Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Reviews
Year : 2023 | Month : January | Volume : 17 | Issue : 1 | Page : UE01 - UE04 Full Version

Comparative Preference of Airtraq Laryngoscope Over Macintosh Laryngoscope- A Review


Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/60681.17330
Yatharth Bhardwaj, Amol Singam

1. Resident, Department of Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India. 2. Professor, Department of Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

Correspondence Address :
Yatharth Bhardwaj,
Department of Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.
E-mail: yatharthbhardwaj1991@gmail.com

Abstract

Tracheal intubation using a Macintosh laryngoscope can save lives. However, because intubation is a difficult procedure to master, failures can have disastrous results. A more recent intubation tool than the Macintosh is the Airtraq optical laryngoscope, which offers glottic plane visualization without requiring correct tracheal, pharyngeal and oral axes alignment. Airtraq can improve the incidence of failed first intubations and the time required to manage an airway, especially in patients who have had cervical spine trauma which requires manual stabilization of the cervical spine. With no differences in hemodynamics or intubation duration, the Airtraq laryngoscope offered patients a better laryngeal vision than the Macintosh laryngoscope by providing shorter laryngoscopy and intubation time, and easier intubation. The aim of this literature review was to compare these two laryngoscopes with respect to endotracheal intubation. This review article was put together after a comprehensive study of the literature using the electronic databases PubMed, Medline, Embase and Google. Airtraq laryngoscope was found to be superior to Macintosh laryngoscope as it provides a better view of the glottic region with more ease and less intubation time than the conventional Macintosh laryngoscope.

Keywords

Airway, Anaesthesia, Endotracheal intubation, Novel, Laryngeal view

Local and regional anaesthesia is used for a variety of surgical procedures. Although many surgical procedures can be carried out with supraglottic devices, many surgical operations still necessitate general anaesthesia and endotracheal intubation to preserve the airway (1). The fundamental tasks of an anesthesiologist include managing the airway, ensuring good patient breathing, and performing endotracheal intubations in particular (2). Unfortunately, endotracheal intubation can be challenging in some situations and impossible in others (3),(4). Numerous measures can be used to evaluate the patient’s airway and predict the likelihood of complications during endotracheal intubation. These measures are based on the input of trained medical professionals and aid in selecting the most appropriate approach, manufacturing the required equipment, and considering alternative options. The potential for fatal accidents is one of the numerous issues that might result from inadequate airway management. It is important for emergency room airway treatments and for saving lives in dire situations. If oesophageal intubation goes undetected, the patient could die (3).

Airway management, and specifically endotracheal intubation, can be evaluated by looking at factors like the duration of time it takes to perform the procedure, the number of times intubation is attempted, and the percentage of intubations that are successful on the first try (while also taking into account the use of cervical spine immobilization). Anesthesiologists routinely perform intubation, but maintaining the airway during surgery remains a concern (5).

Intubation failure by inexperienced personnel is still a major source of death and morbidity in anaesthesia and emergencies (6). Though there have been many advancements in the technology of laryngoscopes and other airway devices, the “Macintosh laryngoscope” is still the most commonly used tool for performing endotracheal intubation (7). Other airway devices are measured against endotracheal intubation as a standard. Unanticipated difficult airways are not detected before anaesthesia induction since they are dependent on several situations (8). The latest video laryngoscope, the Airtraq, helps doctors to intubate subjects with easy or problematic (difficult airways) air routes. It is possible to view the glottic field with minimal movement of the tracheal, pharyngeal, and oral axis due to the curved design of the Airtraq blade and the meticulous inner arrangement of the optical components. This is made possible by the fact that the Airtraq blade is curved (9). Indirect laryngeal exposure is achieved with less cervical spine movement than with traditional Macintosh laryngoscopes (10). The Airtraq rotor has two streams, one on each side. The other uses optics to project a wide-angle image from the lighted apex, through the glottis, and onto the trachea and adjacent laryngeal structures. There is a high-quality endotracheal tube insertion option (ETT). Airtraq is compatible with standard ETTs since its design mimics the human body (11). This article compares efficacy of Airtraq over Macintosh laryngoscope for endotracheal intubation, focusing on its efficacy and safety.

SEARCH METHODOLOGY

A literature search in English was conducted using the electronic databases PubMed, Medline, Embase, and Google. The search terms were Airtraq OR Macintosh OR Laryngoscope OR Endotracheal Intubation OR General Anaesthesia. The archiving of relevant papers was supported by the writers’ personal knowledge and experience in the field. Manuscripts on laryngoscopes and endotracheal intubation were included, (Table/Fig 1).

