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Indirekte Laryngoskopie

Alternativen zur Atemwegssicherung

Indirect laryngoscopy

Alternatives to securing the airway

  • Notfallmedizin
  • Published:
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Zusammenfassung

Die endotracheale Intubation gilt als Goldstandard zur Sicherung der Atemwege und erfolgte bisher meistens mithilfe der direkten Laryngoskopie. Seit Kurzem sind Alternativen verfügbar, bei denen eine Ausrichtung der oral-pharyngealen Achse zur gradlinigen Sicht auf die Glottisebene aufgrund von Videotechnik oder speziellen Optiken entfällt. Bei schwierigen Sichtverhältnissen kann mit diesen Geräten oft eine verbesserte Sicht erzielt und die endotracheale Intubation erfolgreich durchgeführt werden. Bisherige Studienergebnisse zeigen, dass die Anwendung der meisten dieser Alternativen schnell und leicht erlernt werden kann. Die Technik der indirekten Laryngoskopie wird derzeit erfolgreich in der anästhesiologischen Routine beim unerwartet schwierigen Atemweg eingesetzt. Dieser Beitrag bietet eine erste Übersicht über häufig angewendete Geräte, mit denen ein Endotrachealtubus per indirekter Laryngoskopie unter Sicht platziert werden kann.

Abstract

Endotracheal intubation remains the gold standard for securing the airway in emergency medicine. However, difficult endotracheal intubation and complications are common during emergency intubation. In contrast to conventional direct laryngoscopy, the new generation of devices does not require direct visualization of the vocal cords for endotracheal tube placement. These devices allow a better glottic view and successful endotracheal placement of the tube, especially if direct laryngoscopy is difficult. Recent studies showed that utilization of these devices can be easily learned. The technique of indirect laryngoscopy is currently used for securing the airway in daily anesthesia routine as well as for managing the difficult airway in the operating room. This article gives an overview of available devices for indirect endotracheal intubation as well as the current literature.

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Interessenskonflikt

Ambu GmbH, B+P Beatmungsprodukte GmbH, Karl-Storz GmbH, Aircraft Medical Ltd., The Surgical Company GmbH und Verathon Medical stellen bzw. stellten der Klinik für Anästhesiologie, Universitätsmedizin der Johannes Gutenberg-Universität, Mainz, diverse Systeme, u. a. Airwayscope®, Airtraq® Laryngoskop, Intubationsendokop nach Bonfils, C-MAC®-Videolaryngoskop, GlideScope® und McGrath®-Videolaryngoskop, für die Ausbildung und klinische Anwendung unentgeltlich zur Verfügung.

Die Firmen Ambu GmbH, Aircraft Medical Ltd., Karl-Storz GmbH, The Surgical Company GmbH und Verathon Medical stellten bzw. stellen Geräte für verschiedene Studien zur Verfügung.

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  1. Klinik für Anästhesiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland

    R.R. Noppens, C. Werner & T. Piepho

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  1. R.R. Noppens
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  2. C. Werner
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  3. T. Piepho
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Correspondence to R.R. Noppens.

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Noppens, R., Werner, C. & Piepho, T. Indirekte Laryngoskopie. Anaesthesist 59, 149–161 (2010). https://doi.org/10.1007/s00101-009-1656-3

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