cases from non-U hospitals. The described details on each report on dfficult intubation (DI) in adults undergoing general anesthesia were thoroughly reviewed by three reviewers to give their consensus opinions on causative factors, outcomes, contributing preventive factors, and strategies for corrections. Descriptive statistics were used for data analysis. Patient factors were the most common cause of DI (88% in U and 87% in non-U hospitals). Fifty percent of U and 51% of non-U DI cases were consequences of human errors, which were preventable...

Background: The TotalTrack® Video Laryngeal Mask (VLM) is a novel airway management device consisting of a disposable
laryngeal mask paired with a reusable video display. Prior to the commencement of this study, there was no published literature
on the performance of the TotalTrack®.
Methods: The device was evaluated in sixty patients without predictors for difficult airway under general anaesthesia with
neuromuscular blockade. Primary outcomes were laryngeal mask seal pressures and success of tracheal intubation through the device.
Results: Insertion and ventilation was successful in 98.3% of cases. Median static leak and maximal inflation pressures of the
laryngeal mask component were 32 and 40 cmH₂O respectively. Tracheal intubation through the device was successful in 95% of
cases, with a mean intubation time of 9.5 s. No gastric insufflation occurred. Haemodynamic variability was found to be clinically insignificant. No significant side-effects were reported.
Conclusions: In this initial study, the TotalTrack® VLM was found to be effective as a laryngeal mask airway, exhibiting good sealing pressures. It facilitated predictable, easy intubating conditions under video guidance, with minimal interruption of ventilation.
Keywords: airway management, intubation, laryngeal masks, laryngoscopes

Up to date, there is no other study that characterizes chilean population with regard to airway management. This is a preliminary report with this objective. A total of 564 patients scheduled for different elective surgery. For difficult mask ventilation we evaluated age >55 y, presence of beard, IMC > 26, snoring history, and edentulism. For difficult intubation we evaluated Mallampati sign, upper lip bite test, interincisors distance, thyromental distance and cervical mobility. Difficult ventilation was predicted in 40 cases (7,1%), difficult intubation in 46 (8,15%) and both in 14 (2,5%). Ventilation was effectively difficult in 9 cases (2,6%). Laryngoscopy was performed in 295 patients and was considered difficult  (grades IIIa, IIIb and IV) in 10,2%. According to Adnet score, intubation was has a moderate to severe difficulty in 7 cases (2,4%). A stylet was used in 17 (5,8%) and a bougie in 5 (1,72%) cases. No failed intubations were recorded. Compared to the reported incidence, we found about half incidence of both difficult ventilation and intubation. To predict difficult ventilation, at least 4 of the 5 factors should be present.