title: CobraPLUS and Cookgas air-Q versus Fastrach for blind endotracheal intubation: a randomised controlled trial.
abstract: OBJECTIVE
  CobraPLUS and Cookgas air-Q are supraglottic airways expected to allow safe ventilation as well as reliable blind intubation. In a prospective, controlled trial, we hypothesised that quality of ventilation and success rate of blind endotracheal intubation of these new devices would be superior to the Fastrach intubating laryngeal mask airway (ILMA). When blind intubation failed the quality of fibrescope-guided intubation was investigated. To allow identification of those patients in whom blind intubation would be difficult, we investigated the predictive value of currently used predictors for ease of endotracheal intubation.
  
  
  METHODS
  One hundred and eighty adult patients with documented BMI, Mallampati score, Cormack-Lehane classification, interincisor gap and thyromental distance were randomised into three groups according to the device used. Ventilation conditions were rated as excellent, good or difficult. When blind intubation failed, fibrescope-guided intubation conditions were rated as well. Statistical analysis was performed by a χ-test.
  
  
  RESULTS
  The quality of ventilation was excellent for all devices. Three patients in the CobraPLUS group and two patients in the ILMA and the Cookgas groups needed a slight reposition. Blind intubation through the CPLA was successful in 47%, through the Cookgas in 57%, whereas the Fastrach group had a success rate of 95%. Fibreoptic intubation was possible in all but one patient. None of the registered scores and measures allowed prediction of difficult blind intubation.
  
  
  CONCLUSIONS
  All devices appeared to be safe airways. The Fastrach ILMA proved to be a reliable facilitator for blind intubation. CobraPLUS and Cookgas air-Q allowed an easy fibrescopic intubation. Failed blind intubations could not be predicted by the used parameters.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Hospital Hietzing, Wolkersbergenstrasse 1, A-1130 Vienna, Austria. wolfgang.erlacher@wienkav.at
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Erlacher
authors.forename: Heide
authors.initials: H
authors.lastname: Tiefenbrunner
authors.forename: Thomas
authors.initials: T
authors.lastname: Kästenbauer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Schwarz
authors.forename: Robert D
authors.initials: RD
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017214:Laryngeal Masks; D008297:Male; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods / Q000592:standards*