Airtraq in difficult paediatric airway: report of three cases
The difficult pediatric airway is a challenge for the anesthetist due to the difficulty achieving an adequate assessment, the paucity of management algorithms, lack of accurate knowledge regarding incidence, as well as limitations of the various devices in this group of patients. We present 3 clinical cases of pediatric patients with craniofacial malformations. Although amenable to ventilation, they had a history of difficult orotracheal intubation during previous interventions but were managed successfully with the Airtraq videolaryngoscope. Although this device has not been studied to a large extent in pediatrics, there are different sizes suitable for patient age. This, together with ease of use, fast learning curve and successful approach to the difficult airway in the few published studies, has contributed to turn it into a primary and rescue technique when the initial approach has failed in situations of difficult pediatric airway.
2. Law JA, Broemling N, Cooper RM, et al. The difficult airway with recommendations for management-Part 1-Difficult tracheal intubation encountered in an unconscious/induced patient. Can J Anaesth 2013;60:1089-1118.
3. Morales AC, San Norberto L, Prieto RM, et al. Airtraq tracheal intubation in a girl with Pierre Robin syndrome. Rev Esp Anestesiol Reanim 2011;58:526-528.
4. Vlatten A, Soder C. Airtraq optical laryngoscope intubation in a 5-month-old infant with a difficult airway because of Robin Sequence. Paediatr Anaesth 2009;19:699-700.
5. Castañeda M, Batllori M, Gómez Ayechu M, et al. Airtraq optical laryngoscopy. An Sist Sanit Navar 2009;32:75-83.
6. Savoldelli GL, Ventura F, Waeber JL, et al. Use of the Airtraq as the primary technique to manage anticipated difficult airway: a report of three cases. J Clin Anesth 2008;20:474-477.
7. Xue FS, Liu HP, Liao X, et al. Endotracheal intubation with Airtraq optical laryngoscope in the pediatric patients. Paediatr Anaesth 2011;21:703-704.
8. Xue FS, Yuan YJ, Wang Q, et al. Laryngoscopes with a guiding channel cannot avoid difficulty in passing endotracheal tube through the glotis. Acta Anaesthesiol Scand 2011;55:134.
9. Holm-Knudsen RJ, White J. The Airtraq may not be the solution for infants with difficult airways. Pediatr Anesth 2010;20:374-375.
10. Burjek NE, Nishisaki A, Fiadjoe JE, et al. Videolaryngoscopy versus fiber-optic intubation through a supraglottic airway in children with a difficult airway: an analysis from the multicenter pediatric difficult intubation registry. Anesthesiology 2017;127:432-440.
11. Shimada N, Hirabayashi Y. Tonsillar injury caused by the Airtraq optical laryngoscope in children. J Clin Anesth 2011;23:344-345.
12. Owada G, Mihara T, Inagawa G, et al. A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: a manikin study. PLoS One 2017;12:e0171889.