Respiratory Failure
Conditions
Keywords
Urgent endotrachel intubation, Direct laryngoscopy, Video laryngoscopy, Glidescope, Critical Care
Brief summary
The safety and efficacy of a video-laryngoscope as a primary intubation tool in urgent endotracheal intubation of critically-ill patients has not been well-described in the literature. This study will answer whether using a VL will impact on the efficacy and safety of intubation compared with a traditional direct laryngoscopy.
Interventions
PROCEDUREDirect laryngoscopy
DEVICEVideo laryngoscopy (Glidescope)
Sponsors
Beth Israel Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients undergoing urgent endotracheal intubation by a pulmonary critical care medicine physician
Exclusion criteria
* Difficult airway * Oxygen saturation \< 92% despite adequate mask ventilation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| First Pass Success Rate | From begining of intubation to verification. Less then 5 minutes approximatly |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severe Desaturation | For 10 minutes post intubation | sat \<80% |
| Hypotension | For 10 minutes post intubation | SBP\<70 |
| Cardiac Arrest | For 1 hour post intubation | — |
| Complications of Intubation | For 10 minutes post intubation | Complications of intubation including aspiration, vomiting, esophageal intubation,and dental injury. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Direct Laryngoscopy Intubation will be done using direct laryngoscopy
Direct laryngoscopy | 60 |
| Video Laryngoscopy Intubation will be done using video laryngoscopy
Video laryngoscopy (Glidescope) | 57 |
| Total | 117 |
Baseline characteristics
| Characteristic | Direct Laryngoscopy | Video Laryngoscopy | Total |
|---|---|---|---|
| Age, Continuous | 69.6 years STANDARD_DEVIATION 15.9 | 65.4 years STANDARD_DEVIATION 14 | 67.4 years STANDARD_DEVIATION 15.1 |
| Sex: Female, Male Female | 26 Participants | 30 Participants | 56 Participants |
| Sex: Female, Male Male | 34 Participants | 27 Participants | 61 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 60 | 0 / 57 |
| serious Total, serious adverse events | 0 / 60 | 0 / 57 |
Outcome results
Primary
First Pass Success Rate
Time frame: From begining of intubation to verification. Less then 5 minutes approximatly
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Direct Laryngoscopy | First Pass Success Rate | 24 percentage of first pass success |
| Video Laryngoscopy | First Pass Success Rate | 42 percentage of first pass success |
Secondary
Cardiac Arrest
Time frame: For 1 hour post intubation
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Direct Laryngoscopy | Cardiac Arrest | 0 percentage of cardiac arrest |
| Video Laryngoscopy | Cardiac Arrest | 1 percentage of cardiac arrest |
Secondary
Complications of Intubation
Complications of intubation including aspiration, vomiting, esophageal intubation,and dental injury.
Time frame: For 10 minutes post intubation
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Direct Laryngoscopy | Complications of Intubation | 9 percentage of other complications |
| Video Laryngoscopy | Complications of Intubation | 6 percentage of other complications |
Secondary
Hypotension
SBP\<70
Time frame: For 10 minutes post intubation
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Direct Laryngoscopy | Hypotension | 8 percentage of hypotension |
| Video Laryngoscopy | Hypotension | 6 percentage of hypotension |
Secondary
Severe Desaturation
sat \<80%
Time frame: For 10 minutes post intubation
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Direct Laryngoscopy | Severe Desaturation | 5 percentage of patients with desaturation |
| Video Laryngoscopy | Severe Desaturation | 2 percentage of patients with desaturation |