Macintosh Laryngoscope

Before the development of muscle relaxants, “Professor Sir Robert Macintosh” described endotracheal intubation as a “tour de force.” A New Zealander who helped establish a private anaesthetic practice in London’s West End in the 1930s, famously declared that “the hallmark of a successful anaesthesiologist was the ability to insert an endotracheal tube under vision. The Macintosh laryngoscope continues to be the benchmark by which other devices are compared, even though its broad use sometimes seems to compromise adequate laryngeal vision (12). Five distinct components make-up the Macintosh laryngoscope blade: The blade tip is a section of the rod that has been shaped at the ends and slotted along its length to fit onto the tip of the blade, pressing to present a rounded, atraumatic end; the lamp holder is made of rod and is internally threaded. The blade pressing is formed from sheet metal in a strong press. The blade block is made from bar material by turning and milling, (Table/Fig 2).

Airtraq laryngoscope

In patients with healthy or difficult airways, tracheal intubation can be performed with the use of a laryngoscope called the Airtraq, which is an optical laryngoscope designed for single use (Prodol Ltd, Vizcaya, Spain). It comes equipped with a light source, a path for the tracheal tube to follow, and a heater to keep the viewfinder from being fogged over with condensation. Viewing of the glottic can be accomplished with the Airtraq without the need to align the 3 axes (13). This is made possible by the unique structure of the optical components and the curve of the stiff blade. Direct laryngoscopy often involves positioning the patient so that their oral, pharyngeal, and laryngeal axes are all in the correct positions so that the vocal cords can be seen. Airtraq, a novel single-use laryngoscope, reveals the glottis without shifting the tracheal, pharyngeal, and oral axes.

The Airtraq blade is made up of 2 channels that travel in opposite directions. The tracheal tube is placed through the more externally located channel. Lens contact with the prism and the increased curvature of the blades transmit the picture to the near field. At the very tip of the blade is a battery-powered light. The intubation process is made less stressful by reducing the potential for cervical spine movement with this design (14). The glottis and its surrounding structures can be observed by placing the display lens over the mouth and nose and inserting the head of a tracheal tube between the vocal cords. Airtraq provides a more legible display for patients who have trouble opening their mouths or moving their necks (assuming it is greater than 3 cm). Transmitting the video footage to an external monitor also allows for real-time guidance from an instructor (14), (Table/Fig 3).

Advantages: Airtraq is advantageous because of its superior presentation. The video feed can also be broadcast to a second screen so that a professional can provide guidance and training at the same time. With Airtraq, intubation times were shorter, problems The direction of passage of the endotracheal tube as it emerges from the guide channel is indicated by the target mark on the monitor, which is positioned in line with the glottic aperture. Airtraq increases protection for healthcare personnel by enabling tracheal intubation while the operator is farther away from potentially contagious fluids. When inserting an endotracheal tube is challenging, Airtraq facilitates the employment of procedures, adjuvants, and assistance. Reports of the Airtraq’s success in aiding tracheal intubation in patients with traumatic asphyxia provide more evidence for the device’s usefulness in clinical situations likely to involve difficult airways.

Disadvantages: The display of an Airtraq video laryngoscope quickly degenerates in the presence of a bulge or secretion, and the gadget is difficult and expensive to use (14). As described by Holst B et al., (15), Airtraq use in oropharyngeal airway sites was associated with a 2 cm long vertical laceration.The device’s short lifespan necessitates keeping spares on hand, which raises costs and reduces its utility (16). To get the most out of the Airtraq system, practioners should plan on allocating some intervals for arrangement. Airtraq requires 30-60 sec. of on time to warm-up the lens and eliminate fogging (17). Because of this, the Airtraq equipment can be less useful in a crisis. The width of Airtraq i.e. 2.8 cm, increases the risk of mucosal tissue injury during insertion (18). Sore throat may develope after surgery due to the device’s effect on the oropharynx. (Table/Fig 5) (19),(20),(21),(22),(23),(24),(25).

Discussion

Medical students, naïve to intubation, also find Airtraq to be easier to use than a Macintosh laryngoscope (26),(27). The Airtraq laryngoscope was found to have less severe mucosal irritation and shorter intubation duration when compared to the Macintosh laryngoscope (28). Successful first intubation was more common with the Airtraq than with a Macintosh laryngoscope among both experienced and untrained doctors (29). This study found that the Macintosh blade was used for oesophageal intubation 69% of the time, while the Airtraq was only used 13% of the time. Similar hemodynamic changes were observed between Airtraq and Lightwand in a head-to-head comparison (30). As a one-time use item, Airtraq reduces the likelihood of prior contamination and subsequent cases of Creutzfeldt-Jacob disease (31).

