Hemodynamic changes following endotracheal intubation with glidescope<sup>®</sup> video-laryngoscope in patients with untreated hypertension

Dashti, M H; Amini, Shahram; Azarfarin, Rasoul; Totonchi, Ziae; Hatami, Maryam

doi:10.5812/cardiovascmed.17598

Cited by 24 publications

(16 citation statements)

References 19 publications

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“…Further, it is important to note that the haemodynamic response to intubation attempts might be less with VLs because of the reduced force on the oral structures. 21 22 In the current study, the use of AWS and C-MAC reduced the force applied to the tongue. The use of VLs enabled intubations without any excessive effort exerted to achieve a direct line of sight as compared with the DL.…”

Section: Discussionmentioning

confidence: 69%

Comparison of the force applied on oral structures during intubation attempts by novice physicians between the Macintosh direct laryngoscope, Airway Scope and C-MAC PM: a high-fidelity simulator-based study

Nakanishi

Shiga²,

Homma³

et al. 2016

BMJ Open

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ObjectiveWe examined whether the use of Airway Scope (AWS) and C-MAC PM (C-MAC) decreased the force applied on oral structures during intubation attempts as compared with the force applied with the use of Macintosh direct laryngoscope (DL).DesignProspective cross-over study.ParticipantsA total of 35 novice physicians participated.InterventionsWe used 6 simulation scenarios based on the difficulty of intubation and intubation devices.Outcome measuresOur primary outcome measures were the maximum force applied on the maxillary incisors and tongue during intubation attempts, measured by a high-fidelity simulator.ResultsThe maximum force applied on maxillary incisors was higher with the use of the C-MAC than with the DL and AWS in the normal airway scenario (DL, 26 Newton (N); AWS, 18 N; C-MAC, 52 N; p<0.01) and the difficult airway scenario (DL, 42 N; AWS, 24 N; C-MAC, 68 N; p<0.01). In contrast, the maximum force applied on the tongue was higher with the use of the DL than with the AWS and C-MAC in both airway scenarios (DL, 16 N; AWS, 1 N; C-MAC, 7 N; p<0.01 in the normal airway scenario; DL, 12 N; AWS, 4 N; C-MAC, 7 N; p<0.01 in the difficult airway scenario).ConclusionsThe use of C-MAC, compared with the DL and AWS, was associated with the higher maximum force applied on maxillary incisors during intubation attempts. In contrast, the use of video laryngoscopes was associated with the lower force applied on the tongue in both airway scenarios, compared with the DL. Our study was a simulation-based study, and further research on living patients would be warranted.

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Section: Discussionmentioning

confidence: 69%

Comparison of the force applied on oral structures during intubation attempts by novice physicians between the Macintosh direct laryngoscope, Airway Scope and C-MAC PM: a high-fidelity simulator-based study

Nakanishi

Shiga²,

Homma³

et al. 2016

BMJ Open

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“…14 Similar finding was observed in the study done on hemodynamic response by Dashti M et al using Glidescope and Macintosh laryngoscope in patients with untreated hypertension. 15 Mean arterial pressure, pulse rate and RPP were lower in Glidescope group after endotracheal intubation (P < 0.05). All these values were returned to pre-intubation values at 3 minutes after intubation in Glidescope group and 4 minutes after intubation in Macintosh group (P < 0.05).…”

Section: Discussionmentioning

confidence: 83%

Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope: A randomized comparative study

