An observational study of airway management at a university hospital in Belgium, with reference to airway equipment and intubation
Airway management, Intubation, Laryngoscopy, Laryngeal masks
Published online: May 17 2024
Abstract
Background: In recent years, an increasing range of equipment and techniques has become available for airway management.
Objectives: To define and compare current departmental airway management in adult (age ≥ 16 years) and Paediatric (age < 16 years) populations and to relate our findings to published international data.
Design and setting: A prospective observational study of airway management was conducted during a 3 month period in a single university hospital in Belgium.
Methods: Ethics committee approval was granted and informed consent was waived. Patients registered for anaesthesia care were screened. Details of airway management during maintenance general anaesthesia were recorded in an electronic database.
Main outcome measures: Data collection included: airway device (with size), intubation technique and use of adjunct techniques (e.g. high flow nasal oxygen).
Results: 4038 patients were included (663 in the paediatric subgroup). General anaesthesia was used in 3747 procedures (660 in the paediatric subgroup). The airway devices used were: tracheal tube, 65.9%, (95%CI, 64.3%-67.4%, n = 2469), supraglottic airway device 28.0%, (95%CI, 26.6%-29.5%, n = 1050) and facemask 3.0%, (95%CI, 2.5%-3.6%, n = 113). The remainder were managed with a tracheostoma, jet ventilation catheter, rigid bronchoscope or high flow nasal oxygen (3.1%, 95%CI 2.5%-3.6%, n = 114). Macintosh laryngoscopy occurred in 89.4% (95%CI 88.1% – 90.6%, n = 2118) of patients. Videolaryngoscopy used mainly a hyperangulated blade (10.7% and 2.5% of adult and paediatric intubations respectively). Flexible bronchoscopy occurred in 25 patients: 21 intubations during general anaesthesia, of whom 4 patients were intubated via an i-gel. There were 4 awake intubations (0.2% of all intubations).
Conclusions: These data are of value for budgetary planning as well as in the elaboration of quality control, teaching and research protocols.
