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An optimal tracheal tube preshaping strategy for endotracheal intubation using video laryngoscopy: a randomized controlled trial

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Abstract

Although video laryngoscopy solves the problem of glottis exposure, it is difficult to deliver the tube to the glottic opening when the tracheal tube is unevenly shaped. This study aimed to compare the effects of different tube shapes on the first-pass success (FPS) rate in patients undergoing video laryngoscopy-assisted tracheal intubation. Three hundred patients above 18 years of age who underwent general anaesthesia and required endotracheal intubation were included in the study. The participants were randomly allocated to three groups with 100 participants in each group as follows: Group A, video laryngoscopes with a self-equipped stylet are used for tube preshaping; Group B: curvature of the video laryngoscope blade is modelled for tube preshaping; Group C: tube preshaping angle is consistent with the video laryngoscope blade, and the bending point is set 1 cm above the tracheal tube cuff. The primary outcome was FPS rates. The secondary outcomes included time to tracheal intubation, haemodynamic responses and adverse events. No significant differences in patient characteristics or airway assessments were noted (P > 0.05). Compared with Groups A, Group B and Group C exhibited a higher FPS rate (68% vs. 86% vs. 92%; P < 0.001). However, there is no significant difference in FPS rate between Group B and Group C (P > 0.05). And the time to tracheal intubation in Group C was significantly less than that in Group A and Group B (22.21 ± 4.01 vs. 19.92 ± 4.11 vs. 17.71 ± 3.47; P < 0.001). The straight-to-cuff stylet preshape angulation of curvature of the blade could provide a higher FPS rate and shorter time to tracheal intubation during video laryngoscopy-assisted endotracheal intubation. Trial registration: Chinese Clinical Trial Registry, ChiCTR1900026019.

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Funding

This work was funded by the Research Foundation of Technology Bureau of Anhui Province, China Grant Nos. 201904a07020026, Zeping Dai, and 201904b11020014, Weidong Yao. The funding agent had no role in the study design, data collection, or data analyses.

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Author notes

  1. Ya Cao and Lianxiang Jiang both have contributed equally to this work.

Authors and Affiliations

  1. Department of Anaesthesia, the First Affiliated Hospital of Wannan Medical College, No. 2, Zheshan West Road, Wuhu, Anhui, China

    Ya Cao, Lianxiang Jiang, Weidong Yao, Yongquan Chen & Zeping Dai

  2. Department of Anaesthesia, Tongling People’s Hospital, Tongling, Anhui, China

    Yan Zhang

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  1. Ya Cao
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  2. Lianxiang Jiang
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  3. Yan Zhang
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  4. Weidong Yao
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  5. Yongquan Chen
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  6. Zeping Dai
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Contributions

ZY and JLX collected the data. YWD and CY supervised the research and analysed the data. JLX and CY wrote and revised the manuscript. CYQ and DZP designed and conducted the study. All of the authors read and approved the final manuscript.

Corresponding author

Correspondence to Zeping Dai.

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Conflict of iInterest

All authors declare that they have no conflict of interest to disclose.

Ethical approval

The study was approved by the Ethical Issues Committee of the First Affiliated Hospital of Wannan Medical College, Anhui, China (Chairperson Prof Wu P) on March 6, 2019.

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Written informed consent was obtained from all the patients.

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Cao, Y., Jiang, L., Zhang, Y. et al. An optimal tracheal tube preshaping strategy for endotracheal intubation using video laryngoscopy: a randomized controlled trial. J Clin Monit Comput 36, 1629–1634 (2022). https://doi.org/10.1007/s10877-022-00806-4

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  • DOI: https://doi.org/10.1007/s10877-022-00806-4

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