Abstract
The Trachway video intubating stylet device facilitates the visualization of the airways of patients from the tip of an endotracheal tube (ETT) during intubation. The major limitations of Trachway are the restricted view due to secretions and the risk of a prolonged apnea during intubation. We conducted a bench study to verify the performance of an alternative, easily applicable airway device that allows better visualization of trackways during Trachway-assisted intubation and prevents the detrimental effects of apnea-related hypoxia. We conducted a bench study to thoroughly evaluate the oral-secretion-elimination ability of a newly designed oxygen delivery device (ODD) to improve vocal-cord visualization using the three commonly used ETT sizes (i.e., 7, 7.5, and 8 mm). Moreover, we measured the fraction of inspired oxygen (FiO2) under different, continuous oxygen-flow supplies (1–10 L/min) during intubation. Each condition was analyzed for a 2 min video-stylet-intubation period. The supplemental oxygen flow and FiO2 fraction achieved using our ODD were higher, and smaller ETTs exhibited better secretion elimination. The ODD, which can be easily coupled with Trachway stylets, enabled high-quality visualization during oxygen flows of 6–8 L/min, and higher FiO2 fractions were achieved at higher oxygen flow rates. The use of the ODD improved the visualization of the airways during video stylet-assisted intubations using the additional FiO2 supply. The ODD developed in this study improves the visualization of airways with Trachway stylets and enhances the safety of intubation.
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Acknowledgements
The authors thank the Biostatistics Task Force at Taipei Veterans General Hospital for their statistical analysis support.
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Protocol development: HYW, CKT; obtaining data for analysis: HYW, KHC; data extraction: CL, MTL; data analysis: CCC, CL, MTL; interpretation of analysis: CKT; article drafting: HYW; final manuscript review: CKT.
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The proposed article reports an experiment to investigate the ODD efficacy in eliminating oral saliva bubbles in mannequin-head–test-lung ventilator system. Therefore, because the study did not involve any human participants or animal subjects, an ethics approval statement has not been included in the manuscript..
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Wang, HY., Lin, C., Chen, CC. et al. Improvement in vocal-cord visualization with Trachway video intubating stylet using direct oxygen flow and effective analysis of the fraction of inspired oxygen: a bench study. J Clin Monit Comput 36, 1723–1730 (2022). https://doi.org/10.1007/s10877-022-00818-0
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DOI: https://doi.org/10.1007/s10877-022-00818-0