Effect of Intubation Chamber on Rigid Laryngoscopy and Endotracheal Intubation in Adult Patients Undergoing Cardiac Surgeries

Objectives: After the COVID-19 pandemic, aerosol-generating procedures pose a transmission risk, especially in resource-limited settings like community health centers, district hospitals, or emergency situations. An intubation chamber and a barrier device offer protection but may restrict hand movement, potentially prolonging laryngoscopy and intubation. These delays can trigger higher cardiovascular responses – including hypertension, tachycardia, and arrhythmias – that are particularly harmful to cardiac surgery patients with limited cardiovascular reserve. The primary objective of the study was to evaluate time to intubation (TTI) using an intubation chamber in adult cardiac surgery patients. Secondary objectives included evaluation of hemodynamic responses and any procedural complications during rigid laryngoscopy and intubation. Material and Methods: A prospective observational clinical study conducted at a single university hospital involving 35 adult patients (out of 38 enrolled) who were scheduled for elective cardiac surgery. The intervention assessed in the study was the use of an intubation chamber during the procedure. Results: Intubation succeeded on the first try for 85.7% of patients, with 11.4% requiring two attempts and 2.9% needing three. A blade change and chamber removal were necessary in one case (2.9%). The mean modified Cormack–Lehane grade was 1.63 ± 0.69, indicating generally favorable glottic views. The mean TTI (primary outcome) was 19.63 ± 4.53 s (range 12–30), with a median of 20 and an interquartile range of 16–22 s. The mean airway difficulty score was 6.69 ± 0.72, while the mean intubation difficulty score was 0.54 ± 0.89, mostly scoring zero. Hemodynamic parameters showed transient but statistically significant changes (repeated-measures analysis of variance, P < 0.001) with return toward baseline within 5 min. Conclusion: The intubation chamber is a safe, efficient tool for adult cardiac surgery, supporting hemodynamic stability and protecting against aerosol transmission. However, caution is advised in interpreting safety and effectiveness due to the limited sample size and no control group.