Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial
Background Airway management in children is challenging because of the smaller size, different proportions of anatomical structures compared to adults, and a higher risk of hypoxemia. Efforts to improve the efficiency of pediatric intubation can be made by manually twisting a spiral endotracheal tub...
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Korean Society of Anesthesiologists
2024-10-01
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Series: | Anesthesia and Pain Medicine |
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Online Access: | http://anesth-pain-med.org/upload/pdf/apm-24018.pdf |
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author | Rahendra Rahendra Fajar Sesario Andi Ade Wijaya Ramlan Raihanita Zahra Christopher Kapuangan Arif Hari Martono Marsaban Aries Perdana |
author_facet | Rahendra Rahendra Fajar Sesario Andi Ade Wijaya Ramlan Raihanita Zahra Christopher Kapuangan Arif Hari Martono Marsaban Aries Perdana |
author_sort | Rahendra Rahendra |
collection | DOAJ |
description | Background Airway management in children is challenging because of the smaller size, different proportions of anatomical structures compared to adults, and a higher risk of hypoxemia. Efforts to improve the efficiency of pediatric intubation can be made by manually twisting a spiral endotracheal tube (ETT) using a flexible stylet to manipulate its shape and angle. Methods This controlled trial randomized fifty children aged one month to six years who underwent elective surgery under general anesthesia into two groups (spiral ETT [sETT] and no-stylet ETT/standard ETT). The sETT was formed by twisting the ETT using a handmade tool. The primary objective was to determine the effectiveness of the sETT compared to the standard ETT in reducing intubation time. Secondary objectives were ETT placement accuracy, first-attempt intubation success rate, and adverse effects. Results The mean total tube handling time in the sETT group was significantly shorter compared to the no-stylet ETT group (sETT 16.8 ± 3.6 vs. standard ETT 18.8 ± 3.7 seconds; P = 0.049). sETT placement had a significantly greater central placement accuracy (odds ratio, 4.846; 95% confidence interval, 1.287-18.255; P = 0.015). However, first-attempt successful intubation rate (sETT 80% vs. standard ETT 64%, P = 0.208) and total intubation time (sETT: 46.5 ± 5.2 vs. standard ETT 48.4 ± 4.9 seconds; P = 0.205) were not significantly different. No adverse effects were observed for either ETT type. Conclusions Spiral ETT effectively reduces total tube handling time and improves ETT placement accuracy in children using video laryngoscopy. |
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id | doaj-art-0dd6a76b5d8a44efb7a9b143b97aaac6 |
institution | Kabale University |
issn | 1975-5171 2383-7977 |
language | English |
publishDate | 2024-10-01 |
publisher | Korean Society of Anesthesiologists |
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series | Anesthesia and Pain Medicine |
spelling | doaj-art-0dd6a76b5d8a44efb7a9b143b97aaac62024-11-18T07:05:39ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772024-10-0119Suppl 1S113S12010.17085/apm.240181261Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trialRahendra Rahendra0Fajar Sesario1Andi Ade Wijaya Ramlan2Raihanita Zahra3Christopher Kapuangan4Arif Hari Martono Marsaban5Aries Perdana6 Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas IndonesiaBackground Airway management in children is challenging because of the smaller size, different proportions of anatomical structures compared to adults, and a higher risk of hypoxemia. Efforts to improve the efficiency of pediatric intubation can be made by manually twisting a spiral endotracheal tube (ETT) using a flexible stylet to manipulate its shape and angle. Methods This controlled trial randomized fifty children aged one month to six years who underwent elective surgery under general anesthesia into two groups (spiral ETT [sETT] and no-stylet ETT/standard ETT). The sETT was formed by twisting the ETT using a handmade tool. The primary objective was to determine the effectiveness of the sETT compared to the standard ETT in reducing intubation time. Secondary objectives were ETT placement accuracy, first-attempt intubation success rate, and adverse effects. Results The mean total tube handling time in the sETT group was significantly shorter compared to the no-stylet ETT group (sETT 16.8 ± 3.6 vs. standard ETT 18.8 ± 3.7 seconds; P = 0.049). sETT placement had a significantly greater central placement accuracy (odds ratio, 4.846; 95% confidence interval, 1.287-18.255; P = 0.015). However, first-attempt successful intubation rate (sETT 80% vs. standard ETT 64%, P = 0.208) and total intubation time (sETT: 46.5 ± 5.2 vs. standard ETT 48.4 ± 4.9 seconds; P = 0.205) were not significantly different. No adverse effects were observed for either ETT type. Conclusions Spiral ETT effectively reduces total tube handling time and improves ETT placement accuracy in children using video laryngoscopy.http://anesth-pain-med.org/upload/pdf/apm-24018.pdfadverse effectsdurationendotracheal intubationpediatricsplacement accuracyspiral endotracheal tube |
spellingShingle | Rahendra Rahendra Fajar Sesario Andi Ade Wijaya Ramlan Raihanita Zahra Christopher Kapuangan Arif Hari Martono Marsaban Aries Perdana Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial Anesthesia and Pain Medicine adverse effects duration endotracheal intubation pediatrics placement accuracy spiral endotracheal tube |
title | Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial |
title_full | Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial |
title_fullStr | Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial |
title_full_unstemmed | Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial |
title_short | Endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a McGrath video laryngoscope: a prospective randomized trial |
title_sort | endotracheal intubation using a spiral endotracheal tube effectively reduces total tube handling time in children aged one month to six years using a mcgrath video laryngoscope a prospective randomized trial |
topic | adverse effects duration endotracheal intubation pediatrics placement accuracy spiral endotracheal tube |
url | http://anesth-pain-med.org/upload/pdf/apm-24018.pdf |
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