scholarly journals Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope: A randomized comparative study

2019 ◽  
Author(s):  
Sarobar Upadhyaya ◽  
Laxmi Pathak
Keyword(s):  
Heart Rate ◽  
Comparative Study ◽  
Direct Laryngoscopy ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Response Alternative ◽  
Intubation Time ◽  
Hemodynamic Changes ◽  
Direct Laryngoscope ◽  
Significant Difference

Introduction: Direct laryngoscopy is associated with sympathetic stimulation and altered hemodynamics. A long intubation time may result in a greater in stress response. Alternative techniques using video laryngoscopes have been developed that do not require direct vocal cord visualization and may decrease the hemodynamic response. This study aimed to compare the difference between hemodynamic changes and intubation time with Airtraq video laryngoscope and conventionl Macintosh direct laryngoscope. Methods: A prospective randomized comparative study was conducted involving 100 adult patients who were undergoing elective surgeries under general anesthesia and endotracheal intubation. The patients were randomly assigned to group V (Video laryngoscope) or group D (Direct laryngoscope). In addition to the baseline vitals and vitals at various time intervals, intubation time was also recorded. We considered a difference in Heart Rate and Mean Arterial pressure of 20% to be clinically significant and statistical significance was p-value <0.05. Results: Significant difference was found in heart rates immediately after laryngoscopy (110.40 vs. 105.02 beats/minute; p<0.01) and 1 minute after intubation (109.30 vs. 106.20 beats/minute; p<0.01) with attenuation seen in video laryngoscopy group. Blood pressures were similar in both the groups at all times. Time for intubation was prolonged in video laryngoscopy group than that for direct laryngoscopy group (26.54 vs. 22.80 seconds; p<0.05). There were no adverse events associated with either of the techniques.  Conclusions: The Airtraq video laryngoscopy resulted in lesser change in heart rate and longer intubation time. However, clinical impact of such a difference seemed to be insignificant.

scholarly journals Why USB-endoscope laryngoscopy is as effective as video laryngoscopy

2020 ◽  
Vol 43 (2) ◽  
pp. E55-59
Author(s):  
Meliha Findik ◽  
Afsin E. Kayipmaz ◽  
Cemil Kavalci ◽  
Tugce Sencelikel Sencelikel ◽  
Murat Muratoglu ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Low Cost ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Correct Placement ◽  
Custom Made ◽  
Significant Difference ◽  
The Cost

Purpose: To compare the efficacy of a low-cost custom-made universal serial bus (USB) endoscope laryngoscope for intubation with a direct laryngoscope and a high-cost video laryngoscope in a mannequin study. Methods: We used one intubation simulator model (mannequin) in our study. A USB endoscope was mounted to the direct laryngoscope as a custom-made USB endoscope laryngoscope (USB-L). We used a video laryngoscope (Glidescope®, Verathon, USA) and a direct laryngoscope (Macintosh) for comparison. Intubation time and the correct placement of the tube were measured. Intubations were performed by two operators and results were compared. Results: We found a statistically significant difference between the video and direct laryngoscope groups (p < 0.001), as well as between the USB-L and direct laryngoscope groups (p = 0.001) for Operator 1. For Operator 2, there was a statistically significant difference between the video laryngoscope group and the direct laryngoscope group (p = 0.022); however, we did not find a significant difference between the USB-L group and the direct laryngoscope group (p = 0.154). Furthermore, there were no significant differences between the USB-L and video laryngoscope groups for either operator (p=0.347 for Operator 1 and p>0.999 for Operator 2). Conclusion: Our study showed that USB endoscope laryngoscope provided similar intubation time to video laryngoscopy at a fraction of the cost; and both had superior times in comparison with direct laryngoscopy.

scholarly journals First attempt success of video versus direct laryngoscopy for endotracheal intubation by ambulance nurses: a prospective observational study

2020 ◽  
Vol 46 (5) ◽  
pp. 1039-1045 ◽  
Author(s):  
Wim Breeman ◽  
Mark G. Van Vledder ◽  
Michael H. J. Verhofstad ◽  
Albert Visser ◽  
Esther M. M. Van Lieshout
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Spontaneous Circulation ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Direct Laryngoscope ◽  
Positive Effect

