Aintree Intubation Catheter
To reference this electronic educational resource according to the APA style for Web references, use:
Turk M, Gravenstein D (2007): Aintree Intubation Catheter Technique in Unanticipated Difficult Intubation. Retrieved <insert date of retrieval here>, from University of Florida Department of Anesthesiology, Center for Simulation, Advanced Learning and Technology, Virtual Anesthesia Machine Web site: http://vam.anest.ufl.edu/airwaydevice/aintree/index.html
Keywords: Aintree Intubation Catheter, Difficult
The Aintree Intubation Catheter (AIC, Cook Medical, USA) is a bougie tube designed for use with a fiberoptic bronchoscope (FOB) to facilitate endotracheal intubation through the standard Classic or Ambu laryngeal mask airway (LMA). The bronchoscope is placed through the lumen of the AIC (white tube) as shown below.
The AIC is an adaptation of the Cook airway exchange catheter with a larger internal diameter (4.8 mm) to allow it to be pre-loaded onto a pediatric fiberoptic bronchoscope. Its external diameter allows its use with endotracheal tubes whose inner diameter is 7 mm or larger and it is 56 cm long and so will cover almost all pediatric bronchoscopes except the distal end. There are several reports of using it in unexpected difficult airways [1,2,3,4].
An unanticipated difficult airway presents challenges because of loss of upper airway soft tissue tone. This loss of upper airway tone will result in the walls of the upper airway opposing each other and obscuring the vocal cords and making mask ventilation difficult. In such situations, a laryngeal mask device is often employed. One method for bridging to an endotracheal tube is to place a bougie through the LMA. However, any blind passage of the bougie has the potential for trauma to the upper airway. The AIC loaded over a bronchoscope allows visually directed placement and avoids trauma and potentially delay. Use of the AIC has been described with the ProSeal LMA, intubating LMA and Tracheal Tube [5,6,7]. Also the AIC has been used in the ICU setting .
The AIC requires minimal skills with the bronchoscope . In our technique, we prefer use of a laryngeal mask airway that has no aperture bars at the outlet which can interfere with visualization. The AIC comes with a Rapid Fit Connector (blue connector in picture above) which allows ventilation of the patient prior to removal of the LMA. The AIC and bronchoscope need to be well lubricated prior to the start of the procedure.
Insertion Technique in 7 easy steps:
1. Insert the laryngeal mask device in the recommended fashion.
Web author: Turk M, Gravenstein D
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