Evaluation of the Hemodynamic Response to Endotracheal Intubation Comparing the Airtraq(®) with Macintosh Laryngoscopes in Cardiac Surgical Patients.

Introduction: Cardiac patients are more prone to develop hemodynamic instability on induction of anesthesia and endotracheal intubation. The Airtraq(®) optical laryngoscope is a single-use rigid video laryngoscope that has been developed to facilitate tracheal intubation. There are limited studies comparing differences in the circulatory responses to Airtraq(®) and direct Macintosh larynngoscopy in cardiac patients.

Aim: The purpose of our study was to evaluate whether there was clinically significant difference between the hemodynamic response to orotracheal intubation guided by either of the two devices (Airtraq(®) and Macintosh laryngoscopes) in patients who underwent coronary artery bypass grafting surgery.

Material And Methods: In this clinical study we analyzed the hemodynamic response to endotracheal intubation performed with Airtraq(®) or Macintosh laryngoscopes in patients who underwent elective coronary artery bypass graft surgery under general anesthesia.

Results: We analyzed: blood pressure (systolic, diastolic, mean), heart rate and peripheral oxygen saturation (all notified before induction in anesthesia, immediately after induction, at the time of intubation and thereafter one and five minutes after intubation). We also recorded the maximal values of blood pressure and heart rate, as well as calculated the product of heart rate and systolic blood pressure. There were statistically significant differences in the hemodynamic response between the groups. At the time of intubation, there was significant inter-group difference in heart rate, systolic, diastolic and mean blood pressure. Endotracheal intubation with Macintosh laryngoscope was accompanied by significant increase in blood pressure and heart rate compared to Airtraq(®) group.

Conclusion: The Airtraq(®) laryngoscope performed better than the Macintosh laryngoscope in terms of hemodynamic to the patient undergoing routine coronary artery bypass graft surgery.