aScope

Report
aScope
Ambu aScope 1: a New Disposable Flexible Video Laryngoscope
Author
Source
Schirin M. Missaghi et al
Internet Journal of Airway Management, Homepage, Volume 6 (January 2010 to December 2011)
Framework
Evaluation of the aScope for orotracheal intubation in 10 patients with apparently normal airways.
Main endpoints
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Comparators
Conclusion
None
Cost
Benefits
Working channel
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The start-up investment of the aScope is significantly lower than that of alternative products
It eliminates time and costs of hygienic reprocessing associated with standard flexible laryngoscopes, requiring a
special automatic endoscopy washing machine, and repair costs.
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The aScope eliminates any risks of cross infection and is always available for use in other patients.
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Experienced endoscopists had regularly problems with fogging of the camera system and the presence of
secretions obscuring the view due to the working channel cannot be used for suctioning.
The manufacturer should redesign the current model of the aScope (1)and provide this device with a larger sized
working channel and the facility for suctioning
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aScope
A cost analysis of reusable and disposable flexible optical scopes for intubation
Author
Source
Tvede MF et al
Acta Anaesthesiol Scand. 2012 May;56(5):577-84. doi: 10.1111/j.1399-6576.2012.02653.x. Epub 2012 Feb 16.
PMID: 22338623
http://www.ncbi.nlm.nih.gov/pubmed/22338623
Framework
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The costs incurred during intubations using FOSs at a large anaesthesia department were identified, and a series of
intubations using a disposable scope were analyzed for comparison
Main endpoints
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Cost per intubation
Cost per intubation per device
Cost per intubation with a fixed no. of intubations/mth
Procedures performed by the staff when using the applicable device
Initial expenditure
Repair cost/ year
Wages cost /year
Operating cost/procedure/intubation using reusable scope
Comparators
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aScope
Flexible optical scope(reusable)
Total cost of an intubation is greater when using disposable compared with reusable equipment (€204.4 vs. €177.7)
If video equipment with an external monitor is considered mandatory, the expenses are of equal magnitude.
The cost analysis is particularly sensitive to the actual number of flexible optic intubations performed; with fewer
intubations, the total cost will begin to favor disposable equipment.
Conclusion
aScope
Preliminary Evaluation of Ambu aScope 2 for Endoscopic Guidance During Percutaneous
Dilatational Tracheostomy
Author
Jamadarkhana S et al
Source
ICS 2011
Framework
10 patients underwent PDT
Main endpoints
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Comparators
None
Ease of use
Quality of image
Ventilatory parameters
Cardiovascular parameters
Conclusion
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Easy handling and maneuvrability
Clarity and quality of endoscopic view was 8-10 (1-10, 10 being the best)
No significant cardiovascular and ventilatory changes during the procedure
No complications were reported
aScope is an alternative to reusable bronchoscopes for PDT on ICU, and the single use design eliminates the risk of
cross contamination and delays with sterilization.
AuraOnce
Comparison between LMA-Classic and AMBU AuraOnce laryngeal mask airway in patients
undergoing elective general anaesthesia with positive pressure ventilation
Author
Suzanna AB et al
Source
Med J Malaysia. 2011 Oct;66(4):304-7.
PMID: 22299547
http://www.ncbi.nlm.nih.gov/pubmed/22299547
Framework
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180 patients allocated into two groups
ASA I and II patients undergoing elective general anaesthesia
Main endpoints
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Ease of insertion
Adequacy of seal intraoperatively
Postoperative complications
Comparators
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Ambu LMA
Classic LMA
Conclusion
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First attempt success rate was comparable between the two groups (Classic LMA 87% versus Ambu LMA 83%)
Time of insertion was significantly shorter in the Ambu LMA group
(Seal performance)Nitrous oxide level was comparable between the two groups up to 20 minutes of operation. At 40
and 60 minutes, the Ambu LMA showed a significant lower nitrous oxide leak compared to the Classic LMA.
