Flexible bronchoscopy intubation versus a combination of flexible bronchoscopy and videolaryngoscopy-assisted intubation in patients with predicted difficult airways Videolaryngoscopy Flexible bronchoscopy Difficult airway
Conditions
Interventions
Flexible bronchoscopy intubation was performed using a standard flexible bronchoscope
Device: KARL STORZ Flexible intubation videoendoscope
Patients were pre-oxygenated, followed by standard general
Active Comparator Device,Experimental Device
Flexible bronchoscopy intubation,Videolaryngoscope-Assisted Flexible bronchoscopy Intubation
Sponsors
University of Medicine and Pharmacy, Hue University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: Eligible patients presented with at least one difficult intubation criterion below but not identified as difficult face mask ventilation patients: 1. A thyromental distance less than 6 cm or a sternomental distance less than 12 cm 2. Oropharyngeal view: Modified Mallampati scale of 3 or 4 3. Abnormal upper teeth: Loose or protruding upper teeth or partially missing upper incisors or canines 4. Impaired temporomandibular joint mobility: Interincisor gap less than 38 mm and inability to move the lower teeth in front of the upper teeth, or ankylosis with limited mouth opening 5. Limited neck movement: Inability to extend and flex neck more than 90-degree angle from full extension to full flexion or presence of cervical spine pathologies 6. History of difficult laryngoscopy or intubation 7. Body Mass Index (BMI) more than 30 kilograms per square meter 8. History of obstructive sleep apnea diagnosed by polysomnography 9. Neck circumference larger than 40 cm in females and 43 cm in males measured at the thyroid cartilage
Exclusion criteria
Exclusion criteria: Patients meeting at least one of the following criteria: 1. Indications for awake endotracheal intubation. 2. Full stomach, diaphragmatic hernia, or a history of severe gastroesophageal reflux disease (GERD). 3. Oropharyngeal or laryngeal pathologies (e.g., tumors, abscesses).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Success rate A maximum of 120 seconds, measured from the moment the flexible bronchoscope passes the patient's teeth/lips until successful tracheal intubation is confirmed Visualization of the endotracheal tube tip above the carina and observation of a stable capnography waveform | — |
Secondary
| Measure | Time frame |
|---|---|
| Total time to successful intubation At the time that successful tracheal intubation is confirmed Measure from the moment the flexible bronchoscope passes the patient's teeth/lips until successful tracheal intubation is confirmed (in seconds),Operator self-assessment score Within 15 minutes after completion of the intubation procedure The operator's performance was self-assessed using a Numerical Rating Scale (NRS) ranging from 0 to 10, where 0 represented 'very poor' and 10 represented 'excellent'.,Supervisor assessment score Within 15 minutes after completion of the intubation procedure The operator's performance was assessed by the Supervisor using a Numerical Rating Scale (NRS) ranging from 0 to 10, where 0 represented 'very poor' and 10 represented 'excellent'.,Supervisor assessment score for flexible bronchoscopy maneuver Within 15 minutes after completion of the intubation procedure Using a Five-Point Global Rating Scale: 1: Hesitant or clumsy movements; 3: Proficient with the flexible bronchoscope, but occasionally stiff or awkward; 5: Highly proficient without hesitation | — |
Countries
Vietnam
Contacts
Public ContactMinh Nguyen
University of Medicine and Pharmacy, Hue University, Vietnam
Outcome results
None listed