title: Supraglottic jet oxygenation and ventilation-assisted fibre-optic bronchoscope intubation in patients with difficult airways.
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 SpO2values 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 SpO2values 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.
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
authors.forename: Caineng
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
authors.forename: Jianqi
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
authors.forename: Qingyun
authors.initials: Q
authors.lastname: Cen
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
authors.forename: Xuefan
authors.initials: X
authors.lastname: Sha
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
authors.forename: Qingxiang
authors.initials: Q
authors.lastname: Cai
authors.affiliation: Department of Anesthesia, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. gzmwh@outlook.com.
authors.forename: Wuhua
authors.initials: W
authors.lastname: Ma
authors.affiliation: School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China. yingcao1986@163.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Cao
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D020680:Bronchoscopes / Q000592:standards* / Q000706:statistics & numerical data; D002681:China; D004867:Equipment Design / Q000592:standards; D005260:Female; D006611:High-Frequency Jet Ventilation / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects
keywords: Difficult airway; Fibre-optic bronchoscope; Laryngeal mask airway; Supraglottic jet oxygenation and ventilation