Abstract Purpose The aim of this study was to compare the rate of first attempt success of endotracheal intubation performed by ambulance nurses in patients with a Glasgow Coma Scale (GCS)  of 3 using video laryngoscopy versus direct laryngoscopy. Methods A prospective cohort study was conducted in a single, independent ambulance service. Twenty of a total of 65 nurse-staffed ambulances were equipped with a video laryngoscope; a classic direct laryngoscope (Macintosh) was available on all 65 ambulances. The primary outcome was first attempt success of the intubation. Secondary outcomes were overall success, time needed for intubation, adverse events, technical or environmental issues encountered, and return of spontaneous circulation (ROSC). Ambulance nurses were asked if the intubation device had affected the outcome of the intubation. Results The first attempt success rate in the video laryngoscopy group [53 of 93 attempts (57%)] did not differ from that in the direct laryngoscopy group [61 of 126 (48%); p = 0.221]. However, the second attempt success rate was higher in the video laryngoscopy group [77/93 (83%) versus 80/126 (63%), p = 0.002]. The median time needed for the intubation (53 versus 56 s) was similar in both groups. Ambulance nurses more often expected a positive effect when performing endotracheal intubation with a video laryngoscope (n = 72, 81%) compared with a direct laryngoscope (n = 49, 52%; p < 0.001). Conclusion Although no significant effect on the first attempt success was found, video laryngoscopy did increase the overall success rate. Ambulance nurses had a more positive valuation of the video laryngoscope with respect to success chances.

Comparison of Video Laryngoscopy and Direct Laryngoscopy in the Success of Intubation Performed by Novice Personnel in Patients with Cervical Immobilization: A Manikin Study

2021 ◽  
Author(s):  
Özge Can ◽  
Sercan Yalcinli ◽  
Yusuf Ali Altunci
Keyword(s):  
Success Rate ◽  
Direct Laryngoscopy ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
First Year ◽  
Success Rates ◽  
Significant Difference ◽  
Intubation Success ◽  
Cervical Immobilization ◽  
Second Year

Introduction: Pre-hospital intubation is a challenging but essential intervention. During intubation, it is difficult to identify vocal cords when using a cervical collar and trauma board. Therefore, the success rate of intubation by paramedics decreases in trauma patients. Video laryngoscopy increases intubation success rate and has been recommended for difficult airways in studies. Objective: In this study, we compared the intubation success rates when using a video laryngoscope and a direct laryngoscope in a manikin with simulated cervical immobilization.  Methods: In this cross-sectional study, the manikin’s neck collar and spine board created a complicated airway model with cervical immobilization. Inexperienced paramedic students tried intubation with both methods, and their trial periods were recorded. Students answered a question evaluating the convenience of the procedure for both methods after the trial. Results: In this study, 83 volunteers, who were first-year and second-year paramedics, participated; 32 (38.6%) of the volunteers were first-year students, while 51 (61.4%) were second-year students. All volunteers had previous intubation experience with direct laryngoscopy, but not with video laryngoscopy. There was a statistically significant difference in the first-attempt success rates of the procedure between the groups in favor of video laryngoscope (p=0.022). Note that there was no significant difference between the groups in terms of first attempt durations (p=0.337). Conclusion: Video laryngoscopy in airway management can increase the success rate of first-attempt intubation by inexperienced pre-hospital healthcare personnel.

scholarly journals The Efficacy of O-Mac®, Patent Video Laryngoscope, and Conventional Laryngoscope for Intubation in the Operating Room

2021 ◽  
Vol 9 (B) ◽  
pp. 646-650
Author(s):  
Jorza Sepmiko ◽  
Tjok Gde Agung Senapathi ◽  
Made Wiryana ◽  
I. Putu Kurniyanta ◽  
I. Made Gede Widnyana ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Operating Room ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Direct Visualization ◽  
Intubation Time ◽  
Hemodynamic Changes ◽  
Custom Made ◽  
Initial Action ◽  
Better Than

