Case reports: Should we do away with them? (original) (raw)
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Video-laryngoscopes in the adult airway management: a topical review of the literature
2010
The aim of the present paper is to review the literature regarding video-laryngoscopes (Storz V-Mac and C-Mac, Glidescope, McGrath, Pentax-Airway Scope, Airtraq and Bullard) and discuss their clinical role in airway management. Video-laryngoscopes are new intubation devices, which provide an indirect view of the upper airway. In difficult airway management, they improve Cormack-Lehane grade and achieve the same or a higher intubation success rate in less time, compared with direct laryngoscopes. Despite the very good visualization of the glottis, the insertion and advancement of the endotracheal tube with video-laryngoscopes may occasionally fail. Each particular device's features may offer advantages or disadvantages, depending on the situation the anaesthesiologist has to deal with. So far, there is inconclusive evidence indicating that video-laryngoscopy should replace direct laryngoscopy in patients with normal or difficult airways.
Trials, 2013
Background: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation. Methods/Design: The objective of this trial is to evaluate and to compare the clinical performance of three videolaryngoscopes with a guiding channel for intubation (Airtraq™, A. P. Advance™, King Vision™) and three videolaryngoscopes without an integrated tracheal tube guidance (C-MAC™, GlideScope™, McGrath™) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt. Discussion: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway.
Comparison of channelled vs unchannelled video laryngoscope-A prospective randomised trial
IP Innovative Publication Pvt. Ltd., 2018
Introduction: Conventional laryngoscopy using the traditional Macintosh blade remains the commonest method of tracheal intubation in the routine clinical scenario. Video laryngoscopes have taken over this position in many scenarios as they have been proved successful over conventional laryngoscope. There are several types of video laryngoscopes available with multiple advantages over one another. We aimed to compare the performance of the Airtraq and McGrath when performing tracheal intubation in routine anaesthesia practice. Materials and Methods: Sixty patients posted for surgery requiring endotracheal intubation were randomized to undergo intubation using an Airtraq (n=30) or McGrath (n=30) video laryngoscope. Primary end points were total duration of intubation, overall success rate of tracheal intubation, number of optimization manoeuvres used and ease of intubation between the two groups. Results: We observed that the duration of successful intubation was shorter in Airtraq 19.18 (±2.86) secs) than in the McGrath laryngoscope.27 (±5.09) secs)* P < 0>A significantly better Cormack lehane view was obtained with the Airtraq. Grade I in 73.3% with the Airtraq group versus 50% in the McGrath group, p<0> Conclusion: We conclude that the Airtraq laryngoscope facilitates a more rapid and successful intubation as compared to McGrath in routine clinical practice. Keywords: Airtraq, McGrath, Intubation.
Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation
European Journal of Anaesthesiology, 2011
Background Video laryngoscopes have been introduced in recent years as an alternative choice to facilitate tracheal intubation. We conducted a meta-analysis to assess their value when compared with direct laryngoscopy. Methods PubMed and EMBASE were searched up until 24 September 2010. Randomised trials that reported data on the comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation were included. Results Eleven trials with a total of 1196 participants were identified. During tracheal intubation, video laryngoscopes can achieve a better view of the glottis and have a similar success rate [rate ratio 1.0; 95% confidence interval (CI) 0.99-1.01].
Internal and emergency medicine, 2016
The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first attempt success. This was a prospective observational study of consecutive intubations performed with video laryngoscopy at an academic medical Intensive Care Unit. Operator, procedural, and complication data were collected. Multivariable logistic regression was used to examine the relationship between the intubation attempts and the occurrence of one or more complications. A total of 905 patients were intubated using a video laryngoscope. First attempt success occurred in 739 (81.7 %), whereas >1 attempt was needed in 166 (18.3 %). One or more complications occurred in 146 (19.8 %) of those intubated on the first attempt versus 107 (64.5 %, p < 0.001) of those r...
IntroductionAmong critically ill patients undergoing orotracheal intubation in the emergency department (ED) or intensive care unit (ICU), failure to visualize the vocal cords and intubate the trachea on the first attempt is associated with an increased risk of complications. Two types of laryngoscopes are commonly available: direct laryngoscopes and video laryngoscopes. For critically ill adults undergoing emergency tracheal intubation, it remains uncertain whether use of a video laryngoscope increases the incidence of successful intubation on the first attempt compared with use of a direct laryngoscope.Methods and AnalysisTheDirEct VersusVIdeo LaryngosCopE(DEVICE) trial is a prospective, multi-center, non-blinded, randomized trial being conducted in 6 EDs and 10 ICUs in the United States. The trial plans to enroll up to 2,000 critically ill adults undergoing orotracheal intubation with a laryngoscope. Eligible patients are randomized 1:1 to the use of a video laryngoscope or a dir...
A Comparison of Two Video laryngoscopes: Truview and Kingvision in Routine Airway Management
Background: With advances in technology, intubation using video laryngoscopy has been gaining popularity, particularly in patients with difficult airways or as rescue devices in failed intubation attempts. Their routine use is, however, an uncommon occurrence. This clinical trial was carried out to support their use in elective airway management. Objective: To evaluate the effectiveness of kingvision video laryngoscope (KVL) in comparison with the Truview video laryngoscope (TVL) in routine airway management. Methods: We studied 60 subjects requiring orotracheal intubation during general anaesthesia for elective surgeries. They were randomly assigned into two groups to undergo tracheal intubation using either a TVL (n=30) or KVL (n=30). Characteristics and consequences of airway management were evaluated. The primary outcomes were the percentage of glottic opening (POGO) and ease of intubation and secondary outcomes were Cormack and Lehane (CL) grading, TTI (time taken for intubation) and successful placement of endotracheal tube (ETT). Results: Both the VLs were comparable with respect to primary and secondary outcomes except TTI which was more with KVL. Conclusion: We opine that both TVL and KVL provide a better laryngoscopic view in routine airway management, but KVL does not have an extra benefit over TVL otherwise, further indicating the need for more experience with the use of a KVL. Keywords: Laryngoscopes; Airway Management; Intubation.
VIDEO-LARYNGOSCOPE: PROCEDURE, PRACTICE AND PITFALLS
Inadequate airway management is a major contributor to morbidity and mortality in the prehospital and out-of-operating room hospital settings. Subsequently, numerous intubation devices like the video laryngoscope have been developed that incorporate an optical fiber image transmitter integrated with a modified laryngoscope blade to facilitate visualization of the glottis opening. This article reviews the different types of video laryngoscopes and focuses on tips for their right use, possible problems that one may encounter during the procedure of intubation and the future prospective of this relatively new category of airway management devices.
Open Access Macedonian Journal of Medical Sciences, 2021
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 prod...