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• W2809344343 abstract "A novel AZ-airway concept introduced at the 2016 Difficult Airway Society annual meeting was well received, encouraging a proof-of-concept study. The device allows interchangeable supraglottic (SG) and endotracheal (ET) ventilation, and provides rescue supraglottic airway device (SAD), ability to convert to endotracheal tube (ETT), and safer smooth or true staged extubation from an existing ETT without the use of an exchange catheter or interrupting ventilation. This allows ‘tracheal rest’ and ‘staged extubation’ in difficult airways or intensive care setting.1–3 The unique design includes a removable (R-piece) tube replaced by an ETT, enabling ventilation in an SG or ET mode depending on ETT depth. The goals were to (i) implement AZ-airway concept on SAD platforms, (ii) test claimed capabilities on manikin, and (iii) trial on patients. No external funding was used for this study. Two SAD models were chosen: the AuraGain™ from Ambu®, St Ives, UK as an inflatable cuff and the i-gel® from Intersurgical® Ltd., East Syracuse, New York as a non-inflatable cuff platform, which were altered according to a three-dimensional printed prototype. The following concepts were verified: (i) SG ventilation with R-piece, (ii) R-piece to ETT change for SG ventilation, (iii) alternating ET and SG ventilation with existing ETT without interruption, (iv) removal of SAD and keeping ETT, and (v) conversion of existing ETT to SAD. In the simulation centre, structurally altered SADs were tested on manikins. Fibreoptic bronchoscopy and video laryngoscopy confirmed optimal positioning. Next, the concept was tested on seven consented patients with sterile manner SAD alteration in the operating room. An anaesthesiology resident or nurse anaesthetist did the initial insertion to test the ease of insertion. Positioning was confirmed by fibreoptic bronchoscope. In both SAD models, AZ-airway alteration was easily done. A longitudinal opening in SAD shaft transformed it to a non-cylindrical, incomplete tube. An R-piece was made using the proximal portion of a larger ETT. The claims were tested in the simulation centre using both platforms of SADs, and all study stages were tested successfully. The clinical trial showed the same results as manikins for ease of insertion, functionality, possibility of interchanging SAD to ETT, and staged extubation. Simulation and clinical trials show the AZ-airway concept is compatible with the tested SADs. The next step is to design a new airway with incorporated features or collaboration with an existing SAD. 1.Biro P, Priebe H. Anesth Analg 2007; 105: 1182–52.Mort TC. Anesth Analg 2007; 105: 1357–623.Perello-Cerda L, Fabregas N, Lopez AM, et al. J Neurosurg Anesthesiol 2015; 27: 194–202" @default.
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• W2809344343 date "2018-07-01" @default.
• W2809344343 modified "2023-09-27" @default.
• W2809344343 title "Proof-of-concept trial for ‘AZ modification’ of supraglottic airways" @default.
• W2809344343 doi "https://doi.org/10.1016/j.bja.2018.02.044" @default.
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