Letter to the Director
Use of the Totaltrack VLM in unexpected difficult airway in urgent caesarean section
Uso del Totaltrack VLM en una vía aérea difícil imprevista en una cesárea urgente
Read
5
Timeswas read the article
2
Total PDF
3
Total HTML
Share statistics
array:24 [ "pii" => "S2341192917301877" "issn" => "23411929" "doi" => "10.1016/j.redare.2017.11.012" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "818" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:62-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935617301056" "issn" => "00349356" "doi" => "10.1016/j.redar.2017.03.012" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "818" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Rev Esp Anestesiol Reanim. 2018;65:62-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 118 "formatos" => array:2 [ "HTML" => 93 "PDF" => 25 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CARTA AL DIRECTOR</span>" "titulo" => "Uso del Totaltrack VLM en una vía aérea difícil imprevista en una cesárea urgente" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "62" "paginaFinal" => "63" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of the Totaltrack VLM in unexpected difficult airway in urgent caesarean section" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1372 "Ancho" => 800 "Tamanyo" => 71875 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Totaltrack VLM. El dispositivo consta de varias partes: 1) el Videotrack, un sistema de fibra óptica desmontable y reutilizable, con pantalla LCD y sistema antivaho; 2) una batería; 3) una vía aérea supraglótica (se evaluó la presión de sellado de la vía aérea con el dispositivo supraglótico<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>; el volumen medio del manguito necesario para alcanzar una presión del manguito de 60<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O fue de 20<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,7<span class="elsevierStyleHsp" style=""></span>ml [rango 18-23], y la presión de fuga orofaríngea media con una presión del manguito de 60<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O fue de 37,1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4,6<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O [rango 29-45]); 4) una pala, que tiene un exoesqueleto rígido para permitir la laringoscopia y que puede retirarse una vez que la intubación es exitosa (el extremo de la pala del Totaltrack VLM está protegida por una cubierta de silicona para minimizar la lesión epiglótica u orofaríngea); 5) un canal guía de intubación, y 6) canales de succión gástrica y laríngea.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.Á. Gómez-Ríos, E. Freire-Vila, D. Gómez-Ríos, M. Diéguez-Fernández" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.Á." "apellidos" => "Gómez-Ríos" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Freire-Vila" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Gómez-Ríos" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Diéguez-Fernández" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192917301877" "doi" => "10.1016/j.redare.2017.11.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917301877?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935617301056?idApp=UINPBA00004N" "url" => "/00349356/0000006500000001/v1_201712140536/S0034935617301056/v1_201712140536/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192917301786" "issn" => "23411929" "doi" => "10.1016/j.redare.2017.11.004" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "837" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:64-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Base excess, a useful marker in the prognosis of chest trauma in the geriatric population" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "64" "paginaFinal" => "65" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Exceso de bases, un marcador útil en el pronóstico del traumatismo torácico en la población geriátrica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Úbeda, L. Alonso, A.M. Esquinas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Úbeda" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Alonso" ] 2 => array:2 [ "nombre" => "A.M." "apellidos" => "Esquinas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935617301408" "doi" => "10.1016/j.redar.2017.06.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935617301408?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917301786?idApp=UINPBA00004N" "url" => "/23411929/0000006500000001/v1_201802080003/S2341192917301786/v1_201802080003/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S234119291730183X" "issn" => "23411929" "doi" => "10.1016/j.redare.2017.11.009" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "835" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:59-61" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Epidural catheter anchored in the posterior lateral epidural space: How to manage it" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "59" "paginaFinal" => "61" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Anclaje del catéter epidural en el espacio epidural posterolateral: cómo manejarlo" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 905 "Ancho" => 2101 "Tamanyo" => 103059 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Contrast lumbar spinal CT. Catheter positioned in the left posterior-lateral epidural space in L1-L2.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Costa, S. Fonseca, L. Guedes, A. Leão, A. Sousa" "autores" => array:5 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Costa" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Fonseca" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Guedes" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Leão" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Sousa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S003493561730138X" "doi" => "10.1016/j.redar.2017.05.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493561730138X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234119291730183X?idApp=UINPBA00004N" "url" => "/23411929/0000006500000001/v1_201802080003/S234119291730183X/v1_201802080003/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Director</span>" "titulo" => "Use of the Totaltrack VLM in unexpected difficult airway in urgent caesarean section" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "62" "paginaFinal" => "63" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.