Presentation on theme: "aScope Ambu aScope 1: a New Disposable Flexible Video Laryngoscope"— Presentation transcript:
1 aScope Ambu aScope 1: a New Disposable Flexible Video Laryngoscope AuthorSchirin M. Missaghi et alSourceInternet Journal of Airway Management, Homepage, Volume 6 (January 2010 to December 2011)FrameworkEvaluation of the aScope for orotracheal intubation in 10 patients with apparently normal airways.Main endpointsCostBenefitsWorking channelComparatorsNoneConclusionThe start-up investment of the aScope is significantly lower than that of alternative productsIt eliminates time and costs of hygienic reprocessing associated with standard flexible laryngoscopes, requiring a special automatic endoscopy washing machine, and repair costs.The aScope eliminates any risks of cross infection and is always available for use in other patients.Experienced endoscopists had regularly problems with fogging of the camera system and the presence of secretions obscuring the view due to the working channel cannot be used for suctioning.The manufacturer should redesign the current model of the aScope (1)and provide this device with a larger sized working channel and the facility for suctioning
2 aScopeA cost analysis of reusable and disposable flexible optical scopes for intubationAuthorTvede MF et alSourceActa Anaesthesiol Scand May;56(5): doi: /j x. Epub 2012 Feb 16.PMID:FrameworkThe costs incurred during intubations using FOSs at a large anaesthesia department were identified, and a series of intubations using a disposable scope were analyzed for comparisonMain endpointsCost per intubationCost per intubation per deviceCost per intubation with a fixed no. of intubations/mthProcedures performed by the staff when using the applicable deviceInitial expenditureRepair cost/ yearWages cost /yearOperating cost/procedure/intubation using reusable scopeComparatorsaScopeFlexible optical scope(reusable)ConclusionTotal cost of an intubation is greater when using disposable compared with reusable equipment (€204.4 vs. €177.7)If video equipment with an external monitor is considered mandatory, the expenses are of equal magnitude.The cost analysis is particularly sensitive to the actual number of flexible optic intubations performed; with fewer intubations, the total cost will begin to favor disposable equipment.
3 aScopePreliminary Evaluation of Ambu aScope 2 for Endoscopic Guidance During Percutaneous Dilatational TracheostomyAuthorJamadarkhana S et alSourceICS 2011Framework10 patients underwent PDTMain endpointsEase of useQuality of imageVentilatory parametersCardiovascular parametersComparatorsNoneConclusionEasy handling and maneuvrabilityClarity and quality of endoscopic view was 8-10 (1-10, 10 being the best)No significant cardiovascular and ventilatory changes during the procedureNo complications were reportedaScope is an alternative to reusable bronchoscopes for PDT on ICU, and the single use design eliminates the risk of cross contamination and delays with sterilization.
4 AuraOnceComparison between LMA-Classic and AMBU AuraOnce laryngeal mask airway in patients undergoing elective general anaesthesia with positive pressure ventilationAuthorSuzanna AB et alSourceMed J Malaysia Oct;66(4):304-7.PMID:Framework180 patients allocated into two groupsASA I and II patients undergoing elective general anaesthesiaMain endpointsEase of insertionAdequacy of seal intraoperativelyPostoperative complicationsComparatorsAmbu LMAClassic LMAConclusionFirst attempt success rate was comparable between the two groups (Classic LMA 87% versus Ambu LMA 83%)Time of insertion was significantly shorter in the Ambu LMA group(Seal performance)Nitrous oxide level was comparable between the two groups up to 20 minutes of operation. At 40 and 60 minutes, the Ambu LMA showed a significant lower nitrous oxide leak compared to the Classic LMA.Postoperatively, incidence of blood stains was comparable between the two groups, however the incidence of sore throat was lower in the Ambu LMA groupThe Ambu LMA was comparable to the Classic LMA in terms of the ease of insertion, but provided better seal during positive pressure ventilation with less postoperative sore throat.
5 AuraOnceRandomised Comparison of the AMBU AuraOnce Laryngeal Mask and the LMA Unique Laryngeal Mask Airway in Spontaneously Breathing AdultsAuthorWilliams DL et alSourceAnesthesiol Res Pract. 2012;2012: Epub 2012 Feb 29.PMID:Framework82 adult patients (ASA status I-IV) were randomly allocated to receive the LMAU or AMBU and were blinded to device selectionComparison of two SGA in spontaneously breathing adult patients undergoing general anaesthesiaAll airway devices were inserted by trained anesthetistsMain endpointsSeal pressureOverall success rateInsertion timeNo of adjustmentsAirway morbidityComparatorsLMA-UniqueAuraOnceConclusionAMBU produced significantly higher airway sealing pressures (AMBU 20 ± 6; LMAU 15 ± 7 cm H(2)O)No statistical difference between the two devices for first time & overall success rate, AuraOnce (35/40) Unique(31/38)Insertion time AuraOnce (27s) Unique(32s)Blood-staining/sore throat, AuraOnce (4/3) Unique (3/4)The AuraOnce provided a higher oropharyngeal leak pressure compared to the LMA Unique in spontaneously breathing adult patients.
