TY - JOUR
T1 - SWIVIT - Swiss video-intubation trial evaluating video-laryngoscopes in a simulated difficult airway scenario
T2 - Study protocol for a multicenter prospective randomized controlled trial in Switzerland
AU - Theiler, Lorenz
AU - Hermann, Kristina
AU - Schoettker, Patrick
AU - Savoldelli, Georges
AU - Urwyler, Natalie
AU - Kleine-Brueggeney, Maren
AU - Arheart, Kristopher L.
AU - Greif, Robert
N1 - Funding Information:
The authors would like to thank Christine Riggenbach, study nurse, for her support. Lorenz Theiler and the study trial described will be supported by research grants from the following institutions: Gottfried and Julia Bangerter-Rhyner Foundation, Basel, Switzerland; Fondation Latine des Voies Aériennes (FLAVA), Lausanne, Switzerland; and the University Department of Anesthesiology and Pain Therapy, Bern, Switzerland.
PY - 2013/4/4
Y1 - 2013/4/4
N2 - Background: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation.Methods/Design: The objective of this trial is to evaluate and to compare the clinical performance of three video-laryngoscopes with a guiding channel for intubation (Airtraq™, A. P. Advance™, King Vision™) and three video-laryngoscopes without an integrated tracheal tube guidance (C-MAC™, GlideScope™, McGrath™) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt.Discussion: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway.Trial registration: NCT01692535.
AB - Background: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation.Methods/Design: The objective of this trial is to evaluate and to compare the clinical performance of three video-laryngoscopes with a guiding channel for intubation (Airtraq™, A. P. Advance™, King Vision™) and three video-laryngoscopes without an integrated tracheal tube guidance (C-MAC™, GlideScope™, McGrath™) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt.Discussion: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway.Trial registration: NCT01692535.
KW - A. P. Advance
KW - Airtraq
KW - C-MAC
KW - Difficult airway
KW - Glidescope
KW - King vision
KW - Mcgrath
KW - Video-laryngoscope
UR - http://www.scopus.com/inward/record.url?scp=84875690321&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875690321&partnerID=8YFLogxK
U2 - 10.1186/1745-6215-14-94
DO - 10.1186/1745-6215-14-94
M3 - Article
C2 - 23556410
AN - SCOPUS:84875690321
VL - 14
JO - Trials
JF - Trials
SN - 1745-6215
IS - 1
M1 - 94
ER -