Effects of direct laryngoscopy versus Glidescope videolaryngoscopy on subjective and objective measures of cognitive workload: an in-vivo randomized trial

Vuolato, Costanza; Caldiroli, Dario; Orena, Eleonora

doi:10.23736/s0375-9393.21.15275-7

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…Medical students likely had the least amount of exposure to intubation out of all novice types and can be considered true novices. Their success with VL may be related to reduced cognitive stress, as VL decreases physical demand, perceived workload, and reaction times compared to DL [6]. This is consistent with other studies that have found that as intubators gain experience, they show less improvement with VL over DL compared to true novices [31].…”

Section: Discussionsupporting

confidence: 86%

“…While novices such as medical students and residents are often supervised when intubating, the potential for patient harm remains due to the high-risk nature of this procedure, and VL may be helpful in finding the crucial balance between patient care and teaching technical skills in clinical practice [5]. VL is also suspected to decrease cognitive overload, which novices are particularly susceptible to as they start to perform challenging procedures such as intubation [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Video Versus Direct Laryngoscopy in Novice Intubators: A Systematic Review and Meta-Analysis

Nalubola¹,

Jin²,

Drugge³

et al. 2022

Cureus

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Video laryngoscopy (VL) is increasingly used in airway management and has been shown to decrease the rate of failed intubation in certain clinical scenarios, such as difficult airways. Training novices in intubation techniques requires them to practice on living patients; however, this is less than ideal from a safety perspective given the increased risk of complications after multiple attempts or failed intubation by inexperienced trainees. One setting in which VL may be beneficial is in training, although whether these devices should be used among novices instead of direct laryngoscopy (DL) remains unclear. The purpose of this systematic review and meta-analysis is to compare the outcomes of VL and DL when used by novices to perform intubation in the operating room. The secondary aims are to correlate outcomes with different types of VLs and with different types of novices, such as medical students, residents, and non-anesthesiology trainees.Databases were searched for studies that compared the outcomes of VL versus DL in endotracheal intubation performed by novices on patients with expected normal airways and no history of difficult intubation or cervical spine instability undergoing general anesthesia in the operating room. The primary outcome was the initial success rate. The secondary outcomes were time to intubate and the number of unintended esophageal intubations. A meta-analysis was performed to determine the difference, if any, in outcomes between VL and DL. Sub-analyses were also performed after the stratification of data by the type of VL used and the type of novice.Ten studies were included with 1,730 intubations. Studies varied by VL type and novice type. The overall results from the meta-analysis demonstrated an increased success rate and decreased time to intubate with VL compared to DL. Four studies showed a reduction in esophageal intubation with VL compared to DL. Subanalysis by VL type showed that improved outcomes with VL over DL were maintained only with the use of channeled VLs rather than non-channeled VLs. Sub-analysis by novice type showed that improved success rates with VL over DL were maintained only among medical students.Novices may have a higher initial success rate and faster intubation time when using a channeled VL compared to DL. Medical students also show improved success rates when using VL rather than DL, while residents and other types of novices do not. These findings may help guide clinicians in determining the most effective devices to use when teaching airway management while also maintaining the highest possible level of patient safety.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Video Versus Direct Laryngoscopy in Novice Intubators: A Systematic Review and Meta-Analysis

Nalubola¹,

Jin²,

Drugge³

et al. 2022

Cureus

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“…Daha önce yapılan çalışmalarda Glidescope laringoskopun Macintosh laringoskopa göre daha iyi görüntüleme sağladığı ve özellikle ilk denemede entübasyonu kolaylaştırdığı belirtilmiştir (15,16) . Çalışmamızda da Glidescop laringoskopunun CLL görünüm sınıflandırmasında Macintosh laringoskopa göre istatistiksel olarak anlamlı bir şekilde üstün olduğu gözlenmiştir.…”

Section: Discussionunclassified

Comparison of Endotracheal Intubation Successes with Macintosh, Glidescope and Airtraq Laryngoscopes