BACKGROUND: Management of the airway in patients undergoing surgery is increasingly difficult. The airway management in the operating room in terms of the initial action of anesthesia is very important. Video-laryngoscopy has been shown to provide a better view of the larynx’s structure compared to direct visualization. AIM: We describe our experience using a custom made and inexpensive tool for a video-laryngoscopy. METHODS: This is an experimental research with single randomized clinical trial conducted at the Anesthesiology Department of Sanglah General Hospital Denpasar. There were 270 patients divides into three group with conventional, O-Mac® and Mc-GRATH™ BF laryngoscope, aged 18–65 years old, with Mallampati grade 1–2, randomly selected, and signed informed consent. RESULTS: Intubation time fastest with O-Mac® median 26 (15–36) s, p = 0.000. Laryngoscopy time fastest with O-Mac® median 5.5 (2–13 s), p = 0.000. O-Mac® does not use many tools, p = 0.000. All three did not produce tissue damage with results p = 0.007. Hemodynamic changes p = 0.000. CONCLUSION: The O-Mac® is superior in terms of laryngoscope time and intubation time compared to the Mc-GRATH™ BF blade and has the same level of safety as the patented Mc-GRATH ™ video laryngoscope, and better than conventional laryngoscopes.

scholarly journals A comparative study of glottis visualization according to the method of lifting the epiglottis in video laryngoscopy: indirect and direct lifting methods

2021 ◽  
Author(s):  
Ji Youn Oh ◽  
Ji Hye Lee ◽  
Yu Yil Kim ◽  
Seung Min Baek ◽  
Da Wa Jung ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Comparative Study ◽  
Prospective Study ◽  
General Anesthesia ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Lehane Grade ◽  
Significant Difference ◽  
Blade Tip ◽  
The Difference

Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient.Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters.Results: Modified Cormack and Lehane grade showed significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001).Conclusions: Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

scholarly journals A Comparative Study of Intubation Performance between Channelled vs. Non-Channelled Blade of King Vision Video Laryngoscope in Orotracheal Intubation

2021 ◽  
Vol 8 (12) ◽  
pp. 732-736
Author(s):  
Shalini Bajpai
Keyword(s):  
Comparative Study ◽  
Statistical Difference ◽  
Orotracheal Intubation ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Anaesthesia Practice ◽  
Measured Time ◽  
Difficult Airways

BACKGROUND Video laryngoscope is an important tool for orotracheal intubation in anaesthesia practice particularly in difficult airways. It provides an indirect view of glottis without the need of alignment of oropharyngeal-laryngeal axis. We compared the intubation characteristics of channelled versus non-channelled blades of King VisionTM Video Laryngoscope. METHODS In this study 60 patients were randomly allocated to two groups; group C were intubated with channelled and group NC with non-channelled blade of King Vision. We measured time for glottis visualisation and intubation time using both blades. Percentage of glottis opening (POGO), insertion attempts, intubation attempts, and ease of intubation were also assessed. RESULTS The time for glottis visualisation was 8.5 ± 3 seconds for group C and 7 ± 2 seconds for group NC. Intubation time was 24 ± 8.5 seconds for group C and 44 ± 5 seconds for NC. There was no statistical difference in POGO, insertion attempts, intubation attempts and ease of intubation between the two groups. CONCLUSIONS We concluded that the time for glottis recognition is longer but intubation time is shorter when using King Vision video laryngoscope channelled blade as compared to non-channelled blade. KEYWORDS Video Laryngoscope, King Vision, Channelled, Non-Channelled

scholarly journals C-MAC Video Laryngoscope versus Conventional Direct Laryngoscopy for Endotracheal Intubation During Cardiopulmonary Resuscitation

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 225 ◽  
Author(s):  
Byeong Chul Min ◽  
Jong Eun Park ◽  
Gun Tak Lee ◽  
Tae Rim Kim ◽  
Hee Yoon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Cardiopulmonary Resuscitation ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Multiple Logistic Regression Analysis ◽  
Video Laryngoscope ◽  
Multiple Logistic Regression ◽  
Total N ◽  
Significant Difference

