Usefulness of the Airtraq DL™ videolaryngoscope for placing a double-lumen tube.
BACKGROUND
Endotracheal insertion of a double-lumen tube (DLT) may be difficult because of its size and shape. The Airtraq™ is a new videolaryngoscope that allows supraglottis exposure without needing to align the oro-pharyngo-laryngeal axis. A specific model (Airtraq DL™), with a large diameter, has been specifically designed to insert a DLT. We have tested the efficiency of this device on the quality of supraglottis exposure and the endotracheal position of the DLT.


STUDY DESIGN
This was a prospective and observational study.


METHODS
This study included 37 consecutive patients with no risk for difficult intubation and who required insertion of a DLT for one-lung ventilation. The main outcomes were the success rate of endotracheal intubation within 120 s, the quality of glottis exposure, the position of the tube within the trachea and the occurrence of any complications.


RESULTS
All patients were safely intubated, but only 33 (89%) were successfully intubated within 120 s (mean time: 44±27 s). Using the Airtraq DL™ videolaryngoscope, significantly more patients were graded Cormack and Lehane I as compared to the Macintosh laryngoscope (97% vs. 73%, P<0.05). Overall, fiberoptic bronchoscopy detected 62% of incorrectly positioned DLTs. Blood was noted on the blade of the videolaryngoscope in seven patients, desaturation occurred in two patients and labial trauma in one patient.


CONCLUSION
The use of the Airtraq DL™ improves exposure of the supraglottis during insertion of a DLT. However, previous removal of the stylet could increase the risk of incorrectly positioning the tube.
['Chastel|Brigitte|B|', 'Perrier|Virginie|V|', 'Germain|Arnaud|A|', 'Seramondi|Régis|R|', 'Rozé|Hadrien|H|', 'Ouattara|Alexandre|A|']
D004867:Equipment Design D005260:Female D006801:Humans D007442:Intubation, Intratracheal D020704:Laryngoscopes D008297:Male D008875:Middle Aged D011446:Prospective Studies D014741:Video Recording
Videolaryngoscope Double-lumen tube