6 AuraOnceUltrasound confirmation of laryngeal mask airway placement correlates with fiberoptic laryngoscope findingsAuthorGupta D et alSourceMiddle East J Anesthesiol Jun;21(2):283-7.PMID:Framework31 ASA I and II patientsGeneral anesthetic technique with AuraOnce or AuraFlex Disposable Laryngeal Mask Airways.The position of the SGA cuff was confirmed by transverse neck ultrasound (USG), and reconfirmed with intra-SGA fibreoptic laryngoscopy (FOL).Main endpointsSGA position after placement and prior to removal with the assistance of ultrasound scanComparatorsNoneConclusionUltrasound examination can replace fibreoptic examination for confirmation of the correct placement of an LMAUltrasound examination can further give insight into the cause of airway/ventilation events that may be interfering with the LMA placement and ventilation.
7 AuraFlexUltrasound confirmation of laryngeal mask airway placement correlates with fiberoptic laryngoscope findingsAuthorGupta D et alSourceMiddle East J Anesthesiol Jun;21(2):283-7.PMID:Framework31 ASA I and II patientsGeneral anesthetic technique with AuraOnce or AuraFlex Disposable Laryngeal Mask Airways.The position of the SGA cuff was confirmed by transverse neck ultrasound (USG), and reconfirmed with intra-SGA fiberoptic laryngoscopy (FOL).Main endpointsSGA position after placement and prior to removal with the assistance of ultrasound scanComparatorsNoneConclusionUltrasound examination can replace fiberoptic examination for confirmation of the correct placement of an LMAUltrasound examination can further give insight into the cause of airway/ventilation events that may be interfering with the LMA placement and ventilation.
8 Ambu ResuscitatorAn In-Vitro Evaluation of Aerosol Delivery Through Tracheostomy and Endotracheal Tubes Using Different InterfacesAuthorAri A et alSourceRespir Care Jan 23. [Epub ahead of print]PMID:FrameworkA manikin was intubated with either an ETT(Mallinckrodt) or an TT(tracheostomy), to compare aerosol delivery via tracheostomy tube (TT) and ETT using interfaces such as T-piece, tracheostomy collar, and Ambu bag.Main endpointsDelivered nominal doseComparatorsT-pieceTracheostomy collarAmbu bag.ConclusionUse of Ambu bag with both TT and ETT increased lung dose more than three fold.Inhaled dose with tracheostomy collar was less than T-piece with either TT or ETTIn an adult model of spontaneous ventilation, aerosol therapy through ETT is less efficient than TT, while the Ambu bag was more efficient than T-piece or tracheostomy collar.
9 Ambu ResuscitatorRadio stethoscopes: an innovative solution for auscultation while wearing protective gearAuthorCandiotti KA et alSourceAm J Disaster Med Sep-Oct;6(5):285-8.PMID:FrameworkTwo blinded anesthesiologists using a radio stethoscope performed a total of 100 assessments (50 each) to evaluate endotracheal tube position on a human patient simulator(HPS)Four ventilation patterns (i.e., right lung ventilation only; left lung ventilation only; ventilation of both lungs; and an esophageal intubation or no breath sounds) were simulated.An Ambu bag was used for ventilation, and subjects had to identify the ventilation pattern. Participants later compared the two types of respirators and their ability to auscultate for breath sounds.Main endpointsComparison of the two types of respirator (positive and negative)ComparatorsNoneConclusionSubjects were able to verify the correct ventilation pattern in all attempts (100 percentRadio stethoscopes appear to provide a viable solution for the problem of patient auscultation while wearing protective gear
10 Pentax - AWSSuccess rates and endotracheal tube insertion times of experienced emergency physicians using five video laryngoscopes: a randomized trial in a simulated trapped car accident victimAuthorWetsch WA et alSourceEur J Anaesthesiol Dec;28(12): doi: /EJA.0b013e32834c7c7f.PMID:Framework25 experienced anaesthetistsAn airway manikin was placed on the driver's seat of a compact car. Access was possible only through the opened driver's door.Main endpointsTime to achieve glottic viewTime of intubationTime for first ventilation & tracheal tube positionComparatorsMacintosh laryngoscopeGlidescope RangerStorz C-MACAmbu-Pentax AWSAirtraqMcGrathConclusionVideo laryngoscope provides a better glottic view, but with significantly delays.Devices with a tube guide (Airtraq and Ambu Pentax AWS) enable tracheal intubation to be achieved significantly faster and with a lower failure rate than devices without a tube guide.No video laryngoscope outperformed direct laryngoscopy with a Macintosh laryngoscope in this simulation study.
