Limits...
A comparison of conventional tube and EndoFlex tube for tracheal intubation in patients with a cervical spine immobilisation.

Gaszynska E, Stankiewicz-Rudnicki M, Wieczorek A, Gaszynski T - Scand J Trauma Resusc Emerg Med (2013)

Bottom Line: All patients have had the cervical collar placed on their neck for the simulation of intubation procedure in case of the spinal injury.The intubation procedure was performed by 16 anesthetists with different experience (5-19 yrs).The assessment of usability: very easy 3.3% vs. 20%, easy 83.4% vs. 56.7%, difficult 10% vs. 20% and very difficult 3.3% vs. 3.3% for standard endotracheal tube with stylet and EndoFlex, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Lodz, Poland. tomasz.gaszynski@umed.lodz.pl.

ABSTRACT

Background: The EndoFlex is a new type of tracheal tube with an adjustable distal tip that can be bent without the use of a stylet. The aim of this study was to compare a standard endotracheal tube with the EndoFlex tracheal tube for intubation in patients with simulated cervical spine injury.

Methods: A group of 60 patients without any kind of the cervical spine injury, classified as the ASA physiological scale I or II and qualified for elective surgery procedures were intubated with the use of classical Macintosh laryngoscope, and either a standard endotracheal tube with the intubation stylet in it or EndoFlex tube without stylet. The subjects were randomized into two subgroups. All patients have had the cervical collar placed on their neck for the simulation of intubation procedure in case of the spinal injury.

Results: The intubation procedure was performed by 16 anesthetists with different experience (5-19 yrs). Time of intubation with the use of EndoFlex tube was similar to that with a the use of standard endotracheal tube and intubation stylet: Me (median) 19.5 s [IQR (interquatile range) 18-50] vs. Me 20 s [IQR 17-60] respectively (p = 0.9705). No significant additional maneuvers were necessary during intubation with the use of EndoFlex tube in comparison with standard endotracheal tube (70% vs. 56.6%) (p = 0.4220). Subjective assessment of the usability of both tubes revealed that more anesthesiologists found intubations with the use of EndoFlex more demanding than intubation with conventional tracheal tube and intubation stylet. The assessment of usability: very easy 3.3% vs. 20%, easy 83.4% vs. 56.7%, difficult 10% vs. 20% and very difficult 3.3% vs. 3.3% for standard endotracheal tube with stylet and EndoFlex, respectively.

Conclusion: In conclusion we asses, that the EndoFlex tube does not improve intubation success rate, in fact it requires more maneuvers facilitating intubation and was found to be more difficult to use.

Show MeSH

Related in: MedlinePlus

Study Flow diagram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4222123&req=5

Figure 2: Study Flow diagram.

Mentions: Using the envelope technique, 60 consecutive individuals were randomly assigned to two different groups: Macintosh laryngoscope with standard intubation stylet–STYLET (n = 30) and Macintosh laryngoscope with EndoFlex tube (n = 30) (Figure 2 Flow diagram). The sample size was not calculated but, based on literature data, we assumed that group size of 30 pts per group was sufficient for detecting differences occurring during intubation. The study was performed in a manner of a randomized, single blind, controlled clinical trial. Randomization was achieved by the following method: computer program was randomly choosing number of envelope, which was opened and the indicated method of intubation (STYLET or EndoFlex) was used in the preoperative area. Sixty envelopes were prepared, 30 for each group, and numbered after closing without knowledge of the content.


A comparison of conventional tube and EndoFlex tube for tracheal intubation in patients with a cervical spine immobilisation.

Gaszynska E, Stankiewicz-Rudnicki M, Wieczorek A, Gaszynski T - Scand J Trauma Resusc Emerg Med (2013)

Study Flow diagram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222123&req=5

Figure 2: Study Flow diagram.
Mentions: Using the envelope technique, 60 consecutive individuals were randomly assigned to two different groups: Macintosh laryngoscope with standard intubation stylet–STYLET (n = 30) and Macintosh laryngoscope with EndoFlex tube (n = 30) (Figure 2 Flow diagram). The sample size was not calculated but, based on literature data, we assumed that group size of 30 pts per group was sufficient for detecting differences occurring during intubation. The study was performed in a manner of a randomized, single blind, controlled clinical trial. Randomization was achieved by the following method: computer program was randomly choosing number of envelope, which was opened and the indicated method of intubation (STYLET or EndoFlex) was used in the preoperative area. Sixty envelopes were prepared, 30 for each group, and numbered after closing without knowledge of the content.

Bottom Line: All patients have had the cervical collar placed on their neck for the simulation of intubation procedure in case of the spinal injury.The intubation procedure was performed by 16 anesthetists with different experience (5-19 yrs).The assessment of usability: very easy 3.3% vs. 20%, easy 83.4% vs. 56.7%, difficult 10% vs. 20% and very difficult 3.3% vs. 3.3% for standard endotracheal tube with stylet and EndoFlex, respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Lodz, Poland. tomasz.gaszynski@umed.lodz.pl.

ABSTRACT

Background: The EndoFlex is a new type of tracheal tube with an adjustable distal tip that can be bent without the use of a stylet. The aim of this study was to compare a standard endotracheal tube with the EndoFlex tracheal tube for intubation in patients with simulated cervical spine injury.

Methods: A group of 60 patients without any kind of the cervical spine injury, classified as the ASA physiological scale I or II and qualified for elective surgery procedures were intubated with the use of classical Macintosh laryngoscope, and either a standard endotracheal tube with the intubation stylet in it or EndoFlex tube without stylet. The subjects were randomized into two subgroups. All patients have had the cervical collar placed on their neck for the simulation of intubation procedure in case of the spinal injury.

Results: The intubation procedure was performed by 16 anesthetists with different experience (5-19 yrs). Time of intubation with the use of EndoFlex tube was similar to that with a the use of standard endotracheal tube and intubation stylet: Me (median) 19.5 s [IQR (interquatile range) 18-50] vs. Me 20 s [IQR 17-60] respectively (p = 0.9705). No significant additional maneuvers were necessary during intubation with the use of EndoFlex tube in comparison with standard endotracheal tube (70% vs. 56.6%) (p = 0.4220). Subjective assessment of the usability of both tubes revealed that more anesthesiologists found intubations with the use of EndoFlex more demanding than intubation with conventional tracheal tube and intubation stylet. The assessment of usability: very easy 3.3% vs. 20%, easy 83.4% vs. 56.7%, difficult 10% vs. 20% and very difficult 3.3% vs. 3.3% for standard endotracheal tube with stylet and EndoFlex, respectively.

Conclusion: In conclusion we asses, that the EndoFlex tube does not improve intubation success rate, in fact it requires more maneuvers facilitating intubation and was found to be more difficult to use.

Show MeSH
Related in: MedlinePlus