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Randomized Controlled Trial
. 2018 Sep 22;22(1):235.
doi: 10.1186/s13054-018-2152-4.

Endotracheal tube-mounted camera-assisted intubation versus conventional intubation in intensive care: a prospective, randomised trial (VivaITN)

Jörn Grensemann  1 , Lars Eichler  2 , Nuowei Wang  2 , Dominik Jarczak  2 , Marcel Simon  3 , Stefan Kluge  2
Affiliations
Randomized Controlled Trial

Endotracheal tube-mounted camera-assisted intubation versus conventional intubation in intensive care: a prospective, randomised trial (VivaITN)

Jörn Grensemann et al. Crit Care. .

Abstract

Background: For critically ill patients, effective airway management with a high first-attempt success rate for endotracheal intubation is essential to prevent hypoxic complications during securing of the airway. Video guidance may improve first-attempt success rate over direct laryngoscopy (DL).

Methods: With ethics approval, this randomised controlled trial involved 54 critically ill patients who received endotracheal intubation using a tube with an integrated video camera (VivaSight™-SL tube, VST, ETView Ltd., Misgav, Israel) or using conventional intubation under DL.

Results: The two groups did not differ in terms of intubation conditions. The first-attempt success rate was VST 96% vs. DL 93% (not statistically significant (n. s.)). When intubation at first attempt failed, it was successful in the second attempt in all patients. There was no difference in the median average time to intubation (VST 34 s (interquartile range 28-39) vs. DL 35 s (28-40), n. s.). Neither vomiting nor aspiration or accidental oesophageal intubation were observed in either group. The lowest pulsoxymetric oxygen saturation for VST was 96 (82-99) % vs. 99 (95-100) % for DL (n. s.). Hypotension defined as systolic blood pressure < 70 mmHg occurred in the VST group at 20% vs. the DL group at 15% (n. s.).

Conclusion: In this pilot study, no advantage was shown for the VST. The VST should be examined further to identify patient groups that could benefit from intubation with the VST, that is, patients with difficult airway conditions.

Trial registration: ClinicalTrials.gov, NCT02837055 . Registered on 13 June 2016.

Keywords: Airway management D058109; Critical care D003422; Diagnostic techniques, Respiratory system D003948; Intubation, Intratracheal D007442; Respiration, Artificial D012121.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Hamburg Chamber of Physicians, Germany, Reference: PV5178, March 1, 2016. Written informed consent was obtained from the patient or a legal guardian.

Consent for publication

n/a

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Consolidated standards of reporting trials (CONSORT) diagram
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References

    1. Simon M, Wachs C, Braune S, de Heer G, Frings D, Kluge S. High-flow nasal cannula versus bag-valve-mask for preoxygenation before intubation in subjects with hypoxemic respiratory failure. Respir Care. 2016;61(9):1160–1167. doi: 10.4187/respcare.04413. - DOI - PubMed
    1. Nolan JP, Kelly FE. Airway challenges in critical care. Anaesthesia. 2011;66(Suppl 2):81–92. doi: 10.1111/j.1365-2044.2011.06937.x. - DOI - PubMed
    1. Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 Emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011;114(1):42–48. doi: 10.1097/ALN.0b013e318201c415. - DOI - PubMed
    1. Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology. 2005;103(2):429–437. doi: 10.1097/00000542-200508000-00027. - DOI - PubMed
    1. De Jong A, Molinari N, Terzi N, Mongardon N, Arnal JM, Guitton C, Allaouchiche B, Paugam-Burtz C, Constantin JM, Lefrant JY, et al. Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study. Am J Respir Crit Care Med. 2013;187(8):832–839. doi: 10.1164/rccm.201210-1851OC. - DOI - PubMed

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