Postoperatively, incidence of blood stains was comparable between the two groups, however the incidence of sore
throat was lower in the Ambu LMA group
The Ambu LMA was comparable to the Classic LMA in terms of the ease of insertion, but provided better seal during
positive pressure ventilation with less postoperative sore throat.
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AuraOnce
Randomised Comparison of the AMBU AuraOnce Laryngeal Mask and the LMA Unique
Laryngeal Mask Airway in Spontaneously Breathing Adults
Author
Source
Framework
Main endpoints
Comparators
Conclusion
Williams DL et al
Anesthesiol Res Pract. 2012;2012:405812. Epub 2012 Feb 29.
PMID: 22505884
http://www.ncbi.nlm.nih.gov/pubmed/22505884
• 82 adult patients (ASA status I-IV) were randomly allocated to receive the LMAU or AMBU and were blinded to device
selection
• Comparison of two SGA in spontaneously breathing adult patients undergoing general anaesthesia
• All airway devices were inserted by trained anesthetists
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Seal pressure
Overall success rate
Insertion time
No of adjustments
Airway morbidity
LMA-Unique
AuraOnce
AMBU produced significantly higher airway sealing pressures (AMBU 20 ± 6; LMAU 15 ± 7 cm H(2)O)
No statistical difference between the two devices for first time & overall success rate, AuraOnce (35/40) Unique(31/38)
Insertion time AuraOnce (27s) Unique(32s)
Blood-staining/sore throat, AuraOnce (4/3) Unique (3/4)
The AuraOnce provided a higher oropharyngeal leak pressure compared to the LMA Unique in spontaneously
breathing adult patients.
AuraOnce
Ultrasound confirmation of laryngeal mask airway placement correlates with fiberoptic
laryngoscope findings
Author
Gupta D et al
Source
Middle East J Anesthesiol. 2011 Jun;21(2):283-7.
PMID: 22435281
http://www.ncbi.nlm.nih.gov/pubmed/22435281
Framework
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31 ASA I and II patients
General anesthetic technique with AuraOnce or AuraFlex Disposable Laryngeal Mask Airways.
The position of the SGA cuff was confirmed by transverse neck ultrasound (USG), and reconfirmed with intra-SGA
fibreoptic laryngoscopy (FOL).
Main endpoints
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SGA position after placement and prior to removal with the assistance of ultrasound scan
Comparators
None
Conclusion
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Ultrasound examination can replace fibreoptic examination for confirmation of the correct placement of an LMA
Ultrasound examination can further give insight into the cause of airway/ventilation events that may be interfering with
the LMA placement and ventilation.
AuraFlex
Ultrasound confirmation of laryngeal mask airway placement correlates with fiberoptic
laryngoscope findings
Author
Gupta D et al
Source
Middle East J Anesthesiol. 2011 Jun;21(2):283-7.
PMID: 22435281
http://www.ncbi.nlm.nih.gov/pubmed/22435281
Framework
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31 ASA I and II patients
General anesthetic technique with AuraOnce or AuraFlex Disposable Laryngeal Mask Airways.
The position of the SGA cuff was confirmed by transverse neck ultrasound (USG), and reconfirmed with intra-SGA
fiberoptic laryngoscopy (FOL).
Main endpoints
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SGA position after placement and prior to removal with the assistance of ultrasound scan
Comparators
None
Conclusion
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Ultrasound examination can replace fiberoptic examination for confirmation of the correct placement of an LMA
Ultrasound examination can further give insight into the cause of airway/ventilation events that may be interfering with
the LMA placement and ventilation.
Ambu Resuscitator
An In-Vitro Evaluation of Aerosol Delivery Through Tracheostomy and Endotracheal Tubes
Using Different Interfaces
Author
Ari A et al
Source
Respir Care. 2012 Jan 23. [Epub ahead of print]
PMID: 22273459
http://www.ncbi.nlm.nih.gov/pubmed/22273459
Framework
A manikin was intubated with either an ETT(Mallinckrodt) or an TT(tracheostomy), to compare aerosol delivery via
tracheostomy tube (TT) and ETT using interfaces such as T-piece, tracheostomy collar, and Ambu bag.
