Comparative effectiveness of the video laryngoscope versus direct laryngoscopy in the predicted difficult airway

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ANKITHA S and SAHAJANAND H, “Comparative effectiveness of the video laryngoscope versus direct laryngoscopy in the predicted difficult airway”, ijmhs, vol. 12, no. 09, pp. 1973–1983, Sep. 2022.
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Abstract

CONTEXT

Tracheal intubation using direct laryngoscopy(DL) is successful in the majority of patients, even when a line-of-sight view of the glottis is not possible. Poor glottic visualization is encountered between 1% and 9% of attempts.

This study was designed to determine the comparative effectiveness of the Videolaryngoscope compared with direct laryngoscopy in the predicted difficult airway. Our hypothesis was that using Vivid tracVideolaryngoscopy results in a higher intubation success compared with direct laryngoscopy in this challenging patient population.

 

Objectives of the study: a. Primary objective – Intubation success at first attempt

  1. Secondary objectives –
  2. Best Cormack-Lehane laryngeal view,
  3. laryngoscopy time,
  4. use of external laryngeal maneuver,
  5. arterial oxygen desaturation by pulse oximetry,
  6. airway-related complications.

 

Methodology

The data for study is collected from subjects fulfilling inclusion/exclusion criteria and  inpatients .

Study design: A hospital based prospective, randomized, two parallel arm clinical study.

Results:

VDL(94%) has more intubation success rate at first attempt than DL(78.7%), Laryngoscopy time for VDL took 49.21 seconds  whereas DL was 32.99 seconds. External maneuvers were used  only for DL (5.3%)  whereas VDL did not require any(0%); videolaryngoscope showed better Cormack lehane view.

 

Conclusion: A diverse group of anesthesia providers achieved a higher intubation success rate on first attempt with the Vividtrac in a broad range of patients with predictors of difficult intubation. Vividtrac laryngoscope offers a new approach to tracheal intubation of patients at increased risk for tracheal intubaton with lesser degree of hemodynamic stimulation compared to Macintosh laryngoscope.

 

Keywords: Difficult airway, Direct laryngoscopy, Vividtrac videolaryngoscopy.

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“I certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (wherever applicable), as well as the writing of the manuscript, to take public responsibility for it. I believe the manuscript represents valid work. I have reviewed the final version of the manuscript and approve it for publication. Neither has the manuscript nor one with substantially similar content under my authorship been published nor is being considered for publication elsewhere, except as described in an attachment. Furthermore I attest that I shall produce the data upon which the manuscript is based for examination by the editors or their assignees, if requested.”