Comparison of intubation success and glottic visualization using King Vision and C-MAC videolaryngoscopes in patients with cervical spine injuries with cervical immobilization: A randomized clinical trial

Shravanalakshmi, Dhanyasi; Bidkar, Prasanna Udupi; Narmadalakshmi, K; Lata, Suman; Mishra, Sandeep Kumar; Adinarayanan, S

doi:10.4103/2152-7806.199560

Cited by 25 publications

(7 citation statements)

References 20 publications

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“…compared conventional C-MAC, CMAC-D and Kings Vision video laryngoscopes and found comparable IDS scores in C-MAC group and Kings Vision group ( P = 0.340). [13] However, the median score of IDS was “0” in all the three groups. In the present study, mean difference in ADS, C-L grade and IDS between the two groups was statistically not significant, and both the devices are equally efficacious for ease of intubation.…”

Section: Discussionmentioning

confidence: 97%

“…[611] A study compared GlideScope with CMAC in patients with cervical spine immobilisation and reported both devices to be effective, although intubation was more often successful with GlideScope. [12] Although video laryngoscopes have been compared with other airway devices in manikin studies[10] or in simulated difficult airway scenario,[16111213] studies are scant in patients with real cervical spine injury/pathology. [12] Bruck et al ., reported that both CMAC and GlideScope provided an excellent glottic view in patients with cervical spine immobilisation, but tracheal intubation was more often successful with Glide Scope.…”

Section: Discussionmentioning

confidence: 99%

“…reported that the mean tracheal intubation time was comparable in CMAC versus Kings Vision (23 vs. 24 s) and Kings Vision versus D blade (24 vs. 26 s), while it was significantly reduced with conventional CMAC as compared to CMAC-D (23 vs 26 s). [13] The increased time was taken for the insertion of CMAC-D blade through the mouth owing to increased curvature of the D blade. [13] It could be because they were not familiar/experienced with the D blade while in our study all the intubations were performed by anaesthetists with experience of more than 50 intubations with each device.…”

Section: Discussionmentioning

confidence: 99%

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GlideScope versus D-blade for tracheal intubation in cervical spine patients: A randomised controlled trial

et al. 2019

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Background and Aims: Airway management in patients with cervical spine pathology is challenging. The aim of the study was to evaluate GlideScope (GVL) and D blade of C-MAC (CMAC-D) using manual inline axial stabilisation (MIAS) for tracheal intubation in patients with cervical spine injury/pathology. Methods: This is a randomised, single-blind, hospital-based study. After obtaining informed consent, 54 patients with cervical spine pathology/injury were grouped into GVL group or CMAC-D group, ( n = 27 each) based on computer-generated random number table. Preoperative airway difficulty score (ADS) was calculated. The primary outcome of the study was intubation difficulty score (IDS) and the secondary outcomes included total time taken to secure airway, failure to intubate, haemodynamic parameters and adverse events. Data was represented in the form of number (%) or mean and standard deviation and median and interquartile range as appropriate. Chi square test was used for analysing IDS. Results: The mean ± SD of IDS of the CMAC-D and GVL groups were 0.04 ± 0.2 (0.04–0.11) and 0.19 ± 0.40 (0.03–0.34), respectively, ( P value = 0.096). The number (%) of patients with IDS > 0 was 1 (3.7) in CMAC-D and 5 (18.5) in GVL group, ( P value = 0.192). Demographic data, ADS, Cormack–Lehane grading, success rate, time of tracheal intubation, type of surgeries, haemodynamic parameters and post-operative complications were similar in both the groups. Conclusion: Both GVL and CMAC-D with MIAS are equally efficacious in tracheal intubation in cervical spine injury/pathology patients without other difficult airway management criteria.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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GlideScope versus D-blade for tracheal intubation in cervical spine patients: A randomised controlled trial

et al. 2019

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“…These victims require constant stabilization of their cervical spine. As shown in many studies, the use of an orthopedic collar limits the opening of the patient's oral cavity [17,18], as well as limits head movement which results in markedly lower rates of first-time intubation success with the use of direct laryngoscopes [19,20]. In a study by Kłosiewicz et al, the use of a standard Macintosh laryngoscope was compared to the use of the TotalTrack VLM device (Fig.…”