Main endpoints
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Delivered nominal dose
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T-piece
Tracheostomy collar
Ambu bag.
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Use of Ambu bag with both TT and ETT increased lung dose more than three fold.
Inhaled dose with tracheostomy collar was less than T-piece with either TT or ETT
In an adult model of spontaneous ventilation, aerosol therapy through ETT is less efficient than TT, while the Ambu
bag was more efficient than T-piece or tracheostomy collar.
Comparators
Conclusion
Ambu Resuscitator
Radio stethoscopes: an innovative solution for auscultation while wearing protective gear
Author
Candiotti KA et al
Source
Am J Disaster Med. 2011 Sep-Oct;6(5):285-8.
PMID: 22235600
http://www.ncbi.nlm.nih.gov/pubmed/22235600
Framework
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Two blinded anesthesiologists using a radio stethoscope performed a total of 100 assessments (50 each) to
evaluate endotracheal tube position on a human patient simulator(HPS)
Four ventilation patterns (i.e., right lung ventilation only; left lung ventilation only; ventilation of both lungs; and an
esophageal intubation or no breath sounds) were simulated.
An Ambu bag was used for ventilation, and subjects had to identify the ventilation pattern. Participants later
compared the two types of respirators and their ability to auscultate for breath sounds.
Main endpoints
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Comparators
Comparison of the two types of respirator (positive and negative)
None
Conclusion
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Subjects were able to verify the correct ventilation pattern in all attempts (100 percent
Radio stethoscopes appear to provide a viable solution for the problem of patient auscultation while wearing
protective gear
Pentax - AWS
Success rates and endotracheal tube insertion times of experienced emergency physicians using
five video laryngoscopes: a randomized trial in a simulated trapped car accident victim
Author
Wetsch WA et al
Source
Eur J Anaesthesiol. 2011 Dec;28(12):849-58. doi: 10.1097/EJA.0b013e32834c7c7f.
PMID: 21986981
http://www.ncbi.nlm.nih.gov/pubmed/21986981
Framework
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25 experienced anaesthetists
An airway manikin was placed on the driver's seat of a compact car. Access was possible only through the opened driver's
door.
Main endpoints
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Time to achieve glottic view
Time of intubation
Time for first ventilation & tracheal tube position
Comparators
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Macintosh laryngoscope
Glidescope Ranger
Storz C-MAC
Ambu-Pentax AWS
Airtraq
McGrath
Video laryngoscope provides a better glottic view, but with significantly delays.
Devices with a tube guide (Airtraq and Ambu Pentax AWS) enable tracheal intubation to be achieved significantly faster
and with a lower failure rate than devices without a tube guide.
No video laryngoscope outperformed direct laryngoscopy with a Macintosh laryngoscope in this simulation study.
Conclusion
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Pentax - AWS
Intubation training survey using four types of laryngoscopes among medical students: a
comparison of the Macintosh laryngoscopes, Miller laryngoscopes, Airtraq, and Pentax-AWS
Airwayscope [Article in Japanese]
Author
Hayashi K et al
Source
Masui. 2011 Mar;60(3):389-94.
PMID: 21485114
http://www.ncbi.nlm.nih.gov/pubmed/21485114
Framework
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66 medical students with no intubation experience
A survey regarding medical students’ usefulness in intubation procedure on mannequin.
A short instruction including practice for the four various devices before intubation procedure were commenced.
Four intubation procedures (one for each device) to the mannequin (Laerdal airway trainer) were performed
Main endpoints
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Time for intubation
POGO score(percentage of glottic opening)
Incidence of esophageal intubation
Teeth click
Comparators
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Macintosh laryngoscope
Miller laryngoscope
Airtraq
Ambu-Pentax AWS
Time for intubation was significantly longer in ATQ
POGO was significantly higher in AWS, but lower in MAC
Complications were fewer in AWS
70% of the participants chose AWS as the best device.
