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Lightwand intubation using the Trachlight™: a brief review of current knowledge

  • Felice AgròEmail author
  • Orlando R. Hung
  • Rita Cataldo
  • Massimiliano Carassiti
  • Stefano Gherardi
Cardiothoracic Anesthesia, Respiration and Airway

Abstract

Purpose

About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the Trachlight™ (TL).

Source

To determine its clinical utility and limitations, we reviewed the current literature (book and journal articles) on the TL since its introduction in 1995.

Principal findings

TL has been shown to be useful both in oral and nasal intubation for patients with difficult airways. It may also be useful in “emergency” situations or when direct laryngoscopy or fiberoptic endoscopy is not effective, such as with patients who have copious secretions or blood in the oropharynx. TL can also be used for tracheal intubation in conjunction with other devices (laryngeal mask airway -LMA-, intubating LMA, direct laryngoscopy). However, TL should be avoided in patients with tumours, infections, trauma or foreign bodies in the upper airway.

Conclusions

Based on the clinical reports available, the TL has proven to be a useful option for tracheal intubation. In addition, the device can also be used together with other intubating devices, such as the intubating LMA and the laryngoscope, to improve intubating success rates. A clear understanding of the principle of transillumination of the TL, and an appreciation of its indications, contraindications, and limitations, will improve the effectiveness of the device as well as reducing the likelihood of complications. Finally, regular practice with the TL with routine surgical patients requiring tracheal intubation will further improve intubation success rates.

Keywords

Tracheal Intubation Laryngeal Mask Airway Difficult Airway Direct Laryngoscopy Anterior Neck 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Intubation avec le stylet lumineux Trachlight™: un aperçu des connaissances actuelles

Résumé

Objectif

La fréquence d’intubation difficile ou impossible varie de 1% à 3%. L’intubation trachéale avec le Trachlight™ (TL) représente une technique efficace, sûre et simple.

Dans cet article nous voulons réviser les connaissances actuelles sur le stylet lumineux TL.

Méthode

Pour déterminer les applications et les limitations du TL, nous avons révisé la littérature (livres ou revues) sur le TL à partir de son introduction en 1995.

Resultats

Le TL permet une intubation oro-ou naso-trachéale dans différentes situations d’intubation difficile. Cette technique d’intubation avec le TL peut également être utile dans des situations d’urgence ou quand l’intubation trachéale avec le bronchoscope n’est pas indiquée, comme chez les patients qui présentent des sécrétions abondantes ou du sang dans l’oropharynx.

Le TL peut également être utilisé pour l’intubation trachéale en même temps que d’autres dispositifs (masque laryngé, masque laryngé pour intubation, laryngoscopie directe). Cependant l’usage du TL devrait être évité chez les patients présentant une tumeur, une infection, un traumatisme ou un corps étranger dans les voies aériennes.

Conclusion

Selon les rapports cliniques à notre disposition, nous pouvons affirmer que le TL représente une solution de remplacement utile à la laryngoscopie traditionnelle. Le TL peut également être utilisé avec d’autre dispositifs comme le masque laryngé et la laryngoscopie directe pour augmenter le taux de réussite de l’intubation trachéale.

En conclusion, la pratique régulière avec le TL et une connaissance de ses indications, contre-indications et limitations, peut améliorer l’efficacité du dispositif et réduire la probabilité de complications.

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Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Felice Agrò
    • 1
    Email author
  • Orlando R. Hung
    • 2
  • Rita Cataldo
    • 1
  • Massimiliano Carassiti
    • 1
  • Stefano Gherardi
    • 1
  1. 1.Department of AnaesthesiaUniversity School of Medicine Campus Bio-MedicoRomeItaly
  2. 2.Department of Anaesthesia and PhamacologyDalhousie UniversityHalifaxCanada

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