“…As shown by scientific studies, CC during direct laryngoscopy significantly prolongs intubation [8,22]. When applying various videolaryngoscopy methods, as in the case the ETView, thanks to obtaining an image of the end of the laryngoscope blade or of the endotracheal tube, the differences in the efficiency between intubation with and without CC are not as significant as with the MAC [33][34][35].…”
BACKGROUND: Currently, the gold standard for airway management in cardiopulmonary resuscitation is endotracheal intubation. This should be performed without interruptions in chest compressions, or with a short break only to introduce the tube. METHODS: A total of 47 nurses were recruited who performed endotracheal intubation on a manikin in 2 scenarios: A-normal airway, without chest compressions; B-normal airway, with continuous chest compressions performed with the Lifeline ARM system. They used 4 devices: a Macintosh blade laryngoscope (MAC), and a Tru-View EVO2 (EVO2), TruView EVO2 PCD (PCD), and an ETView SL (ETView) laryngoscope. The intubation time and effectiveness, the grade of larynx visibility, and the ease of intubation in adults were compared.
“…As shown by scientific studies, CC during direct laryngoscopy significantly prolongs intubation [8,22]. When applying various videolaryngoscopy methods, as in the case the ETView, thanks to obtaining an image of the end of the laryngoscope blade or of the endotracheal tube, the differences in the efficiency between intubation with and without CC are not as significant as with the MAC [33][34][35].…”
BACKGROUND: Currently, the gold standard for airway management in cardiopulmonary resuscitation is endotracheal intubation. This should be performed without interruptions in chest compressions, or with a short break only to introduce the tube. METHODS: A total of 47 nurses were recruited who performed endotracheal intubation on a manikin in 2 scenarios: A-normal airway, without chest compressions; B-normal airway, with continuous chest compressions performed with the Lifeline ARM system. They used 4 devices: a Macintosh blade laryngoscope (MAC), and a Tru-View EVO2 (EVO2), TruView EVO2 PCD (PCD), and an ETView SL (ETView) laryngoscope. The intubation time and effectiveness, the grade of larynx visibility, and the ease of intubation in adults were compared.
“…Three examples could well reflect the high variability in definition since time to intubation is described as (i) the time “from the passage of the tip of the laryngoscope past the patient’s teeth to the appearance of CO 2 on the capnograph trace” [20], (ii) the moment “from when the facemask was removed from the patient’s face to when end-tidal CO 2 of at least 20 mm Hg was measured on the end-tidal gas monitor” [21] or when (iii) “the time started to run when a participant took a laryngoscope into his/her hand and stopped when the appropriate position of the tube was confirmed by the fact that it was possible to ventilate with a bag valve mask and by the movements of the chest and the abdomen” (Fig. 3) [22]. Fig.…”
Background
Airway management is crucial and, probably, even the most important key competence in anaesthesiology, which directly influences patient safety and outcome. However, high-quality research is rarely published and studies usually have different primary or secondary endpoints which impedes clear unbiased comparisons between studies. The aim of the present study was to gather and analyse primary and secondary endpoints in video laryngoscopy studies being published over the last ten years and to create a core set of uniform or homogeneous outcomes (COS).
Methods
Retrospective analysis. Data were identified by using MEDLINE® database and the terms “video laryngoscopy” and “video laryngoscope” limited to the years 2007 to 2017. A total of 3351 studies were identified by the applied search strategy in PubMed. Papers were screened by two anaesthesiologists independently to identify study endpoints. The DELPHI method was used for consensus finding.
Results
In the 372 studies analysed and included, 49 different outcome categories/columns were reported. The items “
time to intubation
” (65.86%), “
laryngeal view grade
” (44.89%), “
successful intubation rate
” (36.56%), “
number of intubation attempts
” (23.39%), “
complications
” (21.24%), and “
successful first-pass intubation rate
” (19.09%) were reported most frequently. A total of 19 specific parameters is recommended.
Conclusions
In recent video laryngoscopy studies, many different and inhomogeneous parameters were used as outcome descriptors/endpoints. Based on these findings, we recommend that 19 specific parameters (e.g., “time to intubation” (inserting the laryngoscope to first ventilation), “laryngeal view grade” (C&L and POGO), “successful intubation rate”, etc.) should be used in coming research to facilitate future comparisons of video laryngoscopy studies.
“…11 As for Pentax AWS, a paediatric manikin based study reports shorter intubation time, higher success rate, and easier performance scores compared to Miller laryngoscopes. 12,13 There are no studies to our knowledge directly comparing Pentax AWS and Macintosh laryngoscope in paediatric patients. The purpose of this randomised non-inferiority study was to evaluate the efficacy of the Pentax AWS regarding intubation time, laryngeal view and ease of intubation in paediatric patients with normal airway, compared to Macintosh laryngoscope.…”
Funding informationDepartmental source.
Background: Pentax Airway Scope (AWS) is a recently developed videolaryngoscopefor use in both normal and difficult airways, yet its use in paediatric patients has not been established. The purpose of this study was to evaluate the efficacy of the Pentax AWS regarding intubation time, laryngeal view and ease of intubation in paediatric patients with normal airway, compared to Macintosh laryngoscope.Method: A total of 136 paediatric patients aged 1-10 with American Society of Anaesthesiologists physical status I or II undergoing general anaesthesia were randomly allocated into two groups: Macintosh laryngoscope (n = 68) and Pentax Airway Scope (n = 68). Primary outcome was intubation time. Cormack-Lehane laryngeal view grade, application of optimal laryngeal external manipulation, intubation difficulty scale, intubation failure rate and adverse events were also measured.Result: No significant difference was observed between the two groups regarding intubation time (P = 0.713). As for the laryngeal view grade, the Pentax group resulted in lower graded cases compared to the Macintosh group (P = 0.000). No optimal laryngeal external manipulation application was required in the Pentax group.Intubation difficulty scale resulted in lower values for Pentax group (P = 0.001).Failure rate was not different between the two groups (P = 0.619). There were significantly more teeth injury cases in the Pentax group than Macintosh group (P = 0.042).Conclusion: Pentax Airway Scope provided similar intubation time and success rate, while improving laryngeal view, compared to Macintosh laryngoscopy in children with normal airway. When using Pentax AWS in children, however, the risk of teeth injury may increase.
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