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01-12-2013 | Original

Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before–after comparative study

Authors: Audrey De Jong, Noémie Clavieras, Matthieu Conseil, Yannael Coisel, Pierre-Henri Moury, Yvan Pouzeratte, Moussa Cisse, Fouad Belafia, Boris Jung, Gérald Chanques, Nicolas Molinari, Samir Jaber

Published in: Intensive Care Medicine | Issue 12/2013

Abstract

Purpose

Airway management in intensive care unit (ICU) patients is challenging. The main objective of this study was to compare the incidence of difficult laryngoscopy and/or difficult intubation between a combo videolaryngoscope and the standard Macintosh laryngoscope in critically ill patients.

Methods

In the context of the implementation of a quality-improvement process for airway management, we performed a prospective interventional monocenter before–after study which evaluated a new combo videolaryngoscope. The primary outcome was the incidence of difficult laryngoscopy (defined by Cormack grade 3–4) and/or difficult intubation (more than two attempts). The secondary outcomes were the severe life-threatening complications related to intubation in ICU and the rate of difficult intubation in cases of predicted difficult intubation evaluated by a specific score (MACOCHA score ≥3).

Results

Two hundred and ten non-selected consecutive intubation procedures were included, 140 in the standard laryngoscope group and 70 in the combo videolaryngoscope group. The incidence of difficult laryngoscopy and/or difficult intubation was 16 % in the laryngoscope group vs. 4 % in the combo videolaryngoscope group (p = 0.01). The severe life-threatening complications related to intubation did not differ between groups (16 vs. 14 %, p = 0.79). Among the 32 patients with a MACOCHA score ≥3, there were significantly more patients with difficult intubation in the standard laryngoscope group in comparison to the combo videolaryngoscope group [12/23 (57 %) vs. 0/9 (0 %), p < 0.01].

Conclusions

The systematic use of a combo videolaryngoscope in ICU was associated with a decreased incidence of difficult laryngoscopy and/or difficult intubation.

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Title: Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before–after comparative study
Authors: Audrey De Jong
Noémie Clavieras
Matthieu Conseil
Yannael Coisel
Pierre-Henri Moury
Yvan Pouzeratte
Moussa Cisse
Fouad Belafia
Boris Jung
Gérald Chanques
Nicolas Molinari
Samir Jaber
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 12/2013
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-013-3099-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before–after comparative study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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