Dataset Information

Vie Scope® versus videolaryngoscopy in expected difficult airways: a randomized controlled trial.

ABSTRACT:

Purpose

The management of patients with an anticipated difficult airway remains challenging. We evaluated laryngeal visualization with the recently introduced Vie Scope® as a straight blade laryngoscope consisting of an illuminated tube necessitating bougie-facilitated intubation vs Macintosh videolaryngoscopy.

Methods

We conducted a prospective randomized controlled noninferiority trial. Patients undergoing elective ear, nose, and throat or oral and maxillofacial surgery with an anticipated difficult airway were randomized 1:1 to receive tracheal intubation with the Vie Scope or Macintosh videolaryngoscope (C-MAC®). The primary outcome measure was laryngeal visualization by the percentage of glottis opening (POGO) scale. Secondary outcome measures were the time to successful intubation (TTI) and first-attempt and overall success rates.

Results

We included two sets of 29 patients in our analysis. For visualization, the Vie Scope was noninferior to videolaryngoscopy (VL) with mean (standard deviation [SD]) POGO scores of 71 (31)% vs 64 (30)% in the VL group [difference in means, 7 (8)%; 95% confidence interval, -9 to 23; P = 0.38]. Mean (SD) TTI was 125 (129) sec in the Vie Scope and 51 (36) sec in the VL group (difference in means, 75 sec; 95% confidence interval, 25 to 124; P = 0.005). The first-attempt and overall success rates were 22/29 (76%) and 27/29 (93%) in both groups. Two patients per group were switched to a different device. Four accidental esophageal intubations occurred in the Vie Scope group, these were presumably due to bougie misplacement.

Conclusion

Visualization with the Vie Scope was noninferior to VL in patients with an anticipated difficult airway, but TTI was longer in the Vie Scope group.

Study registration

ClinicalTrials.gov (NCT05044416); registered 5 September 2021.

SUBMITTER: Petzoldt M

PROVIDER: S-EPMC10447594 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Vie Scope® versus videolaryngoscopy in expected difficult airways: a randomized controlled trial.

Petzoldt Martin M Grün Catharina C Wünsch Viktor A VA Bauer Marcus M Hardel Tim T TT Grensemann Jörn J

Canadian journal of anaesthesia = Journal canadien d'anesthesie 20230803 9

<h4>Purpose</h4>The management of patients with an anticipated difficult airway remains challenging. We evaluated laryngeal visualization with the recently introduced Vie Scope® as a straight blade laryngoscope consisting of an illuminated tube necessitating bougie-facilitated intubation vs Macintosh videolaryngoscopy.<h4>Methods</h4>We conducted a prospective randomized controlled noninferiority trial. Patients undergoing elective ear, nose, and throat or oral and maxillofacial surgery with an ...[more]

PMID: 37537324

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Project description:BackgroundDuring laparoscopic gynecological surgery, increased peak airway pressure (PAWP) can cause airway leak upon ventilation with the LMA® ProSeal™. We hypothesized that compared with the use of volume-controlled ventilation (VCV), the use of the AutoFlow® mode would decrease PAWP and airway leak during laparoscopic gynecological surgery with LMA ProSeal.MethodsThis single-center, randomized, controlled trial allocated 80 adult women undergoing elective laparoscopic gynecological surgery to one of two groups, namely, the AutoFlow group or the VCV group. Ventilation settings for both groups were 8 ml/kg of tidal volume and 5 cmH2O of positive end-expiratory pressure, and respiratory rate was adjusted to maintain end-tidal carbon dioxide at 35-40 mmHg. Airway leak, PAWP, and other ventilatory parameters and vital signs were recorded at four timepoints (1, 1 min after insertion of the gastric tube; 2, 2 min after intravenous administration of rocuronium 0.6-0.8 mg/kg; 3, 1 min after initiation of pneumoperitoneum; and 4, 1 min after changing to the Trendelenburg position). The primary outcome was PAWP during pneumoperitoneum and in the Trendelenburg position, whereas the secondary outcomes included PAWP at other timepoints and airway leak development. We used the Mann-Whitney U test for PAWP and Fisher's exact test for comparing airway leak among the groups.ResultsData from 40 patients in the AutoFlow group and 39 in the VCV group were used for analysis. PAWP at pneumoperitoneum pressure and in the Trendelenburg position was significantly lower in the AutoFlow group than in the VCV group [median (interquartile range), 16 (15-18) cmH2O vs. 18 (17-19) cmH2O; P < 0.001]. Similarly, patients in the AutoFlow group showed lower PAWP at the other three timepoints measured. Airway leak occurred in four patients in the AutoFlow group and in two patients in the VCV group; however, this incidence was not significantly different (P = 0.68).ConclusionsEven though AutoFlow ventilation decreased PAWP, it did not reduce the incidence of airway leak compared with VCV during laparoscopic gynecological surgery with the LMA ProSeal.Trial registrationUMIN Clinical Trials Registry, identifier UMIN000023173 .

Dataset Information

Vie Scope® versus videolaryngoscopy in expected difficult airways: a randomized controlled trial.

Purpose

Methods

Results

Conclusion

Study registration

Publications

Vie Scope® versus videolaryngoscopy in expected difficult airways: a randomized controlled trial.

Similar Datasets

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