Comparison of glottic views and intubation times in the supine and 25 degree back-up positions

Background: We explored whether positioning patients in a 25° back-up sniffing position improved glottic views and ease of intubation. Methods: In the first part of the study, patients were intubated in the standard supine sniffing position. In the second part, the back of the operating table was raised 25° from the horizontal by flexion of the torso at the hips while maintaining the sniffing position. The best view obtained during laryngoscopy was assessed using the Cormack and Lehane classification and Percentage of Glottic Opening (POGO) score. The number of attempts at both laryngoscopy and tracheal intubation, together with the use of ancillary equipment and manoeuvres were recorded. The ease of intubation was indirectly assessed by recording the time interval between beginning of laryngoscopy and insertion of the tracheal tube. Results: Seven hundred eighty one unselected surgical patients scheduled for non-emergency surgery were included. In the back-up position, ancillary laryngeal manoeuvres, which included cricoid pressure, backwards upwards rightward pressure and external laryngeal manipulation, were required less frequently (19.6 % versus 24. 6 %, p = 0.004). The time from beginning of laryngoscopy to insertion of the tracheal tube was 14 % shorter (median time 24 versus 28 s, p = 0.031) in the back-up position. There was no significant difference in glottic views. Conclusions: The 25° back-up position improved the ease of intubation as judged by the need for fewer ancillary manoeuvres and shorter time for intubation. Trial registration: ClinicalTrials.gov Identifier: NCT02934347 registered retrospectively on 14th Oct 2016

Buried channel normally-off AIGaN/GaN MOS-HEMT with a p-n junction in GaN buffer

A buried channel normally-off AlGaN/GaN MOS-HEMT with gate recess etching is reported. The buried channel operation is achieved by in situ doping of GaN to introduce a p-n junction in the GaN buffer. The fabricated buried channel MOS-HEMT with 12.5 nm atomic layer deposition (ALD) Al2O3 gate dielectric featured a threshold voltage of 1.3 V with a drain saturation current of 287 mA mm(-1) for a device with 3.5 mu m long gate length and 11 mu m sourcedrain spacing. The field effect mobility improved from 25 cm(2)/Vs for a reference device to 142 cm(2)/Vs for the buried channel device. Due to the presence of the p-n junction depletion region in the GaN buffer, the leakage in the off state decreased by about 4 orders of magnitude (4 nA mm(-1) compared to 76 uA mm(-1) for the reference device). The buried channel device also gives better breakdown characteristics, with a breakdown voltage of 158 V compared to 98 V for the reference device