iWay - Nasopharyngeal Airway

Overview

iWay® - Nasopharyngeal Airway

Safer oxygenation and ventilation, simply

Oxygen flows through a dedicated lumen with lateral orifices which are specially located and sized to favor naturally heated and humidified oxygen delivery into the nasopharynx. The nasopharyngeal deadspace is constantly filled with oxygen, CO2 is washed out reducing rebreathing, and the O2 reservoir is increased. This allows a greater fraction of inspired oxygen.

All-in-one breathing safety

With the iWay® you have a complete device : a nasopharyngeal airway for safer airway patency, the ability to effectively oxygenate your patient, and the obtention of accurate capnography. Also, the iWay® is as quick and easy to set up as comfortable and lightweight.

Now, oxygenation is more efficient and economical

Oxygen leads into the back of the nasal cavity, loops to be naturally humidified and heated, and continuously flushes the nasopharynx with oxygen, leading to a better FiO2.

Get accurate capnography even when you deliver oxygen

Exhaled CO2 is sampled directly in the oropharynx in front of the tracheal output. This allows a high quality exhaled CO2 sample giving a precise capnogram and an EtCO2 value closer to PaCO2 even with O2 supplementation. The CO2 sampling site is protected against fluids thanks to a unique design.

The iWay® favors airway patency in a simple and quick way

The hollow body of the iWay® ensures the passage of air even when soft tissues (base of the tongue, soft palate) collapse against the pharyngeal wall. Moreover, the tube of the iWay® is soft and kink resistant. Those characteristics allow a safer patency of the upper airway.

Product Characteristics

Optimized oxygen delivery

Direct CO₂ sampling

Exhaled CO2 is sampled in front of the tracheal output, allowing accurate sampling and remarkable capnography. Particular care was brought to prevent the CO2 sampling to be distorted by oxygen delivery and a unique design protects it from liquids.

The comfort of a thin, flexible device

With its inner diameter of 5.4 mm, the iWay® increases airway patency while having an outer diameter reduced to a minimum. This maximizes patient comfort during and after insertion. The material of the iWay® is soft, yet kink-resistant.

A rounded tip for smoother insertion

The tip of the iWay® is specially curved to allow smoother insertion and to preserve the nasal and pharyngeal mucosa.

Standard connectors to use the iWay® with your equipment

The iWay® comprises an oxygen tube (2.5 m long) with a standard connector, and a CO2 tube (2.5 m long) with a sidestream luer-lock male and female connector.

Lubricant included

Each iWay® comes with a water-soluble lubricant sachet for easier insertion.

Two sizes to adapt different morphologies

The iWay® is available in 2 sizes to fit the morphology of the adult male and adult female : length 15 cm for a male or a large female (height 5’65” to 6’45”) and length 13 cm for a female or a short man (height 4’10” to 5’65”).

Overview

Anaesthesia & Emergency

In the operating room, a simple, non invasive and effective way to secure your patient’s breathing.

During moderate or deep sedation, or general anesthesia the iWay® increases the upper airway’s permeability, ensures effective oxygenation and accurate capnography in a non invasive way. The iWay®is a valuable ally, including for patients with one or more increased risk factors (obesity, age, snoring patient with or without sleep apnea, etc.). The iWay®can also be very useful before and during intubation, and also during the post extubation phase.

Respiratory safety during recovery

The recovery phase is a period of risk due to the residual effects of the anesthetic agents and the patient’s risk profile. Potential adverse events such as obstruction of the upper airway, respiratory depression and apnea require constant monitoring of the patient’ breathing. In this frame, the iWay®is invaluable.

Your ally of choice in emergency medicine.

In the emergency context (inside or outside the hospital), health care teams must ensure the permeability of the upper airways, effectively administer oxygen and monitor ventilation accurately and continuously. The iWay®allows to do it conveniently. It is also an excellent oxygen delivery and respiratory monitoring device before and during intubation.

Bibliography

Oxygenation is better when O2 is administered in the pharynx rather than in the nostrils.

Comparison of oxygenation among different supplemental oxygen methods during flexible bronchoscopy in infants. Soong WJ, Lee YS, Tsao PC, Yang CF, Jeng MJ. J Chin Med Assoc, 2011.

“The Nasal Cannula group had the lowest SpO(2) at the pharynx (p 0.01) and carina (p 0.01). The (…) Nasopharyngeal Catheter groups had better SpO(2).”

Twice less oxygen is consumed when the latter is brought directly into the pharynx.

