Current Evidences for the Use of UEscope in Airway Management

Abstract

Objective: UEscope is a new angulated videolaryngoscope (VL). This review aimed to describe the features of UEscope and provide clinical evidences regarding the efficacy and safety of this video device in adult tracheal intubation and its roles in airway management teaching.

Data sources: The Wan Fang Data, CNKI, PubMed, Embase, Cochrane Library, and Google Scholar were searched for relevant English and Chinese articles published up to January 15, 2017, using the following keywords: "HC video laryngoscope", "UE videolaryngoscope", "video laryngoscope", and "videolaryngoscopy".

Study selection: Human case reports, case series, observable studies, and randomized controlled clinical trials were included in our search. The results of these studies and their reference lists were cross-referenced to identify a common theme.

Results: UEscope features the low-profile portable design, intermediate blade curvatures, all-angle adjustable monitor, effective anti-fog mechanisms, and built-in video recording function. During the past 5 years, there have been a number of clinical studies assessing the application and roles of UEscope in airway management and education. As compared with direct laryngoscope, UEscope improves laryngeal visualization, decreases intubation time (IT), and increases intubation success rate in adult patients with normal and difficult airways. These findings are somewhat different from the previous results regarding the other angulated VLs; they can provide an improved laryngeal view, but no conclusive benefits with regard to IT and intubation success rate. Furthermore, UEscope has extensively been used for intubation teaching and shown a number of advantages.

Conclusions: UEscope can be used as a primary intubation tool and may provide more benefits than other VLs in patients with normal and difficult airways. However, more studies with large sample are still needed to address some open questions about clinical performance of this new VL.

Figure 1

UEscopes. From left to right: Upper row, four reusable angulated blades (sizes 1–4); The bottom row, three disposable devices with angulated blades (sizes 2–4) and one reusable device with size 1 Miller blade. A separable 2.5-inch pocket LCD color monitor can be used for all models. The recommended angulated blade sizes are size 1 for infant and children aged 0–2 years, size 2 for children aged 2–6 years, size 3 for children aged >6 years and small adults, and size 4 for normal-obese adult patients. The recommended Miller blade sizes are size 0 for neonates and size 1 for infants and children aged <2 years.

Figure 2

Blade shapes of various videolaryngoscopes. (a) Storz C-MAC videolaryngoscope (Macintosh type); (b) Storz D-Blade videolaryngoscope (angulated type); (c) Glidescope videolaryngoscope (angulated type); (d) McGrath series 5 videolaryngoscope (angulated type); (e) UEscope (angulated type); (f) Pentax-airway scope (guided-channel type).