Difficult Intubation, Cervical Injury Spine
Conditions
Keywords
difficult airway, carvical collar, endotracheal intubation
Brief summary
In the presented study, our aim was to compare intubation conditions regarding the modified Cormack & Lehane score (CL) between the D-Blade® in indirect laryngoscopy or Macintosh blade in direct and indirect laryngoscopy with C-MAC PM® in a simulated setting of a difficult airway in human subjects.
Detailed description
Patients with unexpected difficult airway requiring endotracheal intubation (ETI) remain extremely challenging for emergency physicians and intubation failure with subsequent hypoxic complications still represents the majority of cases in a recent closed claims analysis. An incidence of major complications in airway management of 1 in 5,500 was estimated in the Fourth National Audit Project in the UK. Therefore, our aim was to compare intubation conditions regarding the modified Cormack & Lehane score (CL) between the D-Blade® in indirect laryngoscopy or Macintosh blade in direct and indirect laryngoscopy with C-MAC PM® in a simulated setting of a difficult airway in human subjects.
Interventions
DEVICEMacintosh blade
Laryngoscopy with C-MAC PM in combination with Macintosh blade
DEVICED-Blade
Laryngoscopy with C-MAC PM in combination with D-Blade
DEVICEIntubation
Intubation with C-MAC PM in combination with D-Blade
Sponsors
Johann Wolfgang Goethe University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients requiring general anesthesia for orthopedic surgery
Exclusion criteria
* known or expected difficult airway * undergoing urgent or emergent surgery * non-fasted * American Society of Anesthesiology Class (ASA) IV-VI * no consent for participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Best view of the glottic structures | 120 seconds after induction of narcosis | Best view of the glottic structures according to the modified Cormack and Lehane (CL) scoring system |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the process of Intubation using a questionnaire | Directly after successful tracheal intubation | As a secondary endpoint, all investigators were asked to evaluate the process of ETI with the D-Blade® from grade 1 to grade 4. Grade 1: Uncomplicated ETI with guide rod Grade 2: Challenging ETI, readjustment or usage of BURP necessary Grade 3: ETI using a stylet Grade 4: ETI failed |
| Subjective assessment of satisfaction using numeric rating scale | Directly after successful tracheal intubation | Finally, all investigators were asked for their subjective assessment from 0 = dissatisfied to 100 = fully satisfied when using the D-Blade®. |
Countries
Germany
Outcome results
None listed