Abstract
Purpose
Difficulty can be encountered during advancement of the tracheal tube (TT) over the bronchoscope after successful endotracheal bronchoscopy due to impingement on laryngeal structures. A new TT, the Parker Flex-Tip (PFT), has been shown to be superior to polyvinylchloride (PVC) TTs in anesthetized, paralyzed patients with normal airways. However, no study to date has shown the superiority of the new tapered tip design in patients with difficult airways during awake fibreoptic intubations (AFOI). The purpose of this study was to compare the PFT with PVC TTs for AFOI in patients with difficult airways or unstable c-spines. Clinical features: In this prospective observational study, 1 1 1 patients with predicted or documented difficult airways, or unstable c-spines were assessed for ease of TT advancement during AFOI. First attempt success rates were 91 % for PFT TTs and 84% for PVC TTs (P = NS). Resistance to TT advancement was none to mild and similar in both groups. Advancement without the need to rotate the TT 180° was also similar in both groups (57% vs 53%). Conclusion: For AFOI in patients with difficult airways, the PFT is not superior to conventional PVC TTs.
Objectif
Il peut être difficile d’avances le tube endotrachéal (TET) le long du bronchoscope lors d’une intubation fibroscopique à cause d’un contact avec des structures laryngées. Un nouveau TET, le Parker Flex-Tip (PFT), s’est révélé supérieur aux TET de polychlorure de vinyle (PCV) chez les patients anesthésiés et paralysés aux voies aériennes normales. Mais aucune étude à ce jour n’a montré la supériorité de ce tube à pointe effilée dans les cas de problèmes de voies aériennes pen-dant l’intubation fibroscopique vigile (IFOV). Notre étude compare le PFT avec les TET de PCV pour l’IFOV en cas d’anomalies des voies aériennes ou d’instabilité de la colonne cervicale. Éléments cliniques : Notre étude observationnelle prospective a évalué 111 patients avec des problèmes de voies aériennes prévus ou documentés ou une instabilité de la colonne cervicale, quant à la faci-lité d’avancer le TET pendant l’IFOV. Les succès du premier essai ont été de 91 % pour le TET PFT et de 84 % pour le TET de PCV (P = NS). La résistance à l’avancement du TET a été de nulle à légère dans les deux groupes. L’avancement sans nécessité de rotation de 180° du TET a aussi été comparable dans les deux groupes (57 % vs 53 %).
Conclusion
Pour l’IFOV chez les patients qui ont des problèmes de voies aériennes, le PFT n’est pas supérieur au TET de PCV traditionnel.
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Assessed June 22, 2004.
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Joo, H.S., Naik, V.N. & Savoldelli, G.L. Parker Flex-Tip™ are not superior to polyvinylchloride tracheal tubes for awake fibreoptic intubations. Can J Anesth 52, 297–301 (2005). https://doi.org/10.1007/BF03016067
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DOI: https://doi.org/10.1007/BF03016067