Á. Gómez-Ríos, E. Freire-Vila, D. Gómez-Ríos, M. Diéguez-Fernández" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M.Á." "apellidos" => "Gómez-Ríos" "email" => array:1 [ 0 => "magoris@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "Freire-Vila" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "D." "apellidos" => "Gómez-Ríos" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Diéguez-Fernández" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Anestesiología y Reanimación, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Anesthesiology and Pain Management Research Group, Institute for Biomedical Research of A Coruña (INIBIC), A Coruña, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso del Totaltrack VLM en una vía aérea difícil imprevista en una cesárea urgente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1372 "Ancho" => 800 "Tamanyo" => 72229 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Totaltrack VLM. The device consists of: (1) the Videotrack™, a detachable and reusable fibreoptic system with LCD screen and antifogging system; (2) a battery-operated light; (3) a supraglottic airway. We assessed the airway sealing pressure of the supraglottic airway device.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> The mean cuff volume necessary to achieve 60<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O cuff pressure was 20<span class="elsevierStyleHsp" style=""></span>ml (±1.7<span class="elsevierStyleHsp" style=""></span>ml; range, 18–23<span class="elsevierStyleHsp" style=""></span>ml) and the mean oropharyngeal leak pressure at 60<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O cuff pressure was 37.1<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O (±4.6<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O; range, 29–45<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O); (4) a blade, which has a rigid exoskeleton to allow direct laryngoscopy but which can be removed once intubation is successful. The tip of the Totaltrack™ blade is protected by a silicone cover to minimise epiglottic or oropharyngeal injury; (5) an intubation guide channel; and (6) gastric and laryngeal suction channels.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The reduced size of the pharyngolaryngeal cavity, rapid onset of hypoxaemia, the risk of pulmonary aspiration, the presence of diseases such as obesity or preeclampsia, combined with the emergency, round-the-clock context make obstetric airway management a challenge. For this reason, difficult intubation is more common in obstetrics than in other settings, and it is important to develop methods that facilitate ventilation and tracheal intubation (TI) to avoid life-threatening complications in both mother and child. We present the use of the Totaltrack VLM (TT) in a case of unexpected difficult intubation in caesarean section. The patient gave written informed consent for publication of this article.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a 30-year-old, 160<span class="elsevierStyleHsp" style=""></span>cm, 62<span class="elsevierStyleHsp" style=""></span>kg, primigravid woman at 40-weeks gestation who presented for emergency caesarean section due to severe foetal bradycardia. Preoperative airway assessment included a Mallampati grade 2, a class 1 upper lip bite test, and a thyromental distance >6.5<span class="elsevierStyleHsp" style=""></span>cm with a flexible neck. After rapid-sequence induction, direct laryngoscopy using a Macintosh #3 blade revealed an unexpected Cormack Lehane grade 4 view. The TT (size 4, the only size available on the market at that time) was inserted immediately, maintaining the cricoid pressure. After obtaining a POGO score of 100%,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> the TT cuff was inflated and the patient's lungs were easily ventilated with 13<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O positive pressure. Intubation through the guide channel was easily accomplished under vision at the first attempt in just 2<span class="elsevierStyleHsp" style=""></span>s, and was confirmed by capnography. Following this, the TT was removed over the endotracheal tube (ETT), according to the manufacturer's instructions. The procedure was uneventful, and a healthy male infant was delivered with initial Apgar score of 6 at 1<span class="elsevierStyleHsp" style=""></span>min improving to 9 at 5<span class="elsevierStyleHsp" style=""></span>min, and a pH of 7.3.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Difficult intubation is a leading cause of anaesthesia-related maternal death.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> The “gold standard” airway management in obstetrics is rapid sequence induction with standard direct laryngoscopy to insert a styletted ETT accompanied by cricoid pressure,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> but this approach is not without its pitfalls. Primary management goals in unanticipated difficult TI with foetal distress include maintenance of maternal oxygenation and ventilation, airway protection, and prompt delivery of the baby.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> When traditional laryngoscopy is unsuccessful, a second attempt can be made using a video laryngoscope, although this can also fail, prolonging the period of apnoea. After a failed second attempt at TI, the use of a supraglottic device must be considered.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3–5</span></a> These devices, however, offer the lungs no protection from regurgitated gastric contents, and fibreoptic-guided TI through them is reliable, but it is rarely available immediately. The Totaltrack (MedComflow S.A., Barcelona, Spain) was developed to aid both ventilation and TI in difficult airway management. It is a hybrid device, between a supraglottic airway and an anatomically-shaped bladed video-laryngoscope, which gives fibreoptic visualisation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> The TT combines the advantages of video-laryngoscopy with several additional benefits<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>: (1) the gastric tube provides functional separation of the respiratory and gastrointestinal tracts once the conduit is correctly positioned under vision, and allows aspiration of stomach content. The seal created by the inflated cuff protects the airway from aspiration until intubation is accomplished; (2) optimal ventilation can be maintained throughout the process of TI, thus minimising apnoea time; (3) the laryngeal suction channel provides a means of aspirating blood or secretions that might otherwise have obscured the view; (4) the conduit guides the transglottic passage of the ETT, under vision. An adequate view of the glottis gives a high first-attempt intubation rate; (5) the blade prevents the epiglottis from down-folding. However, the TT requires a minimum inter-incisor distance of at least 2<span class="elsevierStyleHsp" style=""></span>cm, and the device may be more difficult to insert in the presence of enlarged breasts, which may be a significant limitation in the obstetric patient.