Comparison of VividTrac®, Airtraq®, King Vision®, Macintosh Laryngoscope and a Custom-Made Videolaryngoscope for difficult and normal airways in mannequins by novices

Abstract

BackgroundDirect laryngoscopy remains the gold standard for endotracheal intubation and is preferred by experienced operators. However, an increasing number of reports currently support videolaryngoscopy, particularly for novice users. The widespread use of videolaryngoscopy may be limited due to financial limitations, especially in low-income countries. Therefore, affordable single-use scopes are now becoming increasingly popular. We sought to compare these new scopes with direct laryngoscopes and the previously tested videolaryngoscopes in mannequins by novices.MethodsFifty medical students were recruited to serve as novice users. Following brief, standardized training, students were asked to execute endotracheal intubation with each of the devices, including the Airtraq®, a custom-made videolaryngoscope, the King Vision®, the Macintosh laryngoscope and the VividTrac®, on an airway trainer (Laerdal Airway Management Trainer®) in normal and difficult airway scenarios. We evaluated the time to and the proportion of successful intubation, the best view of the glottis, esophageal intubation, dental trauma and user satisfaction.ResultsWe observed no differences in esophageal intubation. However, intubation-related times, the view of the glottis and operator satisfaction were significantly better throughout the study with the commercial videolaryngoscopes. In comparison, the custom-made videolaryngoscope performance proved to be similar to that of the Macintosh laryngoscope. The VividTrac® performance was similar (P > 0.05) or significantly better than that of the King Vision® in both scenarios.ConclusionsBased upon our results, the Airtraq®, King Vision® and VividTrac® were superior to the Macintosh laryngscope in both normal and difficult airway scencarios for novice users. In particular, our study is the first to report that the VividTrac® shows promise for further clinical evaluation.

Videolaryngoscopy vs. Macintosh laryngoscopy for double‐lumen tube intubation in thoracic surgery: a systematic review and meta‐analysis

“…Generally, in routine tracheal intubation, videolaryngoscopy is easier to learn than direct laryngoscopy for novice or inexperienced operators . Double‐lumen tube intubation is more complex than routine tracheal intubation, but it has not been determined whether videolaryngoscopes have any advantages in double‐lumen intubation specifically for novices.…”

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

“…In a Szalast et al study [16], intubation with Airtraq was significantly shorter than that with Macintosh (26 vs. 53 s, respectively). Rendeki et al [24] indicated that Airtraq was superior to the Macintosh laryngoscope in difficult airway intubation performed by novice users. This finding is in line with studies by other researchers [25,26].…”

A comparison of exposure of Glottis using the Airtraq or the Macintosh Laryngoscope in Potentially difficult airway management: A self-controlled clinical trial

“…Airtraq is one of the relatively inexpensive and widely used video-laryngoscopes in China. 6 , 18 Airtraq adopted in the experiment attributed to less haemodynamic stimulation following tracheal intubation in comparison with Macintosh laryngoscope. 7 , 19 , 20 This finding probably reflects the fact that Airtraq provides a view of glottis without the need to align the oral, pharyngeal and tracheal axes, and therefore requires less force during laryngoscopy.…”