Second-generation supraglottic airway device effective intubation tool even for emergency airway management: Study

Recently published study aimed to assess the Ambu Aura-i as an independent ventilatory device and conduit for fiberoptic-guided endotracheal intubation in adults. The Ambu® Aura-i™ is designed as a second-generation supraglottic airway device and is compatible with standard cuffed tracheal tubes, phthalate-free, and MRI-compatible. A descriptive observational study was conducted with 80 patients to evaluate the efficiency of the Ambu® Aura-i™ in various aspects.

Following the induction of general anesthesia, the Ambu® Aura-i™ was inserted, and fiberoptic examination of the glottis was conducted. The ease of insertion, time for insertion, glottic view grading, ease of intubation, success rate, time for fiberoptic-guided intubation, and removal duration were recorded. The Ambu® Aura-i™ was found to be easy to insert, with negligible variation in insertion and intubation times between different patient groups.

Comparison of Insertion and Intubation

Both groups experienced similar ease of insertion, with average insertion times being around 13-14 seconds and fiberoptic-guided intubation times averaging about 14 seconds. The success rate for the first attempt intubation was around 75-87.5% in both groups, and the removal duration of the Ambu® Aura-i™ from the tracheal tube was comparable in both groups.

Study Findings and Conclusion

No significant adverse events were reported, and the device was found to be suitable for various age groups and compatible with MRI machines. The study concluded that the Ambu® Aura-i™ is an effective and appealing ventilatory device and intubation tool for both normal and emergency airway management.

Overall Assessment and Limitation

Overall, the study demonstrated that the Ambu® Aura-i™ is an efficient and cost-effective ventilatory device and intubation tool, making it both anesthetist- and patient-friendly, and has potential use in fiberoptic-guided airway management in both operating theaters and the ICU. However, a limitation of the study was the restriction to only sizes 3 and 4 of the Ambu® Aura-i™, limiting its use to patients weighing up to 70 kg.

Key Points

- The study assessed the Ambu® Aura-i™ as a ventilatory device and conduit for fiberoptic-guided endotracheal intubation in adults, concluding that the device is easy to insert, with negligible variation in insertion and intubation times between different patient groups. The average insertion times were around 13-14 seconds, and fiberoptic-guided intubation times averaged about 14 seconds. The success rate for the first attempt intubation was around 75-87.5% in both groups, and the removal duration of the Ambu® Aura-i™ from the tracheal tube was comparable in both groups.

- The study found no significant adverse events and concluded that the Ambu® Aura-i™ is an effective and appealing ventilatory device and intubation tool for both normal and emergency airway management. It is considered suitable for various age groups and compatible with MRI machines. The research suggests that the device is efficient, cost-effective, anesthetist- and patient-friendly, and has potential use in fiberoptic-guided airway management in operating theaters and the ICU.

Reference -

Mishra N, Sinha N, Kharwar R K, et al. (April 20, 2024) Clinical Assessment of the Ambu® Aura-i™ as an Independent Ventilatory Device and Conduit for Fiberoptic-Guided Endotracheal Intubation in Adults. Cureus 16(4): e58629. DOI 10.7759/cureus.58629