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Colombian Journal of Anestesiology
Print version ISSN 0120-3347On-line version ISSN 2256-2087
Abstract
ALVAREZ ROBLES, Saúl et al. Aerosol box for intubation of patients with suspected COVID-19: simulation study. Rev. colomb. anestesiol. [online]. 2022, vol.50, n.1, e201. Epub Jan 18, 2022. ISSN 0120-3347. https://doi.org/10.5554/22562087.e1006.
Introduction
Endotracheal intubation is a procedure associated with a high level of exposure to the COVID-19 virus. This has led to the search of alternatives to reduce the risk of contamination, including the so-called aerosol box.
Objective
To compare time and difficulty of orotracheal intubation when using the aerosol box in a simulated setting.
Methodology
Observational study conducted with the participation of 33 anesthetist physicians and anesthesia residents; groups were compared in terms of time and intubation difficulty using a conventional Macintosh laryngoscope and the McGRATH™ MAC (Medtronic) videolaryngoscope with or without aerosol box. In order to determine performance with the intubation maneuver, crude hazard ratios were estimated, and a Cox multivariate regression model was built, adjusted by anesthetist years of experience and difficulties during the procedure.
Results
On average, the aerosol box increased intubation time by 7.57 seconds (SD 8.33) when the videolaryngoscope was used, and by 6.62 (SD 5.74) with the Macintosh. Overall, 132 intubations were performed, with 121 successful and 6 failed first-time attempts (4 with the use of the aerosol box); 16 participants (48.48%) reported difficulty handling the box. With the use of the Macintosh, intubation was found to be faster than with the videolaryngoscope (cHR: 1.36 [95% CI 0.64-2.88]; adjusted HR: 2.20 [95% CI 0.73-6.62]).
Conclusions
The use of the aerosol box and personal protective equipment in a simulation setting hinders the intubation maneuver and may result in protracted execution time.
Keywords : Intra-tracheal intubation; Respiratory protection devices; SARS virus; Anesthesiology; COVID-19.