Tracheal intubation during chest compressions using Pentax-AWS Ò , GlideScope Ò , and Macintosh laryngoscope: a randomized crossover trial using a mannequin Intubation trachéale avec le Pentax-AWS Ò , le GlideScope Ò et le laryngoscope Macintosh pendant des compressions thoraciques: une étude croisée randomisée sur un mannequin Abstract Background A randomized crossover trial was conducted to compare the performance of two videolaryngoscopes (Pentax-AWS Ò , GlideScope Ò ) with the Macintosh laryngoscope for tracheal intubation during continuous chest compressions on a mannequin. Methods Thirty-two inexperienced junior interns performed tracheal intubations on an advanced life support simulator with either a normal or difficult airway scenario. The sequence of intubating devices and airway difficulty were randomized. The following data were measured and recorded: time to complete tracheal intubation (primary end point), overall success rate, time to visualize the vocal cords, percentage of glottic opening, dental compression, and ease of intubation. Results With a normal airway, the times (median [interquartile range]) to complete tracheal intubation were shorter with the Pentax-AWS (12.1 [10.1-14.4] sec) and the ] sec) than with the Macintosh laryngoscope (16.5 [13.1-22.1] sec) (P \ 0.03 for both). The time difference between the two videolaryngoscopes was not statistically significant. With a difficult airway scenario, the times to complete tracheal intubation were 13.9 [10.9-20.4] sec, 19.2 [16.4-32.3] sec, and 30.1 [21.0-56.5] sec, respectively (P \ 0.05 for all differences). The videolaryngoscopes were also more effective than the Macintosh laryngoscope with respect to secondary outcomes.
ConclusionsThe two videolaryngoscopes were superior to the Macintosh laryngoscope in terms of performing tracheal intubation during continuous chest compressions on a mannequin. In a difficult airway scenario simulating cardiac arrest, the Pentax-AWS performed better than the GlideScope.
RésuméContexte Une e´tude croise´e randomise´e a e´te´re´alise´e afin de comparer la performance de deux vide´olaryngoscopes (Pentax-AWS Ò , GlideScope Ò ) et du laryngoscope Macintosh pour l'intubation trache´ale pendant des compressions thoraciques continues sur un mannequin. Méthode Trente-deux re´sidents sans expe´rience ont re´alise´des intubations trache´ales sur un simulateur de re´animation avance´e dans des sce´narios de voies ae´riennes normales ou difficiles. Les dispositifs d'intubation et la difficulte´des voies ae´riennes ont suivi un ordre d'apparition ale´atoire. Les donne´es suivantes ont e´te´mesure´es et enregistre´es : temps jusqu'a`intubation trache´ale re´ussie (crite`re d'e´valuation principal), taux de re´ussite global, temps jusqu'a`visualisation des cordes vocales, pourcentage d'ouverture glottique, compression dentaire et facilited 'intubation. Résultats Dans les cas de voies ae´riennes normales, les temps (moyenne [e´cart interquartile]) jusqu'a`intubation trache´ale e´taient plus courts avec le Pentax-AWS (12,1...