Abstract
A difficult airway may lead to hypoxia and brain damage. The WEI Nasal Jet Tube (WNJ) is a new nasal pharyngeal tube that applies supraglottic jet oxygenation and ventilation (SJOV) for patients during tracheal intubation without the need for mask ventilation. We evaluated the effectiveness and safety of SJOV-assisted fibre-optic bronchoscopy (FOB) using the WNJ in the management of difficult tracheal intubations. A total of 50 adult patients with Cormack–Lehane grade ≥3 and general anesthesia with tracheal intubation were randomly assigned to either the laryngeal mask airway (LMA) or WNJ groups. The primary outcome was the percentage of patients with SpO2 values lower than 94 % during intubation. The proportion of successful intubations, total time of intubation, and associated complications were also recorded. The percentage of patients with SpO2 values lower than 94 % during intubation was significantly higher in the LMA group (25 % in the LMA vs. 0 % in the WNJ, P = 0.01). Although there were no statistically significant differences in the total success rates of intubation, the first-attempt success rate was significantly higher in the WNJ group (100 vs. 79.2 %, P = 0.02). The total time required for intubation with the WNJ was shorter than that of the LMA (73.4 vs. 99.5 s, P < 0.001), although the duration of fibre-optic intubation was similar. The incidence of complications was similar between the two groups. SJOV-assisted FOB using the WNJ improved oxygenation and successful tracheal intubation in the management of difficult airways. This technique can be used as an alternative approach to improve success and minimize hypoxia during difficult airway management.
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Acknowledgments
We appreciate the editing of the manuscript by Huafeng Wei from the University of Pennsylvania. This study was supported by the Department of Anesthesia of the First Affiliated Hospital of Guangzhou University of Chinese Medicine.
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Dr. Huafeng Wei provided the WNJ and assisted in the editing of the manuscript. Dr. Huafeng Wei is the inventor of the WEI Nasal Jet Tube (WEI NASAL JET or WNJ) and holds multiple patent applications.
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All procedures performed in our studies involving human participants were in accordance with ethical standards of the 1964 Helsinki declaration and its later amendments.
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Informed consent was obtained from all participants included in the study.
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This study was supported by the Department of Anesthesia of the First Affiliated Hospital of Guangzhou University of Chinese Medicine.
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W. Ma and Y. Cao contributed equally to the concept and design of this study and can be considered to be co-corresponding authors.
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Wu, C., Wei, J., Cen, Q. et al. Supraglottic jet oxygenation and ventilation-assisted fibre-optic bronchoscope intubation in patients with difficult airways. Intern Emerg Med 12, 667–673 (2017). https://doi.org/10.1007/s11739-016-1531-6
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DOI: https://doi.org/10.1007/s11739-016-1531-6