Airtraq laryngoscope: Embracing video laryngoscopy.

Sir,

Compared to a Macintosh laryngoscope, the Airtraq optical laryngoscope (AOL) improves the view of the larynx and outperforms the Macintosh for accuracy, success, response time, and number of attempts to intubate, both in normal and difficult airways.[1] It was designed using optic laryngoscopy technology, which lacks some of the useful features of video laryngoscopy. The Airtraq device has an optional accessory, the Airtraq video camera, that allows images to be transmitted by radiofrequency to a monitor, solving this limitation[2] [Figure 1a]. The development of a Wi-Fi camera and smartphone adapter for assembly onto the proximal viewfinder of every Airtraq model has made this new technology accessible to all anesthesiologists. The camera also allows Wi-Fi connection with commonly used devices like the iPhone or with a tablet like the iPad (Apple, Cupertino, CA, USA) or with a personal computer [Figure 1b–d]. This produces a high-resolution image, while retaining the laryngoscope's original portability and ease of use.

Figure 1

(a) Airtraq video camera and Airtraq wireless monitor; (b) Airtraq with assembly Wi-Fi camera; (c) Shares Wi-Fi real time images with iPad®; (d) Airtraq with phone adapter. The patient gave written informed consent for publication

We aim to evaluate the advantages of the Airtraq device plus this technology innovation (“Airtraq video laryngoscope” [AVL]) versus AOL. After obtaining the approval of our Institution's Ethics Committee and getting the informed consent signed, we studied 20 American Society of Anesthesiologists physical status I-III patients, aged 18 years of age or older, scheduled for surgical procedures requiring tracheal intubation. Patients were not included if risk factors for gastric aspiration were present. All patients were intubated by one of four anesthesiologists experienced in the use of AOL using “both devices.” After completion of the study, the anesthesiologist was asked to state their preferred device. Tables 1 and 2 show data of this evaluation.

Table 1

Demographic characteristics of patients enrolled in the study

Table 2

Data for intubation attempts with each device

The anesthesiologist showed their preference for AVL and they found that this innovation offers several benefits in contrast to direct visión via the eyepiece. The advantages are:

A bigger image is produced. Thus, ergonomics is improved, including a better posture for the operator and a shared view of the airway, as is essential for teaching and training airway management. The procedure can be supervised, recorded, exported, and documented.

The target mark on the monitor, aligned with the glottic opening, indicates the direction of travel of the endotracheal tube as it advances from the guide channel.

Tracheal intubation is possible in non-standard positions, like face to face.

It enables the use of techniques, adjuvants, and assistance that facilitate endotracheal tube insertion when the procedure is difficult.

It allows tracheal intubation while the operator is more remote from potentially infectious secretions, adding protection for healthcare workers.

These data suggest that the “new AVL” should be preferably considered when facing challenges in airway management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.