Comparison of the novel VieScope with conventional and video laryngoscope in a difficult airway scenario – a randomized, controlled simulation trial

Ecker, Hannes; Kolvenbach, Simone; Stranz, Sebastian; Herff, Holger; Wetsch, Wolfgang A.

doi:10.1186/s12873-021-00484-6

Cited by 14 publications

(13 citation statements)

References 16 publications

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“…On the other hand, intubation with the VSC required significantly more time than the conventional approach. So far, the VSC has only been studied in simulated airway scenarios (6)(7)(8). Although helpful in the initial assessment of new devices, manikin studies have limitations as, e.g., secretions obscuring the view on the larynx are often not adequately modeled (15).…”

Section: Discussionmentioning

confidence: 99%

“…Feasibility of the VSC in normal and difficult airways has been evaluated in manikin studies with promising results ( 6 , 7 ) and the VSC has been shown to be superior to conventional DL during simulated cardiopulmonary resuscitation with providers wearing personal protective equipment ( 8 ). However, clinical studies comparing the VSC with DL as the current clinical standard technique are missing, so far.…”

Section: Introductionmentioning

confidence: 99%

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Elective Tracheal Intubation With the VieScope—A Prospective Randomized Non-inferiority Pilot Study (VieScOP-Trial)

et al. 2022

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BackgroundTracheal intubation is commonly performed after direct laryngoscopy using Macintosh laryngoscopes (MacL), but visualization of the larynx may be inadequate. The VieScope (VSC) as a new type of laryngoscope consisting of a straight, shielded, illuminated tube used to perform intubation via a bougie was investigated in this prospective randomized trial in patients without expected difficult airways.MethodsWith ethics approval, 2 × 29 patients for elective surgery were randomized 1:1 to intubation with VSC or MacL. Endpoints were first attempt success rates (FAS), Percentage of Glottis Opening Scale (POGO), time to intubation (TTI), and difficulty ratings on visual analog scales (0–100, lower values better). Data are given as mean ± standard deviation.ResultsThe FAS was 83 ± 38% for VSC and 86 ± 34% for MacL (P = 0.723). For VSC, POGO was 86 ± 17% and for MacL 68 ± 30% (P = 0.007). TTI for VSC was 93 ± 67s vs. 38 ± 17 for MacL (P < 0.001). Difficulty of intubation was rated 23 ± 22 for VSC vs. 18 ± 22 for MacL (P = 0.422), viewing conditions 12 ± 15 vs. 24 ± 25 (P = 0.031), and difficulty of tube placement was rated 27 ± 30 vs. 7 ± 8 (P = 0.001).ConclusionNo difference in FAS was detected between VSC and MacL. Visualization of the larynx was superior using the VSC, while TTI was prolonged and tube placement via bougie was more challenging. The VSC could be an alternative to MacL in patients with difficult laryngoscopy, but this should be investigated further in patients with expected difficult airways.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Elective Tracheal Intubation With the VieScope—A Prospective Randomized Non-inferiority Pilot Study (VieScOP-Trial)

et al. 2022

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“…Thus, while certain interventions may be sound in the laboratory setting, real-life clinical settings may be complex to prove them in the field. There are multiple methods for oxygenation and ventilation 19 20 21 22 23 24 25 26 27 and multiple reasons to apply (moderate) PEEP levels in multiple trauma patients: one of the most important is the prevention of atelectasis resulting in less shunting volume and finally better oxygenation. Further, many multiple trauma patients suffer from severe thoracical trauma where PEEP may be lifesaving by alveolar stabilization.…”

Section: Discussionmentioning

confidence: 99%

Influence of positive end-expiratory pressure on arterial blood pressure in mechanically ventilated trauma patients in the field

Herff

Krappinger

Paal

et al. 2023

Medical Gas Research

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Ventilation with positive end-expiratory pressure (PEEP) may result in decreased venous return to the heart and therefore decrease cardiac output. We evaluated the influence of PEEP ventilation on arterial blood pressure in the field in 296 posttraumatic intubated patients being treated by a helicopter emergency medical service in a retrospective cohort study. Initial systolic blood pressure on the scene, upon hospital admission and their mean difference were compared between patients being ventilated with no/low PEEP (0–0.3 kPa) and moderate PEEP (0.3–1 kPa). In a subgroup analysis of initially hemodynamic unstable patients (systolic blood pressure < 80 mmHg), systolic blood pressure was compared between patients being ventilated with no/low or moderate PEEP Further, the mean difference between initial systolic blood pressure and upon hospital admission was correlated with the chosen PEEP. Systolic arterial blood pressure of patients being ventilated with no/low PEEP improved from 105 ± 36 mmHg to 112 ± 38 mmHg, and that of patients being ventilated with moderate PEEP improved from 105 ± 38 mmHg to 119 ± 27 mmHg. In initially unstable patients being ventilated with no/low PEEP systolic blood pressure improved from initially 55 ± 36 mmHg to 78 ± 30 mmHg upon hospital admission, and in those being ventilated with moderate PEEP, the systolic blood pressure improved from 43 ± 38 mmHg to 91 ± 27 mmHg. There was no significant correlation between the chosen PEEP and the mean difference of systolic blood pressure (Pearson’s correlation, r = 0.07, P = 0.17). Ventilation with moderate PEEP has no adverse effect on arterial systolic blood pressure in this cohort of trauma patients requiring mechanical ventilation. Initially unstable patients being ventilated with moderate PEEP tend to be hemodynamically more stable.

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“…It allows direct visualisation of the glottis and aids endotracheal intubation using a bougie. [ 32 ] The infrared red intubation system (IRRIS) consists of a small infrared light source placed on the anterior cervical surface and over the cricothyroid membrane. The device emits infrared red light through the skin of the patient to the subglottic space.…”

Section: Newer Tools and Techniques For Airway Managementmentioning

confidence: 99%

Recent advances in airway management

Myatra

Dhawan

D'Souza

et al. 2023

Indian Journal of Anaesthesia

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Airway management is a core skill essential for anaesthesiologists and health care providers involved in resuscitation and acute care of patients. Advancements in airway management are continuously evolving. This narrative review highlights the recent advancements with respect to innovations, tools, techniques, guidelines, and research in both technical and non-technical aspects of airway management. These include nasal endoscopy, virtual endoscopy, airway ultrasound, video endoscopes, supraglottic airways with enhanced protection against aspiration, hybrid devices, and the use of artificial intelligence and telemedicine, the utility of which has increased in recent times, thereby improving success with airway management and enhancing patient safety. There has been an increasing emphasis on peri-intubation oxygenation strategies to reduce complications in patients with a physiologically difficult airway. Recent guidelines for difficult airway management and preventing unrecognised oesophageal intubation are available. Large multicentre airway data collection helps us examine airway incidents, aetiology, and complications to expand our knowledge and give us insights for change in practice.

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Comparison of the novel VieScope with conventional and video laryngoscope in a difficult airway scenario – a randomized, controlled simulation trial

Cited by 14 publications

References 16 publications

Elective Tracheal Intubation With the VieScope—A Prospective Randomized Non-inferiority Pilot Study (VieScOP-Trial)

Elective Tracheal Intubation With the VieScope—A Prospective Randomized Non-inferiority Pilot Study (VieScOP-Trial)

Influence of positive end-expiratory pressure on arterial blood pressure in mechanically ventilated trauma patients in the field

Recent advances in airway management

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