Cargando…

Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents

Background: Airway management in children is challenging due to anatomical and physiological differences. This randomized trial investigates whether anaesthesia residents can intubate the paediatric trachea more quickly and with a higher success rate using the King Vision™ Paediatric aBlade™ video l...

Descripción completa

Detalles Bibliográficos
Autores principales: Epp, Katharina, Zimmermann, Sophie, Wittenmeier, Eva, Kriege, Marc, Dette, Frank, Schmidtmann, Irene, Pirlich, Nina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573319/
https://www.ncbi.nlm.nih.gov/pubmed/36233540
http://dx.doi.org/10.3390/jcm11195676
_version_ 1784810839678648320
author Epp, Katharina
Zimmermann, Sophie
Wittenmeier, Eva
Kriege, Marc
Dette, Frank
Schmidtmann, Irene
Pirlich, Nina
author_facet Epp, Katharina
Zimmermann, Sophie
Wittenmeier, Eva
Kriege, Marc
Dette, Frank
Schmidtmann, Irene
Pirlich, Nina
author_sort Epp, Katharina
collection PubMed
description Background: Airway management in children is challenging due to anatomical and physiological differences. This randomized trial investigates whether anaesthesia residents can intubate the paediatric trachea more quickly and with a higher success rate using the King Vision™ Paediatric aBlade™ video laryngoscope (KVL) compared to conventional direct laryngoscopy (DL). Methods: Eleven anaesthesia residents (mean age: 31 years, mean training status 47 months) were each asked to perform intubations with the KVL and DL in paediatric patients. The primary outcome was the first-attempt success rate. Secondary outcomes were the time to best view (TTBV), time to placement of the tracheal tube (TTP), time to ventilation (TTV), and participant-reported ease of use on a Likert scale. Results: 105 intubations with the KVL and 106 DL were performed by the residents. The success rate on the first attempt with the KVL was 81%, and the success rate on the first attempt within a given time limit of 30 s was 45%, which was lower than with DL (93% and 77% with time limit, p < 0.01). The median TTBV [IQR] on the first attempt with KVL was 7 [5–10] s, the median TTP was 28 [19–44] s, and the median TTV was 51 [39–66] s. DL-mediated intubation was significantly faster (TTP: 17 [13–23] s; p < 0.0001 and TTV: 34 [28–44] s; p < 0.001). Application of the KVL was rated as difficult or very difficult by 60% of the residents (DL: 5%). Conclusion: In contrast to promising data on the paediatric training manikin, residents took longer to intubate the airway in children with the KVL and were less successful compared to the DL. Therefore, the KVL should not be recommended for learning paediatric intubation by residents.
format Online
Article
Text
id pubmed-9573319
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95733192022-10-17 Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents Epp, Katharina Zimmermann, Sophie Wittenmeier, Eva Kriege, Marc Dette, Frank Schmidtmann, Irene Pirlich, Nina J Clin Med Article Background: Airway management in children is challenging due to anatomical and physiological differences. This randomized trial investigates whether anaesthesia residents can intubate the paediatric trachea more quickly and with a higher success rate using the King Vision™ Paediatric aBlade™ video laryngoscope (KVL) compared to conventional direct laryngoscopy (DL). Methods: Eleven anaesthesia residents (mean age: 31 years, mean training status 47 months) were each asked to perform intubations with the KVL and DL in paediatric patients. The primary outcome was the first-attempt success rate. Secondary outcomes were the time to best view (TTBV), time to placement of the tracheal tube (TTP), time to ventilation (TTV), and participant-reported ease of use on a Likert scale. Results: 105 intubations with the KVL and 106 DL were performed by the residents. The success rate on the first attempt with the KVL was 81%, and the success rate on the first attempt within a given time limit of 30 s was 45%, which was lower than with DL (93% and 77% with time limit, p < 0.01). The median TTBV [IQR] on the first attempt with KVL was 7 [5–10] s, the median TTP was 28 [19–44] s, and the median TTV was 51 [39–66] s. DL-mediated intubation was significantly faster (TTP: 17 [13–23] s; p < 0.0001 and TTV: 34 [28–44] s; p < 0.001). Application of the KVL was rated as difficult or very difficult by 60% of the residents (DL: 5%). Conclusion: In contrast to promising data on the paediatric training manikin, residents took longer to intubate the airway in children with the KVL and were less successful compared to the DL. Therefore, the KVL should not be recommended for learning paediatric intubation by residents. MDPI 2022-09-26 /pmc/articles/PMC9573319/ /pubmed/36233540 http://dx.doi.org/10.3390/jcm11195676 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Epp, Katharina
Zimmermann, Sophie
Wittenmeier, Eva
Kriege, Marc
Dette, Frank
Schmidtmann, Irene
Pirlich, Nina
Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents
title Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents
title_full Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents
title_fullStr Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents
title_full_unstemmed Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents
title_short Video Laryngoscopy Using King Vision™ aBlade™ and Direct Laryngoscopy in Paediatric Airway Management: A Randomized Controlled Study about Device Learning by Anaesthesia Residents
title_sort video laryngoscopy using king vision™ ablade™ and direct laryngoscopy in paediatric airway management: a randomized controlled study about device learning by anaesthesia residents
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573319/
https://www.ncbi.nlm.nih.gov/pubmed/36233540
http://dx.doi.org/10.3390/jcm11195676
work_keys_str_mv AT eppkatharina videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents
AT zimmermannsophie videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents
AT wittenmeiereva videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents
AT kriegemarc videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents
AT dettefrank videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents
AT schmidtmannirene videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents
AT pirlichnina videolaryngoscopyusingkingvisionabladeanddirectlaryngoscopyinpaediatricairwaymanagementarandomizedcontrolledstudyaboutdevicelearningbyanaesthesiaresidents