Acta Anaesthesiologica ScandinavicaVolume 50, Issue 3 p. 388-388 Use of a new intubating laryngeal mask – CTrach™– in patients with known difficult airways C. E. Bjerkelund, Corresponding Author C. E. Bjerkelund * C. E. Bjerkelund Department of Anesthesiology Ulleval University Hospital Oslo Norway e-mail: [email protected]Search for more papers by this author C. E. Bjerkelund, Corresponding Author C. E. Bjerkelund * C. E. Bjerkelund Department of Anesthesiology Ulleval University Hospital Oslo Norway e-mail: [email protected]Search for more papers by this author First published: 14 February 2006 https://doi.org/10.1111/j.1399-6576.2006.00915.xCitations: 7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 American Society of Anesthesiologists. Practice Guidelines for Management of the Difficult Airway. Anesthesiology 2003; 98: 1269–77. 2 Henderson JJ, Popat MT, Latto IP, Pearce AC. Difficult Airway Society Guidelines for management of the unanticipated difficult intubation. Anaesthesia 2004; 59: 675–94. 3 Szmuk P, Ezri T, Akca O, Alfrey DD. Use of a new supraglottic airway device – the CobraPLA –in a ‘difficult to intubate/difficult to ventilate’ scenario. Acta Anasthesiol Scand 2005; 49: 421–3. 4 Vaida SJ, Gaitini D, Ben-David B, Somri M, Hagberg CA, Gaitini LA. A new supraglottic airway, the Elisha Airway device: a preliminary study. Anesth Analg 2004; 99: 124–7. 5 Ferson DZ, Rosenblatt WH, Johansen MJ, Osborn I. Use of the intubating LMA-Fastrach in 254 patients with difficult-to-manage airways. Anaesthesiology 2001; 95: 1175–81. 6 Wahlen BM, Gercek E. Three-dimensional cervical spine movement during intubation using the Macintosh and Bullard laryngoscopes, the Bonfils fibrescope and the Intubating Laryngeal Mask Airway. Eur J Anaesthesiol 2004; 21: 907–13. 7 Henderson JJ. The use of paraglossal straight blade laryngoscopy in difficult tracheal intubation. Anaesthesia 1997; 52: 552–60. Citing Literature Volume50, Issue3March 2006Pages 388-388 ReferencesRelatedInformation

The effects of Ringer's acetate (RAc) infusion with different temperatures, 18d̀C compared to 36d̀C, were studied in 20 healthy volunteers. An infusion volume of 20% of the estimated extracellular volume was given over 45 min. Before and after the RAc infusion, interstitial colloid osmotic pressure and interstitial fluid hydrostatic pressure were measured on the lateral part of the thorax and in the lower leg. Blood sampling and pressure measurements were performed through a cannula placed in the left radial artery, and arterial oxygen saturation was measured by pulse oximetry. Atrial peptides ANF (99–126) and ANF (1–98) in plasma were measured as indicators of volume loading. Cold RAc infusion increased mean arterial pressure from 82 (s.d. ± 7) to 96 (s.d. ± 9) mmHg (10.9–12.8 kPa) at the end of the infusion with a simultaneous fall in heart rate. Warm RAc infusion gave no changes in blood pressure or heart rate. The arterial oxygen saturation during the infusion of cold RAc was higher than during warm RAc infusion. Cold infusion produced the expected haemodilution with a fall in erythrocyte volume fraction (EVF) from 0.39 (± 0.03) to 0.33 (± 0.03) and a fall in plasma colloid osmotic pressure (COPp) from 21.7 (± 1.1) mmHg to 15.0 (± 1.3) mmHg (2.9–2.0 kPa). Warm infusion induced a nearly identical haemodilution. Interstitial colloid osmotic pressure fell from 11.6 (± 2.3) mmHg to 8.9 (± 2.7) mmHg (1.5–1.2 kPa) after warm infusion while cold infusion gave no changes. The changes in interstitial fluid hydrostatic pressure were not significant. Cold infusion induced a higher diuresis compared to warm RAc infusion. ANF increased during cold, but not during warm infusion. We conclude that infusions of RAc at 18d̀C vs. 36d̀C have different volume effects. Cold infusion increased blood pressure and diuresis, while warm infusion induced peripheral vasodilation with increased capillary leakage and subcutaneous oedema formation.

Atrial peptides ANF(1-98) and ANF(99-126) were measured in plasma before and after infusion of Ringer-Acetate solution in healthy volunteers. The solution was infused over a 45 min period in an amount equal to 20 per cent of estimated extra-cellular volume. We found that the increase in atrial peptide immunoreactivity after infusion depended on the temperature of the infusate. The molar increase in ANF(1-98) was much larger than the increase in ANF(99-126). We speculate that plasma levels of ANF(1-98) may be a clinically useful parameter of atrial distension secondary to hypervolaemia.