This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nishikawa, M. Articles by Inomata, S. Search for Related Content PubMed PubMed Citation Articles by Nishikawa, M. Articles by Inomata, S.

---

LETTER TO THE EDITOR

Cautious Use of Trachlight^TM in Infants

Department of Anesthesiology, University of Tsukuba, Tsukuba City, Ibaraki, Japan, inomatas{at}md.tsukuba.ac.jp

To the Editor:

Trachlight^TM is a device for tracheal intubation without requiring direct laryngoscopy (1,2). There have been several reports regarding its effectiveness for intubating difficult airways (3–5).

We attempted tracheal intubation on an infant with a small chin. Tracheal intubation using direct laryngoscopy was unsuccessful. Neither blind nasal intubation nor intubation with a flexible bronchoscope was possible. We therefore tried tracheal intubation using the Trachlight^TM.

We were able to successfully intubate the trachea using the Trachlight^TM without requiring a muscle relaxant. Our patient had significant bucking and breath-holding just after intubation. If intubation had not been successful, there would have been a danger of laryngospasm. Because the infant's neck was uniformly and powerfully transilluminated, we were unable to determine the position of the tube tip (Fig. 1) in the trachea. We believe that the quantity of light produced by the Trachlight^TM is too bright for use in newborns and infants, and improvements in the device are necessary for optimal use in this population. Fiberoptic intubation through a laryngeal mask airway (LMA) was considered for this patient (6,7). In this case we used Trachlight^TM before the use of LMA, and we were successful. However, a LMA might have induced less response in the unrelaxed airway. This method should be considered when others forms of tracheal intubation prove unsuccessful.

View larger version (87K): [in this window] [in a new window]   Figure 1. A 35-day-old male infant, 1800 g, 44 cm, with Dandy-Walker syndrome with frequent malformation (e.g., a little chin symptom). Because thin tissue of the neck was transilluminated uniformly and powerfully, we were unable to determine the position of the tracheal tube tip using TrachlightTM.

References

1. Hung OR, Stewart RD. Lightwand intubation: I–a new lightwand device. Can J Anaesth 1995;42:820–5.[Web of Science][Medline]
2. Tsutsui T, Setoyama K. A clinical evaluation of blind orotracheal intubation using Trachlight in 511 patients [in Japanese]. Masui 2001;50:854–8.[Medline]
3. Hung OR, Pytka S, Morris I, et al. Lightwand intubation: II–Clinical trial of a new lightwand for tracheal intubation in patients with difficult airways. Can J Anaesth 1995;42:826–30.[Web of Science][Medline]
4. Hung OR, Pytka S, Morris I, et al. Clinical trial of a new lightwand device (Trachlight) to intubate the trachea. Anesthesiology 1995;83:509–14.[Web of Science][Medline]
5. Langeron O, Lenfant F, Aubrun F, et al. Assessment of a new light guide (Trachlight) for tracheal intubation. Ann Fr Anesth Reanim 1997;16:229–33.[Medline]
6. Ellis DS, Potluri PK, O'Flaherty JE, Baum VC. Difficult airway management in the neonate: a simple method of intubating through a laryngeal mask airway. Paediatr Anaesth 1999;9:460–2.[Web of Science][Medline]
7. Osses H, Poblete M, Asenjo F. Laryngeal mask for difficult intubation in children. Paediatr Anaesth 1999;9:399–401.[Web of Science][Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nishikawa, M. Articles by Inomata, S. Search for Related Content PubMed PubMed Citation Articles by Nishikawa, M. Articles by Inomata, S.