ERTÜRK¹,

Özkan²,

İnangil³

et al. 2021

JARSS

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Başarılı hava yolu yönetimi, anestezi uygulamalarında hasta güvenliğinde gerekli birincil ve en önemli adımdır. Son yıllarda ventilasyon ve entübasyon için kullanılan malzemelerin çeşitliliğinin artmasından dolayı zor hava yolu yönetiminde daha avantajlı duruma gelinmiştir. Glidescope ve Airtraq laringoskoplar da bu amaçla geliştirilmiş alternatif laringoskopi cihazlarıdır. Bu prospektif, randomize, klinik çalışmamızda Macintosh, Glidescope ve Airtraq laringoskoplar ile gerçekleştirilen endotrakeal entübasyon başarısını; Cormack-Lehane laringoskopik sınıflaması, entübasyon süresi, deneme sayısı, entübasyon için ihtiyaç duyulan kolaylaştırıcı manevra kullanımı yönünden birbirlerine olan üstünlüklerini karşılaştırmayı amaçladık. Yöntem: Çalışmaya elektif cerrahi uygulanacak, 18 yaşından büyük, ASA I-II fizyolojik risk grubundaki 180 hasta dahil edildi. Hastalar rastgele üç gruba ayrıldı. Grup-A' da Macintosh laringoskopla, Grup-B'de Glidescope laringoskopla ve Grup-C'de Airtraq laringoskopla entübe edilen hastaların Cormack-Lehane laringoskopik sınıflaması, entübasyon süresi, entübasyon deneme sayısı, entübasyon için ihtiyaç duyulan kolaylaştırıcı manevralar ve entübasyona ait komplikasyonlar kaydedildi ve karşılaştırıldı. Bulgular: Demografik veriler gruplar arasında benzer bulundu. Glidescop ve Airtraq laringoskop gruplarının Cormack Lehane laringoskopik skoru, entübasyon süreleri, deneme sayıları ve kolaylaştırıcı manevra kullanımı parametreleri benzer olup Macintosh grubundan üstündü. Grupların entübasyon başarı oranları ve entübasyona bağlı komplikasyonlar açısından, Glidescope ve Airtraq laringoskopi grupları ile Macintosh laringoskopi grubu ile sıklığı benzerdi. Sonuç: Çalışmamızın sonucunda Glidescope ve Airtraq laringoskoplarının Macintosh laringoskopa kıyasla daha iyi glotis görüntüsü sağladığı ve entübasyonu kolaylaştırdığı kanısına vardık. Bununla birlikte gruplar arasında entübasyon başarı oranlarında ve komplikasyon sıklıklarında ise farklılık tespit etmedik.

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“…The shared airway view provided by VL facilitates teamwork, communication, and teaching during intubation and other aspects of airway care and substantially improves the margin of safety in airway management [ 27 ]. Furthermore, the study of Vuolato et al [ 32 ], which investigated the differences in subjective and objective cognitive workload between HA-VL (Glidescope) versus direct laryngoscopy in a real clinical setting found that a videolaryngoscopy significantly reduced both measures; hence, proficiency with HA-VL constitutes an ergonomic option that could limit operators’ workload and improve patients’ safety. The Cochrane meta-analysis of Hansel et al [ 33 ], which included more than 200 randomized controlled trials and more than 26,000 patients, concluded that VLs of any design reduce the rates of failed intubation and increase the rates of successful first-attempt intubation.…”

Section: Background Of Videolaryngoscopy In Obstetricsmentioning

confidence: 99%

Videolaryngoscopy as a primary intubation modality in obstetrics: A narrative review of current evidence

Pintarič¹

2023

Biomol Biomed

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Pregnancy-related physiologic and anatomic changes affect oxygenation and airway management, and it is widely believed that airway difficulty may be more common in obstetric patients as a result. In addition, most obstetric intubations are performed under emergency conditions, and preoperative airway assessment poorly predicts airway management outcomes. These considerations necessitate special protocols for airway care in the obstetric population, and the evolution of the videolaryngoscope represents one of the most important milestones in recent decades. However, recommendations for the use of videolaryngoscopy in obstetrics remain unclear. A considerable body of evidence affirms that videolaryngoscopy improves laryngeal visualisation, increases first-attempt and overall intubation success rates, shortens intubation time, and facilitates team communication and education. In contrast, a significant number of studies have also reported conflicting results regarding comparative clinical outcomes and have highlighted other limitations regarding the adoption of videolaryngoscopy in routine obstetric care. Nevertheless, considering the peculiarities of obstetric intubation, the Macintosh-style videolaryngoscope can be suggested as the primary intubation device as it offers the benefits of both videolaryngoscopy and direct laryngoscopy. However, more rigorous evidence is needed to clarify the current blind spots and controversies regarding the role of videolaryngoscopy in obstetrics.

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Effects of direct laryngoscopy versus Glidescope videolaryngoscopy on subjective and objective measures of cognitive workload: an in-vivo randomized trial

Cited by 11 publications

References 24 publications

Video Versus Direct Laryngoscopy in Novice Intubators: A Systematic Review and Meta-Analysis

Video Versus Direct Laryngoscopy in Novice Intubators: A Systematic Review and Meta-Analysis

Comparison of Endotracheal Intubation Successes with Macintosh, Glidescope and Airtraq Laryngoscopes

Videolaryngoscopy as a primary intubation modality in obstetrics: A narrative review of current evidence

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