Upadhyaya

Pathak

2019

J. Soc. Anesth. Nep.

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Introduction: Direct laryngoscopy is associated with sympathetic stimulation and altered hemodynamics. A long intubation time may result in a greater in stress response. Alternative techniques using video laryngoscopes have been developed that do not require direct vocal cord visualization and may decrease the hemodynamic response. This study aimed to compare the difference between hemodynamic changes and intubation time with Airtraq video laryngoscope and conventionl Macintosh direct laryngoscope. Methods: A prospective randomized comparative study was conducted involving 100 adult patients who were undergoing elective surgeries under general anesthesia and endotracheal intubation. The patients were randomly assigned to group V (Video laryngoscope) or group D (Direct laryngoscope). In addition to the baseline vitals and vitals at various time intervals, intubation time was also recorded. We considered a difference in Heart Rate and Mean Arterial pressure of 20% to be clinically significant and statistical significance was p-value <0.05. Results: Significant difference was found in heart rates immediately after laryngoscopy (110.40 vs. 105.02 beats/minute; p<0.01) and 1 minute after intubation (109.30 vs. 106.20 beats/minute; p<0.01) with attenuation seen in video laryngoscopy group. Blood pressures were similar in both the groups at all times. Time for intubation was prolonged in video laryngoscopy group than that for direct laryngoscopy group (26.54 vs. 22.80 seconds; p<0.05). There were no adverse events associated with either of the techniques. Conclusions: The Airtraq video laryngoscopy resulted in lesser change in heart rate and longer intubation time. However, clinical impact of such a difference seemed to be insignificant.

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“…Additionally, several complications (e.g. bradycardia, cardiopulmonary arrest) are associated with the excess force applied on the oral structures [ 3 – 5 ]. In this context, intubation with a lower force applied on the oral structure is an important part of intubation skills to prevent complications in the ED.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal acquisition of endotracheal intubation skills in novice physicians

et al. 2017

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Little is known about the acquisition of intubation skills among novice physicians during their one-year clinical training. Our primary objective was to determine the changes in the intubation skills of novice physicians between prior to the clinical training and after completion of the clinical training. We used data of a prospective longitudinal multicenter data registry developed to investigate factors associated with the improvement of intubation skills among novice physicians. The study participants included 90 postgraduate year 1 physicians in 2015–2016. We used 4 simulation scenarios based on the devices used (direct laryngoscope [DL] and Airway scope [AWS]) and difficulty of intubation (normal and difficult scenarios). As a marker of the intubation skills, we used the force applied on the maxillary incisors and the tongue with each intubation. We compared the data obtained prior to clinical training with those obtained after completion of one-year clinical training. When using DL, compared to prior, significantly less force were applied on the maxillary incisors and the tongue after clinical training in the normal scenario (28.0 N vs 19.5 N, p < 0.001, and 11.1 N vs 8.4 N, p = 0.004). Likewise, when using AWS, compared to prior, significantly less force were applied on the tongue after clinical training in the normal scenario (22.0 N vs 0 N, p < 0.001). The force on the tongue decreased after clinical training but not significant. These associations persisted in the difficult airway scenario. These findings suggest that force applied on oral structures can be quantified as a marker of intubation skills by using high-fidelity simulators, and the assessment of procedural competency is recommended for all novice physicians prior to performing intubation in the clinical setting to improve the quality of emergency care.

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Hemodynamic changes following endotracheal intubation with glidescope^® video-laryngoscope in patients with untreated hypertension

Cited by 24 publications

References 19 publications

Comparison of the force applied on oral structures during intubation attempts by novice physicians between the Macintosh direct laryngoscope, Airway Scope and C-MAC PM: a high-fidelity simulator-based study

Comparison of the force applied on oral structures during intubation attempts by novice physicians between the Macintosh direct laryngoscope, Airway Scope and C-MAC PM: a high-fidelity simulator-based study

Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope: A randomized comparative study

Longitudinal acquisition of endotracheal intubation skills in novice physicians

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Hemodynamic changes following endotracheal intubation with glidescope® video-laryngoscope in patients with untreated hypertension

Cited by 24 publications

References 19 publications

Comparison of the force applied on oral structures during intubation attempts by novice physicians between the Macintosh direct laryngoscope, Airway Scope and C-MAC PM: a high-fidelity simulator-based study

Comparison of the force applied on oral structures during intubation attempts by novice physicians between the Macintosh direct laryngoscope, Airway Scope and C-MAC PM: a high-fidelity simulator-based study

Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope: A randomized comparative study

Longitudinal acquisition of endotracheal intubation skills in novice physicians

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Hemodynamic changes following endotracheal intubation with glidescope^® video-laryngoscope in patients with untreated hypertension