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Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study

The aim of this study was to compare the performance of the Truview EVO2 laryngoscope in manikin-simulated cardiopulmonary resuscitation (CPR) and no-CPR scenarios with standard intubation technique. Participants performed 4 scenarios in random order: endotracheal intubation (ETI) using Macintosh la...

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Autores principales: Gaszynska, Ewelina, Gaszynski, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616286/
https://www.ncbi.nlm.nih.gov/pubmed/25255021
http://dx.doi.org/10.1097/MD.0000000000000078
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author Gaszynska, Ewelina
Gaszynski, Tomasz
author_facet Gaszynska, Ewelina
Gaszynski, Tomasz
author_sort Gaszynska, Ewelina
collection PubMed
description The aim of this study was to compare the performance of the Truview EVO2 laryngoscope in manikin-simulated cardiopulmonary resuscitation (CPR) and no-CPR scenarios with standard intubation technique. Participants performed 4 scenarios in random order: endotracheal intubation (ETI) using Macintosh laryngoscope (MCL), Truview EVO2 laryngoscope in no-CPR patient scenario, and intubation during uninterrupted chest compressions using both laryngoscopes. The participants were directed to make 3 attempts in each scenario. Primary outcomes were time to tracheal intubation (TTI) and intubation success, whereas secondary outcomes were cumulative success ratio and the number of esophageal intubation (EI). TTI and success ratios were reported per attempt. Thirty paramedics completed the study. Median TTI with Truview EVO2 with CPR was 36 (interquartile range [IQR] 29.00–52.00), 22.5 (IQR 18.33–35.00), and 18 (IQR 11.00–23.00) seconds; MCL with CPR was 23 (IQR 18.92–36.90), 16.8 (IQR 14.00–22.31), and 14.5 (IQR 11.12–16.36) seconds; Truview EVO2 without CPR was 28.6 (IQR 24.02–38.34), 21.7 (IQR 17.00–25.00), and 13 (IQR 11.90–17.79) seconds; MCL without CPR was 17 (IQR 13.23–22.29), 13 (IQR 12.09–15.26), and 12.4 (IQR 10.08–19.84) seconds for first, second, and third attempts, respectively. The P values for differences in TTI between Truview EVO2 and MCL were P < 0.0001, P = 0.0540, and P = 0.7550 in CPR scenario and P = 0.0080, P = 0.1570, and P = 0.7652 in no-CPR scenario for first, second, and third attempts, respectively. The success ratios for each of the scenarios were as follows: in CPR scenario it was 0.73 versus 0.53 (P = 0.0558), 0.83 versus 0.76 (P = 0.2633), and 1 versus 0.8 (P = 0.0058); in no-CPR scenario it was 0.63 versus 0.73 (P = 0.2068), 0.86 versus 0.86, and 0.97 versus 1 (P = 0.1637) for Truview EVO2 vs MCL in first, second, and third attempts, respectively. The cumulative success ratio related to the time of ETI was better for MCL compared with Truview EVO2 laryngoscope in both scenarios (P = 0.0029 and P = 0.0004 in no-CPR and CPR scenarios). The number of EI with MCL was 30% versus 13.3% (P = 0.0113), and for Truview EVO2 it was 20.45% versus 15.56% in CPR and no-CPR scenarios, respectively. The application of Truview EVO2 during uninterrupted chest compressions increased TTI but increased the success ratio of ETI and decreased number of EIs.
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spelling pubmed-46162862015-10-27 Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study Gaszynska, Ewelina Gaszynski, Tomasz Medicine (Baltimore) Article The aim of this study was to compare the performance of the Truview EVO2 laryngoscope in manikin-simulated cardiopulmonary resuscitation (CPR) and no-CPR scenarios with standard intubation technique. Participants performed 4 scenarios in random order: endotracheal intubation (ETI) using Macintosh laryngoscope (MCL), Truview EVO2 laryngoscope in no-CPR patient scenario, and intubation during uninterrupted chest compressions using both laryngoscopes. The participants were directed to make 3 attempts in each scenario. Primary outcomes were time to tracheal intubation (TTI) and intubation success, whereas secondary outcomes were cumulative success ratio and the number of esophageal intubation (EI). TTI and success ratios were reported per attempt. Thirty paramedics completed the study. Median TTI with Truview EVO2 with CPR was 36 (interquartile range [IQR] 29.00–52.00), 22.5 (IQR 18.33–35.00), and 18 (IQR 11.00–23.00) seconds; MCL with CPR was 23 (IQR 18.92–36.90), 16.8 (IQR 14.00–22.31), and 14.5 (IQR 11.12–16.36) seconds; Truview EVO2 without CPR was 28.6 (IQR 24.02–38.34), 21.7 (IQR 17.00–25.00), and 13 (IQR 11.90–17.79) seconds; MCL without CPR was 17 (IQR 13.23–22.29), 13 (IQR 12.09–15.26), and 12.4 (IQR 10.08–19.84) seconds for first, second, and third attempts, respectively. The P values for differences in TTI between Truview EVO2 and MCL were P < 0.0001, P = 0.0540, and P = 0.7550 in CPR scenario and P = 0.0080, P = 0.1570, and P = 0.7652 in no-CPR scenario for first, second, and third attempts, respectively. The success ratios for each of the scenarios were as follows: in CPR scenario it was 0.73 versus 0.53 (P = 0.0558), 0.83 versus 0.76 (P = 0.2633), and 1 versus 0.8 (P = 0.0058); in no-CPR scenario it was 0.63 versus 0.73 (P = 0.2068), 0.86 versus 0.86, and 0.97 versus 1 (P = 0.1637) for Truview EVO2 vs MCL in first, second, and third attempts, respectively. The cumulative success ratio related to the time of ETI was better for MCL compared with Truview EVO2 laryngoscope in both scenarios (P = 0.0029 and P = 0.0004 in no-CPR and CPR scenarios). The number of EI with MCL was 30% versus 13.3% (P = 0.0113), and for Truview EVO2 it was 20.45% versus 15.56% in CPR and no-CPR scenarios, respectively. The application of Truview EVO2 during uninterrupted chest compressions increased TTI but increased the success ratio of ETI and decreased number of EIs. Wolters Kluwer Health 2014-09-19 /pmc/articles/PMC4616286/ /pubmed/25255021 http://dx.doi.org/10.1097/MD.0000000000000078 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle Article
Gaszynska, Ewelina
Gaszynski, Tomasz
Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study
title Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study
title_full Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study
title_fullStr Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study
title_full_unstemmed Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study
title_short Truview EVO2 and Standard Macintosh Laryngoscope for Tracheal Intubation During Cardiopulmonary Resuscitation: A Comparative Randomized Crossover Study
title_sort truview evo2 and standard macintosh laryngoscope for tracheal intubation during cardiopulmonary resuscitation: a comparative randomized crossover study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616286/
https://www.ncbi.nlm.nih.gov/pubmed/25255021
http://dx.doi.org/10.1097/MD.0000000000000078
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