Background and objectives: To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). Materials and Methods: This study was a single-center, retrospective study conducted from April 2014 to July 2018. Patients were categorized into either the C-MAC or DL group, according to the device used on the first endotracheal intubation (ETI) attempt. The primary outcome was the FPS rate. A multiple logistic regression model was developed to identify factors related to the FPS. Results: A total of 573 ETIs were performed. Of the eligible cases, 263 and 310 patients were assigned to the C-MAC and DL group, respectively. The overall FPS rate was 75% (n = 431/573). The FPS rate was higher in the C-MAC group than in the DL group, but there was no statistically significant difference (total n = 431, 79% compared to 72%, p = 0.075). In the multiple logistic regression analysis, the C-MAC use had higher FPS rate (adjusted odds ratio: 1.80; 95% CI, 1.17–2.77; p = 0.007) than that of the DL use. Conclusions: The C-MAC use on the first ETI attempt during cardiopulmonary resuscitation in the emergency department had a higher FPS rate than that of the DL use.

Utilizing Video versus Direct Laryngoscopy to Intubate Simulated Newborns while Contained within the Incubator: A Randomized Crossover Study

2019 ◽  
Vol 37 (05) ◽  
pp. 519-524
Author(s):  
Yuri Ozawa ◽  
Shigehiro Takahashi ◽  
Humiko Miyahara ◽  
Kenichiro Hosoi ◽  
Mazumi Miura ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Neonatal Intensive Care ◽  
Crossover Trial ◽  
Linear Models ◽  
Video Laryngoscopy ◽  
Neonatal Intensive Care Units ◽  
Intubation Time ◽  
Randomized Crossover Trial ◽  
Side Walls ◽  
Randomized Crossover Study

Abstract Objective The use of video laryngoscopy for intubating neonates in ergonomically challenging settings has not been studied well. We aimed to assess the usefulness of video laryngoscopy for experienced neonatologists to intubate neonatal manikins in incubators via side hand ports or head window. Study Design In this randomized crossover trial at three neonatal intensive care units in Japan, 27 neonatologists were randomized into two groups, namely, those intubating neonatal simulators using video laryngoscopy and then using direct laryngoscopy, or vice versa. The intubations were performed via hand ports or head window without opening top and side walls in incubators in two manikin positions (rotated 90° or unrotated). Glottis visualization (0–100%), success rate, intubation time, and ease of laryngoscopy (from 1 [very difficult] to 10 [very easy]) were compared between video laryngoscopy and direct laryngoscopy. Generalized linear models were used for the analyses. Results This study assessed 108 intubations performed by 27 neonatologists. The use of video laryngoscopy improved the glottis visualization by 14% (95% confidence interval, 7.4–20%; p < 0.01) and easiness scores of laryngoscopy by 0.8 (0.2–1.4; p < 0.01), but did not reduce the intubation time. Conclusion Video laryngoscopy is useful for experienced neonatologists for intubating neonatal manikins in incubators without opening the top or side walls.

scholarly journals Comparison of Direct and Indirect Laryngoscopes in Vomitus and Hematemesis Settings: A Randomized Simulation Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryosuke Mihara ◽  
Nobuyasu Komasawa ◽  
Sayuri Matsunami ◽  
Toshiaki Minami
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Mcgrath Mac ◽  
Significant Difference ◽  
Intubation Success ◽  
Intubation Success Rate

Background.Videolaryngoscopes may not be useful in the presence of hematemesis or vomitus. We compared the utility of the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope (AWS) and McGRATH MAC (McGRATH), which are videolaryngoscopes, in simulated hematemesis and vomitus settings.Methods.Seventeen anesthesiologists with more than 1 year of experience performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH under normal, hematemesis, and vomitus simulations.Results.In the normal setting, the intubation success rate was 100% for all three laryngoscopes. In the hematemesis settings, the intubation success rate differed significantly among the three laryngoscopes (P=0.021). In the vomitus settings, all participants succeeded in tracheal intubation with McL or McGRATH, while five failed in the AWS trial with significant difference (P=0.003). The intubation time did not significantly differ in normal settings, while it was significantly longer in the AWS trial compared to McL or McGRATH trial in the hematemesis or vomitus settings (P<0.001, compared to McL or McGRATH in both settings).Conclusion.The performance of McGRATH and McL can be superior to that of AWS for tracheal intubation in vomitus and hematemesis settings in adults.

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