Abstract
Background
Previous studies have shown the utility of indirect glottis viewing videolaryngoscopes for tracheal intubation during chest compression, but the efficacy of a videolaryngoscope with tube guide has not been sufficiently validated. We compared the utility of two videolaryngoscopes, the KingVISION® (KingV) with or without tube guide blade and Pentax-AWS Airwayscope® (AWS), which contain tube guide function, during chest compressions on an adult manikin.
Methods
Twenty-five novice doctors and 22 experienced anesthesiologists performed tracheal intubation on an adult manikin using the AWS and KingV with or without chest compressions. The KingV trials were performed either with a tube guide ‘channeled blade’ (KingV-Guided) or without, using a ‘standard blade’ (KingV-Guideless).
Results
In the KingV-Guideless trial, all novice doctors successfully secured the airway without chest compressions but seven failed with chest compressions (p < 0.05), while no experienced doctors failed without chest compression and two did during chest compression. In the AWS and KingV-Guided trials, all participants succeeded both with and without chest compressions performed by both novice doctors and experienced anesthesiologists. Intubation time was lengthened significantly by chest compressions in the KingV-Guideless trial (p < 0.05), but not in the AWS or KingV-Guided trials performed by both novice doctors and experienced anesthesiologists. The intubation time for KingV-Guided during chest compression was significantly smaller by experienced anesthesiologists compared to by novice doctors.
Conclusions
These findings suggest that the AWS and KingV-Guided devices are more effective than the KingV-Guideless for airway management with chest compressions in adult simulations, especially performed by novice doctors. The tube guide function may contribute to successful airway management during chest compression by the added videolaryngoscopy function.
Similar content being viewed by others
References
Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, Deakin C, Koster RW, Wyllie J, Böttiger B. European resuscitation council guidelines for resuscitation, 2010 section 1. Exec summ Resusc. 2010;81:1219–76.
Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, Perkins GD. European resuscitation council guidelines for resuscitation 2010 section 4. Adult adv life support Resusc. 2010;81:1305–52.
Asai T, Liu EH, Matsumoto S, Hirabayashi Y, Seo N, Suzuki A, Toi T, Yasumoto K, Okuda Y. Use of the Pentax-AWS in 293 patients with difficult airways. Anesthesiology. 2009;110:898–904.
Komasawa N, Ueki R, Itani M, Nomura H, Nishi S, Kaminoh Y. Evaluation of tracheal intubation in several positions by the Pentax-Aws Airway Scope: a manikin study. J Anesth. 2010;24:908–12.
Komasawa N, Ueki R, Nomura H, Itani M, Kaminoh Y. Comparison of tracheal intubation by Macintosh laryngoscope and Pentax-AWS (Airway Scope) during chest compression: a manikin study. J Anesth. 2010;24:306–8.
Koyama J, Iwashita T, Okamoto K. Comparison of three types of laryngoscope for tracheal intubation during rhythmic chest compressions: a manikin study. Resuscitation. 2010;81:1172–4.
Gaszynska E, Samsel P, Stankiewicz-Rudnicki M, Wieczorek A, Gaszynski T. Intubation by paramedics using the ILMA or AirTraq, KingVISION, and Macintosh laryngoscopes in vehicle-entrapped patients: a manikin study. Eur J Emerg Med. 2014;21:61–4.
Gaszynska E, Gaszynski T. Endotracheal intubation using the Macintosh laryngoscope or KingVISION Video Laryngoscope during uninterrupted chest compression. Biomed Res Int. 2014;2014:250820.
Komasawa N, Ueki R, Itani M, Nishi S, Kaminoh Y. Validation of Pentax-AWS Airwayscope utility for intubation device during cardiopulmonary resuscitation on the ground. J Anesth. 2010;24:582–6.
Komasawa N, Ueki R, Kohama H, Nishi S, Kaminoh Y. Comparison of Pentax-AWS Airwayscope video laryngoscope, Airtraq optic laryngoscope, and Macintosh laryngoscope during cardiopulmonary resuscitation under cervical stabilization: a manikin study. J Anesth. 2011;25:898–903.
Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA. Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario. Circulation. 2002;105:645–9.
Yu T, Weil MH, Tang W, Sun S, Klouche K, Povoas H, Bisera J. Adverse outcomes of interrupted precordial compression during automated defibrillation. Circulation. 2002;106:368–72.
Helm M, Hossfeld B, Schafer S, Hoitz J, Lampl L. Factors influencing emergency intubation in the pre-hospital setting—a multicentre study in the German Helicopter Emergency Medical Service. Br J Anaesth. 2006;96:67–71.
Ueshima H, Asai T. Tracheal intubation in daylight and in the dark: a randomised comparison of the Airway Scope, Airtraq, and Macintosh laryngoscope in a manikin. Anaesthesia. 2010;65:684–7.
Asai T. Tracheal intubation with restricted access: a randomised comparison of the Pentax-Airway Scope and Macintosh laryngoscope in a manikin. Anaesthesia. 2009;64:1114–7.
Komasawa N, Fujiwara S, Mihara R, Minami T. Comparison of McGrath® and Pentax-AWS Airwayscope® for tracheal intubation by anaesthesiologists during chest compression in a manikin: a randomized crossover trial. Eur J Anaesth. 2014 (in press).
Shin DH, Choi PC, Han SK. Tracheal intubation during chest compressions using Pentax-AWS®, GlideScope®, and Macintosh laryngoscope: a randomized crossover trial using a mannequin. Can J Anaesth. 2011;58:733–9.
Ng I, Hill AL, Williams DL, Lee K, Segal R. Randomized controlled trial comparing the McGrath videolaryngoscope with the C-MAC videolaryngoscope in intubating adult patients with potential difficult airways. Br J Anaesth. 2012;109:439–43.
Wetsch WA, Spelten O, Hellmich M, Schier R, Böttiger BW, Hinkelbein J. Comparison of different video laryngoscopes for emergency intubation in a standardized airway manikin with immobilized cervical spine by experienced anaesthetists. A randomized, controlled crossover trial. Resuscitation. 2012;83:740–5.
Gatward JJ, Thomas MJ, Nolan JP, Cook TM. Effect of chest compressions on the time taken to insert airway devices in a manikin. Br J Anaesth. 2008;100:351–6.
Conflict of interest
The authors have no affiliation with any manufacturer of any device described in the manuscript and declare no financial interest in relation to the material described here. Financial support for the study was provided by our institution and department.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Okada, D., Komasawa, N., Fujiwara, S. et al. Comparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial. J Anesth 29, 331–337 (2015). https://doi.org/10.1007/s00540-014-1936-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00540-014-1936-1