Savoldelli GL et al., (32) found that the Airtraq required less time to implant the endotracheal tube than the McGrath and Glidescope.

Based on this analysis, Airtraq has the easiest learning curve. One study including 318 morbidly obese individuals found that the Airtraq laryngoscope reduced the time it took to intubate the trachea by about a minute compared to the Laryngeal Mask Airways (LMA) CTrach (33). Using the “Airtraq,” “Macintosh laryngoscope,” and “airway scope,” researchers looked at the achievement rate of intubation attempts and the time it took to complete them (34). When combined, these two elements were found to increase visibility throughout the airway by a large margin. Airtraq intubation takes longer than other methods because the eye must be completely opposed to the laryngoscope. Das B et al., concluded that for endotracheal intubation, patients with elevated intraocular pressure, Airtraq optical laryngoscope would be a superior substitute for the Macintosh. With the Airtraq, there is also less risk of hemodynamic pressure response and airway injury (35). According to Castillo-Monzón CG et al., Airtraq laryngoscope enhanced the glottic (modified Cormack-Lehane classification), decreased the need for additional tracheal intubation maneuvers, and also decreased the sympathetic stimulus indicated by a slight increase in heart rate following tracheal intubation (36).

Since the Airtraq laryngoscope offered better laryngoscopic views, quicker laryngoscopy and intubation, easier intubation, with noticeably minimal increase in heart rate and systolic blood pressure than Macintosh laryngoscope (37). Ndoko SK et al., had shown that the Airtraq laryngoscope allows for the quick and secure tracheal intubation of individuals who are morbidly obese than the typical Macintosh laryngoscope (38). In comparison to the Macintosh laryngoscope, Hoshijima H et al., find that the Airtraq attenuates the hemodynamic response at 60 s following tracheal intubation (39).

Conclusion

The Airtraq gadget is easy to learn and use, even in difficult airway situations. Although Airtaq has been shown to decrease the number of unsuccessful initial intubations and the time needed to manage an airway, this benefit is limited to individuals who had cervical spine trauma which requires manual stabilization of the cervical spine. With nominal differences in hemodynamics, the Airtraq laryngoscope offered patients a better laryngeal view than the Macintosh laryngoscope. More research is required to ascertain whether two or more devices have significantly different serious adverse effects.

References

1.
Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Richard P, et al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology. 2022;136:31-81 doi: https://doi.org/10.1097/ALN.0000000000004002 [crossref] [PubMed]
2.
Saasouh W, Laffey K, Turan A. Degree of obesity is not associated with more than one intubation attempt: A large centre experience. Br J Anaesth. 2018; 120:1110-16. 10.1016/j.bja.2018.01.019 [crossref] [PubMed]
3.
Higgs A, McGrath BA, Goddard C. Difficult Airway Society, Intensive Care Society, Faculty of Intensive Care Medicine, Royal College of Anaesthetists. Guidelines for the management of tracheal intubation in critically ill adults. Braz J Anesthesiol. 2018;120:323-52. 10.1016/j.bja.2017.10.021
4.
Szarpak L. Laryngoscopes for difficult airway scenarios: a comparison of the available devices. Expert Rev Med Devices. 2018;15:631-43. 10.1080/17434440.2018.1511423 [crossref] [PubMed]
5.
Haliem AM, Ashrey EM. Comparative study between C-MAC, Air Traq laryngoscope, and Air Q in adult patients. The Scientific Journal of Al-Azhar Medical Faculty, Girls. 2020;4(1):22.10.4103/sjamf.sjamf_106_19. [crossref]
6.
Abdelgalel EF, Mowafy MS. Comparison between Glidescope, Airtraq and Macintosh laryngoscopy for emergency endotracheal intubation in intensive care unit: randomised controlled trial Egyptian. J Anaesth. 2018;34:123-28:10.1016/j.egja.2018.06.002. [crossref]
7.
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DOI and Others

DOI: 10.7860/JCDR/2023/60681.17330

Date of Submission: Oct 10, 2022
Date of Peer Review: Nov 14, 2022
Date of Acceptance: Dec 15, 2022
Date of Publishing: Jan 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 12, 2022
• Manual Googling: Nov 26, 2022
• iThenticate Software: Dec 06, 2022 (4%)

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