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British Journal of Anaesthesia, Vol 80, Issue 4 525-527, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia


EQUIPMENT

Video-intuboscopy: a new aid to routine and difficult tracheal intubation

M. Weiss
Department of Anaesthesia, University Children's Hospital, Steinwiesstrasse 75, CH 8032 Zurich, Switzerland

Video-intuboscopy gives a video display of the view from the tip of the tracheal tube during conventional laryngoscopy, and was developed particularly to assist the immediate management of unexpected difficult intubation. A lightweight, malleable video-optical intubation stylet transmits the view from the stylet tip onto a monitor. It is inserted in the tracheal tube before starting anaesthesia, and the view from the tracheal tube tip enables the anaesthetist to verify tracheal tube position in the trachea. During difficult intubation the video view is used to guide the tracheal tube into the trachea. When used to allow confirmation of tracheal placement, the system did not interfere with conventional intubation procedures. The method showed the subglottic airway, gave immediate confirmation of tracheal tube position, and aided teaching and supervision. The method was used to guide intubation in two patients with unanticipated grade 3 laryngoscopic views. Intubation was simple, rapid and atraumatic, without the need for head, neck or laryngeal manipulation. Tracheal placement was instantly confirmed using the video view from the stylet tip. Clinical studies are required to define the value of this new intubation technique.
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