Section: Endotracheal Intubation Techniques In Literaturementioning

confidence: 99%

“…For the purposes of the study, the anterior portion of the collar was removed, and the patient's chin was stabilized by hand. The first attempt intubation success rate was 93.3% vs 100% respectively, while the total procedure time was comparable at 24.9 ± 7.2 seconds [17]. Meanwhile, Smereka et al compared the C-MAC video laryngoscope with the Macintosh laryngoscope.…”

Section: Endotracheal Intubation Techniques In Literaturementioning

confidence: 99%

Use of video laryngoscopes by inexperienced personnel in difficult intubations

Sip

Zalewski

Kłosiewicz

et al. 2018

Disaster Emerg Med J

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The current gold standard in securing airway patency remains to be endotracheal intubation. It is the only method, which allows for nearly 100% protection of the bronchial tree from aspiration of gastric contents as well as providing the most ideal circumstances for control of ventilation parameters. Endotracheal intubation, although in many aspects superior to other methods of securing airways, can only be performed by skilled and experienced personnel in ideal conditions. An example of such conditions are in an operating room in the preoperative period when an anesthesiologist is able to proficiently perform the task with all of the tools and equipment needed at hand. However, in many situations, especially in emergencies, such ideal conditions are difficult or impossible to achieve. One of the many reasons behind this is often the lack of experienced personnel at the scene of an emergency. Another significant difficulty arises from trauma patients who must maintain an immobilized cervical spine, as well as those patients who are undergoing active cardiopulmonary resuscitation when providing high quality chest compressions is the highest priority. Therefore, it seems reasonable to look for the methods which on one hand will secure an airway with a tube inserted directly into the larynx, and on the other hand will make the procedure more accessible to less experienced personnel by maintaining the proper patient safety throughout the whole procedure. A noteworthy method, which achieves this goal, is the use of the video laryngoscopes for endotracheal intubation. The participation in a short introductory training, regarding the use of the device itself, is sufficient to allow for the efficient intubation. The parameters which can be used to compare these different intubation methods include the ease of use, the rate of effectiveness of the first intubation trial as well as the total time needed for the procedure. The authors of this article attempt to compare classic laryngoscopes to video-assisted laryngoscopes.

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Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review

Dean

Kerrey

2022

JACEP Open

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Objective Published studies of video laryngoscopes are often limited by the lack of a clear definition of video laryngoscopy (VL). We performed a systematic review to determine how often published studies of VL report on video screen visualization. Methods We searched PubMed, EMBASE and Scopus for interventional and observational studies in which a video laryngoscope equipped with a standard geometry blade was used for tracheal intubation. We excluded simulation based studies. Our primary outcome was data on video laryngoscope screen visualization. Secondary outcomes were explicit methodology for screen visualization. Results We screened 4838 unique studies and included 207 (120 interventional and 87 observational). Only 21 studies (10% of 207) included any data on video screen visualization by the proceduralist, 19 in a yes/no fashion only (ie, screened viewed or not) and 2 with detail beyond whether the screen was viewed or not. In 11 more studies, visualization patterns could be inferred based on screen availability and in 16 more studies, the methods section stated how screen visualization was expected to be performed without reporting data collection on how the proceduralist interacted with the video screen. Risk of bias was high in the majority of included studies. Conclusions Published studies of VL, including many clinical trials, rarely include data on video screen visualization. Given the nuances of using a video laryngoscope, this is a critical deficiency, which largely prevents us from knowing the treatment effect of using a video laryngoscope in clinical practice. Future studies of VL must address this deficiency.

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Comparison of intubation success and glottic visualization using King Vision and C-MAC videolaryngoscopes in patients with cervical spine injuries with cervical immobilization: A randomized clinical trial

Cited by 25 publications

References 20 publications

GlideScope versus D-blade for tracheal intubation in cervical spine patients: A randomised controlled trial

GlideScope versus D-blade for tracheal intubation in cervical spine patients: A randomised controlled trial

Use of video laryngoscopes by inexperienced personnel in difficult intubations

Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review

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