Dardeer Abdulrahman, Alhammad Muhammad Firas, Zaza Khaled J, Shallik Anas N, Hammad Yasser Ali, Elkarta El-Sayed Mohamed, Shallik Nabil A
Watford General Hospital, West Hertfordshire Teaching Hospitals NHS Trust, Watford, UK.
Aaesthesia, ICU and Perioperative Medicine Department, Hamad Medical Corporation, Doha, Qatar.
J Clin Monit Comput. 2025 Sep 26. doi: 10.1007/s10877-025-01361-4.
Endotracheal intubation is a critical skill in anesthesia, particularly for patients with compromised airways. This randomized pilot study evaluated the feasibility and impact of the Infrared Red Intubation System (IRRIS) on video laryngoscopy performance, first-attempt success rate, and intubation time.
Thirty patients were randomized into two groups: one with the IRRIS device and one without (control). The primary outcome was the impact of IRRIS on first-pass success. Secondary outcomes included glottic visibility, intubation time, and adverse effects.
Results showed that both groups demonstrated nearly identical percentages of glottic opening (POGO) and glottic entrance visibility, achieving successful intubation on the first attempt. Although the IRRIS group had a slightly longer intubation time and more instances of required external manipulation, the vocal cords were not visible without IRRIS in the most obese patient in our cohort.
The IRRIS device effectively illuminated the laryngeal inlet, enhancing differentiation from surrounding structures, such as the esophagus. This study suggests that IRRIS may be a valuable adjunct for video laryngoscopy in patients with difficult airways, though further research is needed to assess its broader applicability.
Endotracheal intubation in patients with compromised airways is a notoriously complex and daunting task for anesthesiologists. Throughout the years, numerous supportive techniques and innovative equipment have been developed to address this challenge. This randomized clinical study sheds light on the potential benefits of utilizing an external pre-cricoid emitting infrared light source, the 'Infrared Red Retrograde Intubation System' (IRRIS), which produces a flashing light that can be detected within the airway. By leveraging this technology, anesthesiologists may be able to identify the airway quicker and more accurately, both in terms of time and anatomical level, compared to relying solely on a video laryngoscope/ flexible bronchoscope.
气管插管是麻醉中的一项关键技能，对于气道受损的患者尤为重要。这项随机试验性研究评估了红外插管系统（IRRIS）对视频喉镜操作、首次尝试成功率和插管时间的可行性及影响。
30名患者被随机分为两组：一组使用IRRIS设备，另一组不使用（对照组）。主要结果是IRRIS对首次通过成功率的影响。次要结果包括声门可视性、插管时间和不良反应。
结果显示，两组的声门开口百分比（POGO）和声门入口可视性几乎相同，首次尝试均成功插管。尽管IRRIS组的插管时间略长，且需要更多外部操作的情况，但在我们队列中最肥胖的患者中，没有IRRIS时声带不可见。
IRRIS设备有效地照亮了喉入口，增强了与周围结构（如食管）的区分。这项研究表明，IRRIS可能是困难气道患者视频喉镜检查的一种有价值的辅助工具，不过需要进一步研究来评估其更广泛的适用性。
对于气道受损的患者，气管插管对麻醉医生来说是一项极其复杂且艰巨的任务。多年来，已经开发了许多支持技术和创新设备来应对这一挑战。这项随机临床研究揭示了利用外部环状软骨前发射红外光源“红外逆行插管系统”（IRRIS）的潜在益处，该系统产生的闪烁光可在气道内被检测到。与仅依靠视频喉镜/柔性支气管镜相比，通过利用这项技术，麻醉医生在时间和解剖层面上可能能够更快、更准确地识别气道。