Nasopharyngeal oxygen in adult intensive care–lower flows and increased comfort. Eastwood GM1, Reeves JH, Cowie BS. Anaesth Intensive Care, 2004.

“Nasopharyngeal oxygen therapy consumed significantly less oxygen than mask administration (…) and was associated with significantly higher comfort than the mask (…).”

In the non intubated patient, CO2 sampling is more precise in the pharynx than in the nostrils.

Accuracy of End-tidal CO2 Measurement Through the Nose and Pharynx in Nonintubated Patients During Digital Subtraction Cerebral Angiography. Zhang C, Wang M, Wang R, Wang W. J Neurosurg Anesthesiol, 2012.

“Arterial to end-tidal CO2 pressure difference (Pa-ETCO2) in sampling through the nose was significantly greater than Pa-ETCO2 sampling through the pharynx.”

Nasopharyngeal catheter is a better device than nasal prongs in maintaining safe oxygenation during apnea.

Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study. Achar SK1, Pai AJ1, Shenoy UK1. Anesth Essays Res., 2014.

“Nasopharyngeal catheter is a better device than nasal prongs in maintaining safe oxygenation during apnea in a simulated prolonged difficult laryngoscopy.”

Capnography should be routinely used for non-intubated patients at risk for respiratory depression, in particular those receiving supplemental oxygen.

Current applications of capnography in non-intubated patients. Restrepo RD, Nuccio P, Spratt G, Waugh J. Expert Rev Respir Med, 2014.

“Capnography should be routinely used for non-intubated patients at risk for respiratory depression, in particular those receiving supplemental oxygen.”

Optimal oxygenation and airway patency are maintained using a nasal trumpet and oxygen supplementation.

Outpatient endoscopic retrograde cholangiopancreatography: Safety and efficacy of anesthetic management with a natural airway in 653 consecutive procedures. Goudra BG1, Singh PM, Sinha AC. Saudi J Anaesth. 2013.

“Optimal oxygenation and airway patency was maintained with high degree of success using simple (…) conduit devices (nasal (…) trumpet) with oxygen supplementation in all patients.”

Sedation in the outpatient setting induces the risk of ventilatory adverse events.

Airway management in the outpatient setting. Luba K, Apfelbaum JL, Cutter TW. Clin Plast Surg. 2013.

“Sedation at any level beyond minimal creates the risk of airway obstruction and ventilatory depression, which can result in irreversible brain injury or death within minutes.”

The use of nasopharyngeal airway is recommended in the frame of extubation.

Difficult Airway Society Guidelines for the management of tracheal extubation. Difficult Airway Society Extubation Guidelines Group, M. Popat et al. Anesthesia, 2012.

“Maintain airway patency with simple airway manoeuvers or (…) nasopharyngeal airway until the patient is fully awake.”

Capnography is a quick, low-cost method of enhancing patient safety with the potential to improve the clinician’s diagnostic power.

Capnography for the Nonintubated Patient in the Emergency Setting. Manifold CA, Davids N, Villers LC, Wampler DA. J Emerg Med. 2013.

“Capnographic changes provide valuable information in such processes as diabetic ketoacidosis, seizures, pulmonary embolism, and malignant hyperthermia.”

Nasopharyngeal oxygenation is a safe and comfortable alternative to face mask.

Nasopharyngeal oxygen (NPO) as a safe and comfortable alternative to face mask oxygen therapy. Eastwood GM1, Dennis MJ. Aust Crit Care, 2006.

“Nasopharyngeal oxygen therapy (…) should be considered (…) because of its effectiveness and improved comfort.”

The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway.

Awake Craniotomy: A New Airway Approach. Sivasankar C1, Schlichter RA, Baranov D, Kofke WA. Anesth Analg., 2016.

“In this case series, we describe the successful use (…) of bilateral nasopharyngeal airways in 90 patients undergoing awake craniotomies. The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway.”

Passive oxygen insufflation is superior to Bag-Valve-Mask Ventilation in Out-of-Hospital Cardiac Arrest.

Passive Oxygen Insufflation Is Superior to Bag-Valve-Mask Ventilation for Witnessed Ventricular Fibrillation Out-of-Hospital Cardiac Arrest. Bentley J. Bobrow et al., Annals of Emergency Medicine, 2009.

“Among adult, (…) out-of-hospital cardiac arrest (…) survival was higher for individuals receiving initial passive ventilation than those receiving initial Bag-Valve-Mask ventilation.”