With minimal instruction including practice, the AWS seemed to achieve safer intubation with better laryngeal view for
novice laryngoscopists
Conclusion
Pentax - AWS
First robotic tracheal intubations in humans using the Kepler intubation system
Author
Hemmerling TM et al
Source
Br J Anaesth. 2012 Jun;108(6):1011-6. Epub 2012 Mar 28.
PMID: 22457483
http://www.ncbi.nlm.nih.gov/pubmed/22457483
Framework
• A pilot study with 12 patients enrolled in the first human testing of a robotic intubation system for oral intubation.
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Main endpoints
The robotic intubation system consist of four main components whereas a Pentax AWS video laryngoscope is
incorporated as part of the system.
A joystick allows simulation of the wrist or arm movements of a human operator.
• Success rate of intubation
•
Intubation times
Comparators
None
Conclusion
• The success rate was high at 91%
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Only one patient failed intubation due to fogging of the video laryngoscope
Intubation time were 93 s(median)
Pentax - AWS
Parker Flex-Tip Tube(®) provides higher intubation success with the Pentax-AWS Airway
scope(®) despite the AWS tip being inserted into the vallecula
Author
Suzuki A et al
Source
J Anesth. 2012 Mar 4. [Epub ahead of print]
PMID: 22391671
http://www.ncbi.nlm.nih.gov/pubmed/22391671
Framework
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Forty patients were randomly assigned into either the standard or Parker tube group
Examination of whether the Parker tube facilitates intubation when the AWS tip is inserted into the vallecula.
Main endpoints
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Success rate for intubation
Time needed for tube placement
Comparators
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Parker tube
Standard tube
Conclusion
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The Parker tube provided both a higher intubation success rate (17/20 vs. 4/20)
The Parker tube provided a faster intubation time (17 ± 5 s vs. 25 ± 4 s)
The Parker tube in combination with the AWS is an optional technique allowing the laryngoscopist to obtain more
reliable intubation success despite insertion of the AWS tip into the vallecula.
Pentax - AWS
Macintosh laryngoscope vs. Pentax-AWS video laryngoscope: comparison of efficacy and
cardiovascular responses to tracheal intubation in major burn patients
Author
Source
Woo CH et al
Korean J Anesthesiol. 2012 Feb;62(2):119-24. Epub 2012 Feb 20.
PMID: 22379565
http://www.ncbi.nlm.nih.gov/pubmed/22379565
Framework
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ASA physical status 2 or 3 adult patients with major burn injury were assigned into two groups.
To compare cardiovascular responses and general efficacy of the Pentax-AWS and Macintosh laryngoscopes in burn
patients
Main endpoints
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Hemodynamic data
Grade of sore throat
Intubation time
Success rate of intubation
Number of intubation attempts
POGO ( percentage of glottic opening)
Comparators
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Pentax-AWS
Macintosh laryngoscopes
A statistically significant increase in heart rate just after laryngoscopy was seen with Macintosh.
The success rate of the first attempt (100%) was greater with the Pentax AWS (46%). POGO scores were higher with
the Pentax AWS (97 ± 4%)
The use of Pentax-AWS offers a reduced degree of heart rate elevation compared with the Macintosh laryngoscope and
better intubation environments in major burn patients.
Conclusion
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Pentax - AWS
Use of the Pentax-AWS in a patient with Cormack 3a difficult airway [Article in Japanese]
Author
Suzuki A et al
Source
Masui. 2007 Mar;56(3):341-4.
PMID: 17366925
http://www.ncbi.nlm.nih.gov/pubmed/17366925
Framework
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Use of Pentax-AWS in a 68-year-old male patient with known (Cormack grade 3a) difficult airway.
Patient was sedated.
Main endpoints
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POGO ( percentage of glottic opening)
Intubation attempts
Comparators
None
Conclusion
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POGO score 70%
Tracheal intubation was successful uneventfully, and the patient's airway was secured without any postoperative
complication.

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