title: Optimising the unprotected airway with a prototype Jaw-Thrust-Device--a prospective randomised cross-over study.
abstract: Despite being a standard procedure during induction of anaesthesia, facemask ventilation can be a major challenge especially for inexperienced anaesthetists. We manufactured a Jaw-Thrust-Device designed to keep the patient's jaws in an optimised position, and thus to maintain the airway in a permanently patent state. Using a cross over design, we compared the influence of using the Esmarch manoeuvre (bimanual jaw-thrust), a nasopharyngeal airway, an oropharyngeal airway, or the Jaw-Thrust-Device on airway physiology in 50 healthy adults with body mass index < 35 kg.m(-2), undergoing standard facemask ventilation for routine induction of anaesthesia. The main study endpoints were expiratory tidal volumes, airway resistances, and gas flow rates. The Jaw-Thrust-Device was more effective in increasing expiratory tidal volumes and peak inspiratory flow than a standard Esmarch manoeuvre, and was more effective than both nasopharyngeal and oropharyngeal airways in decreasing airway resistance.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, County Hospital Steyr, Steyr, Austria.
authors.forename: A
authors.initials: A
authors.lastname: von Goedecke
authors.forename: L
authors.initials: L
authors.lastname: Mitterschiffthaler
authors.forename: P
authors.initials: P
authors.lastname: Paal
authors.forename: T
authors.initials: T
authors.lastname: Mitterlechner
authors.forename: V
authors.initials: V
authors.lastname: Wenzel
authors.forename: H
authors.initials: H
authors.lastname: Herff
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000517:prevention & control*; D000769:Anesthesia, Inhalation / Q000295:instrumentation*; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D019416:Head Movements; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D008297:Male; D008397:Masks; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation*; D015656:Respiratory Mechanics; D055815:Young Adult