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">We have completed an initial evaluation in 100 patients<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> undergoing head and neck, general, and gynaecologic surgery, and have used the device for several “low aspiration risk” parturients undergoing elective caesarean section under general anaesthesia. In all cases to date, an initial full view of the glottis was obtained and adequate ventilation was established. There were no detectable leaks, episodes of desaturation, aspiration or other complications. In expert hands, securing the airway with the TT takes approximately 40<span class="elsevierStyleHsp" style=""></span>s.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We believe the TT is a primary rescue device that could simplify obstetric difficult airway algorithms and become the new paradigm in obstetric anaesthesia. Further studies are needed to confirm this hypothesis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gómez-Ríos MÁ, Freire-Vila E, Gómez-Ríos D, Diéguez-Fernández M. Uso del Totaltrack VLM en una vía aérea difícil imprevista en una cesárea urgente. Rev Esp Anestesiol Reanim. 2018;65:62–63.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1372 "Ancho" => 800 "Tamanyo" => 72229 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Totaltrack VLM. The device consists of: (1) the Videotrack™, a detachable and reusable fibreoptic system with LCD screen and antifogging system; (2) a battery-operated light; (3) a supraglottic airway. We assessed the airway sealing pressure of the supraglottic airway device.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> The mean cuff volume necessary to achieve 60<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O cuff pressure was 20<span class="elsevierStyleHsp" style=""></span>ml (±1.7<span class="elsevierStyleHsp" style=""></span>ml; range, 18–23<span class="elsevierStyleHsp" style=""></span>ml) and the mean oropharyngeal leak pressure at 60<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O cuff pressure was 37.1<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O (±4.6<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O; range, 29–45<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O); (4) a blade, which has a rigid exoskeleton to allow direct laryngoscopy but which can be removed once intubation is successful. The tip of the Totaltrack™ blade is protected by a silicone cover to minimise epiglottic or oropharyngeal injury; (5) an intubation guide channel; and (6) gastric and laryngeal suction channels.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of laryngeal view: percentage of glottic opening score vs Cormack and Lehane grading" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.A. Ochroch" 1 => "J.E. Hollander" 2 => "S. Kush" 3 => "F.S. Shofer" 4 => "R.M. Levitan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/BF03013137" "Revista" => array:6 [ "tituloSerie" => "Can J Anaesth" "fecha" => "1999" "volumen" => "46" "paginaInicial" => "987" "paginaFinal" => "990" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10522589" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is it time to revisit tracheal intubation for cesarean delivery?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.S. Habib" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12630-012-9719-3" "Revista" => array:6 [ "tituloSerie" => "Can J Anaesth" "fecha" => "2012" "volumen" => "59" "paginaInicial" => "642" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22528169" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.C. Mushambi" 1 => "S.M. Kinsella" 2 => "M. Popat" 3 => "H. Swales" 4 => "K.K. Ramaswamy" 5 => "A.L. Winton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/anae.13260" "Revista" => array:6 [ "tituloSerie" => "Anaesthesia" "fecha" => "2015" "volumen" => "70" "paginaInicial" => "1286" "paginaFinal" => "1306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26449292" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of a ProSeal™ laryngeal mask airway for airway maintenance during emergency caesarean section after failed tracheal intubation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Awan" 1 => "J.P. Nolan" 2 => "T.M. Cook" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2004" "volumen" => "92" "paginaInicial" => "144" "paginaFinal" => "146" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14665568" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The LMA Supreme™ in 700 parturients undergoing cesarean delivery: an observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.Y. Yao" 1 => "S.Y. Li" 2 => "B.L. Sng" 3 => "Y. Lim" 4 => "A.T. Sia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12630-012-9718-4" "Revista" => array:6 [ "tituloSerie" => "Can J Anaesth" "fecha" => "2012" "volumen" => "59" "paginaInicial" => "648" "paginaFinal" => "654" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22556005" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Totaltrack™: an initial evaluation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. Gómez-Ríos" 1 => "E. Freire-Vila" 2 => "L. Vizcaíno-Martínez" 3 => "E. Estévez-González" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aev335" "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2015" "volumen" => "115" "paginaInicial" => "798" "paginaFinal" => "799" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26475812" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006500000001/v1_201802080003/S2341192917301877/v1_201802080003/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006500000001/v1_201802080003/S2341192917301877/v1_201802080003/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192917301877?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 0 | 2 |
| 2018 March | 1 | 0 | 1 |
| 2018 January | 0 | 1 | 1 |
| 2017 November | 0 | 1 | 1 |
