title: A feasibility study using the VivaSight Single Lumen™ to intubate the trachea through the Fastrach laryngeal mask airway: a preliminary report of 50 cases.
abstract: BACKGROUND
  The VivaSight Single Lumen™ (SL) is new endotracheal tube with a video camera and a light source in the tip allowing continuous visual observation of the airway. In this study, we checked the feasibility of endotracheal intubation with a VivaSight-SL through the Fastrach Laryngeal Mask Airway(®) (FT-LMA).
  
  
  METHODS
  We studied 50 patients with normal airways, scheduled for elective surgery during general anesthesia requiring endotracheal intubation. The FT-LMA was inserted and once adequate ventilation was achieved, the VivaSight-SL was passed through the FT-LMA into the trachea under visual control. The following criteria were used to score the laryngeal view: grade 1: full view of the arytenoids and glottis; grade 2: epiglottis, arytenoids or glottic opening are partly visible, the structure of cords is difficult to see; grade 3: dark areas indicating an open space; and grade 4: no part of the larynx can be identified.
  
  
  RESULTS
  The FT-LMA was placed successfully in 49 patients at the first attempt. One patient was excluded from the study after 2 failed attempts to ventilate with the FT-LMA. All 49 patients were successfully intubated with the VivaSight-SL, (95% confidence interval [CI] 0.89-0.99), 47 patients at the first attempt (95% CI, 0.83-0.98) and 2 patients at the second attempt. (95% CI, 0.004-0.13). The time to achieve an effective airway with the FT-LMA was 15.4 ± 6 (mean ± SD) seconds. The time to achieve a laryngeal view with the VivaSight-SL was 28.8 ± 5 seconds. Correct position of the VivaSight-SL was confirmed with visualization of the carina. Time of successful intubation with VivaSight-SL from picking up the VivaSight-SL to observing a end-tidal CO(2) curve was 45 ± 7 seconds. After introducing the VivaSight-SL through the intubating channel of the FT-LMA, a grade 1 view was obtained in 18 patients, grade 2 in 18 patients, a grade 3 in 4 patients, and grade 4 in 9 patients.
  
  
  CONCLUSIONS
  The high first-attempt intubation success rate using the VivaSight-SL to intubate the trachea through a FT-LMA makes this technique an attractive and promising concept.
authors: Department of Anesthesiology, Bnai-Zion Medical Center, 47 Golomb, St. Haifa 31048, Israel. luis.gaitini@b-zion.org.il
authors: Luis A
authors: LA
authors: Gaitini
authors: Boris
authors: B
authors: Yanovski
authors: Somri
authors: S
authors: Mustafa
authors: Carin A
authors: CA
authors: Hagberg
authors: Pedro Charco
authors: PC
authors: Mora
authors: Sonia J
authors: SJ
authors: Vaida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design / Q000295:instrumentation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D055815:Young Adult