11 Pentax - AWSIntubation training survey using four types of laryngoscopes among medical students: a comparison of the Macintosh laryngoscopes, Miller laryngoscopes, Airtraq, and Pentax-AWS Airwayscope [Article in Japanese]AuthorHayashi K et alSourceMasui Mar;60(3):PMID:Framework66 medical students with no intubation experienceA survey regarding medical students’ usefulness in intubation procedure on mannequin.A short instruction including practice for the four various devices before intubation procedure were commenced.Four intubation procedures (one for each device) to the mannequin (Laerdal airway trainer) were performedMain endpointsTime for intubationPOGO score(percentage of glottic opening)Incidence of esophageal intubationTeeth clickComparatorsMacintosh laryngoscopeMiller laryngoscopeAirtraqAmbu-Pentax AWSConclusionTime for intubation was significantly longer in ATQPOGO was significantly higher in AWS, but lower in MACComplications were fewer in AWS70% of the participants chose AWS as the best device.With minimal instruction including practice, the AWS seemed to achieve safer intubation with better laryngeal view for novice laryngoscopists
12 Pentax - AWSFirst robotic tracheal intubations in humans using the Kepler intubation systemAuthorHemmerling TM et alSourceBr J Anaesth Jun;108(6): Epub 2012 Mar 28.PMID:FrameworkA pilot study with 12 patients enrolled in the first human testing of a robotic intubation system for oral intubation.The robotic intubation system consist of four main components whereas a Pentax AWS video laryngoscope is incorporated as part of the system.A joystick allows simulation of the wrist or arm movements of a human operator.Main endpointsSuccess rate of intubationIntubation timesComparatorsNoneConclusionThe success rate was high at 91%Only one patient failed intubation due to fogging of the video laryngoscopeIntubation time were 93 s(median)
13 Pentax - AWSParker Flex-Tip Tube(®) provides higher intubation success with the Pentax-AWS Airway scope(®) despite the AWS tip being inserted into the valleculaAuthorSuzuki A et alSourceJ Anesth Mar 4. [Epub ahead of print]PMID:FrameworkForty patients were randomly assigned into either the standard or Parker tube groupExamination of whether the Parker tube facilitates intubation when the AWS tip is inserted into the vallecula.Main endpointsSuccess rate for intubationTime needed for tube placementComparatorsParker tubeStandard tubeConclusionThe Parker tube provided both a higher intubation success rate (17/20 vs. 4/20)The Parker tube provided a faster intubation time (17 ± 5 s vs. 25 ± 4 s)The Parker tube in combination with the AWS is an optional technique allowing the laryngoscopist to obtain more reliable intubation success despite insertion of the AWS tip into the vallecula.
14 Pentax - AWSMacintosh laryngoscope vs. Pentax-AWS video laryngoscope: comparison of efficacy and cardiovascular responses to tracheal intubation in major burn patientsAuthorWoo CH et alSourceKorean J Anesthesiol Feb;62(2): Epub 2012 Feb 20.PMID:FrameworkASA physical status 2 or 3 adult patients with major burn injury were assigned into two groups.To compare cardiovascular responses and general efficacy of the Pentax-AWS and Macintosh laryngoscopes in burn patientsMain endpointsHemodynamic dataGrade of sore throatIntubation timeSuccess rate of intubationNumber of intubation attemptsPOGO ( percentage of glottic opening)ComparatorsPentax-AWSMacintosh laryngoscopesConclusionA statistically significant increase in heart rate just after laryngoscopy was seen with Macintosh.The success rate of the first attempt (100%) was greater with the Pentax AWS (46%). POGO scores were higher with the Pentax AWS (97 ± 4%)The use of Pentax-AWS offers a reduced degree of heart rate elevation compared with the Macintosh laryngoscope and better intubation environments in major burn patients.
15 Pentax - AWSUse of the Pentax-AWS in a patient with Cormack 3a difficult airway [Article in Japanese]AuthorSuzuki A et alSourceMasui Mar;56(3):341-4.PMID:FrameworkUse of Pentax-AWS in a 68-year-old male patient with known (Cormack grade 3a) difficult airway.Patient was sedated.Main endpointsPOGO ( percentage of glottic opening)Intubation attemptsComparatorsNoneConclusionPOGO score 70%Tracheal intubation was successful uneventfully, and the patient's airway was secured without any postoperative complication.