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. 2022 Mar 15:9:820847.
doi: 10.3389/fmed.2022.820847. eCollection 2022.

Elective Tracheal Intubation With the VieScope-A Prospective Randomized Non-inferiority Pilot Study (VieScOP-Trial)

Martin Petzoldt  1 , Yasmin Engels  2 , Zohal Popal  1 , Pischtaz A Tariparast  2 , Phillip B Sasu  1 , Andrés Brockmann  2 , Mark A Punke  1 , Jörn Grensemann  2
Affiliations

Elective Tracheal Intubation With the VieScope-A Prospective Randomized Non-inferiority Pilot Study (VieScOP-Trial)

Martin Petzoldt et al. Front Med (Lausanne). .

Abstract

Background: Tracheal intubation is commonly performed after direct laryngoscopy using Macintosh laryngoscopes (MacL), but visualization of the larynx may be inadequate. The VieScope (VSC) as a new type of laryngoscope consisting of a straight, shielded, illuminated tube used to perform intubation via a bougie was investigated in this prospective randomized trial in patients without expected difficult airways.

Methods: With ethics approval, 2 × 29 patients for elective surgery were randomized 1:1 to intubation with VSC or MacL. Endpoints were first attempt success rates (FAS), Percentage of Glottis Opening Scale (POGO), time to intubation (TTI), and difficulty ratings on visual analog scales (0-100, lower values better). Data are given as mean ± standard deviation.

Results: The FAS was 83 ± 38% for VSC and 86 ± 34% for MacL (P = 0.723). For VSC, POGO was 86 ± 17% and for MacL 68 ± 30% (P = 0.007). TTI for VSC was 93 ± 67s vs. 38 ± 17 for MacL (P < 0.001). Difficulty of intubation was rated 23 ± 22 for VSC vs. 18 ± 22 for MacL (P = 0.422), viewing conditions 12 ± 15 vs. 24 ± 25 (P = 0.031), and difficulty of tube placement was rated 27 ± 30 vs. 7 ± 8 (P = 0.001).

Conclusion: No difference in FAS was detected between VSC and MacL. Visualization of the larynx was superior using the VSC, while TTI was prolonged and tube placement via bougie was more challenging. The VSC could be an alternative to MacL in patients with difficult laryngoscopy, but this should be investigated further in patients with expected difficult airways.

Keywords: VieScope; airway management; bougie; intubation; laryngoscope; laryngoscopy.

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Conflict of interest statement

MPe received a research grant awarded by Verathon. PT and AB have received study support from Ambu. JG has received study support from ETView, Ambu, Pfizer, and Infectopharm, and received consultant and lecture fees from Drägerwerk, GE Healthcare, Fresenius Medical, and Smith Medical. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Consolidated standards of reporting (CONSORT) diagram.
Figure 2
Figure 2
First attempt success rates, visualization, and time to intubation. FAS, First attempt success rate; POGO, Percentage of Glottis Opening Scale; TTI, Time to intubation; Error bars indicate standard deviation.
Figure 3
Figure 3
Intubation difficulty ratings on visual analog scales. All items rated on visual analog scales (0–100, lower values better); intubation: overall difficulty of intubation; visualization: difficulty to obtain adequate view on larynx; Tube placement: difficulty of advancing tube into trachea; Error bars indicate standard deviation.
See this image and copyright information in PMC

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