VieScope a useful option for correct tracheal tube positioning in difficult airways: Study

Endotracheal intubation continues to be the gold standard for securing the airway in emergency situations. This is usually achieved by direct laryngoscopy, but is increasingly being supplemented by video laryngoscopy - and in some cases even replaced by it. Difficult intubation due to anatomical conditions or other situational circumstances is a dreadful situation when securing the airway occurring in an estimated 1–6% of the cases.

A group of researchers from Germany conducted a study to compare VieScope with Glidescope and conventional Macintosh laryngoscopy (MAC) in a simulated difficult airway situation.

In this randomized controlled simulation trial, 35 anesthesiologists performed endotracheal intubation using VieScope, GlideScope and MAC in a randomized order on a certified airway manikin with a difficult airway.

The results of the study are as follows:

• For the primary endpoint of the correct tube position, no statistical difference was found.
• Time until intubation for GlideScope and MAC were shorter compared to the VieScope.
• Time to first ventilation, GlideScope and MAC were also shorter compared to the VieScope.
• There was no difference was shown between handling time for VieScope and time until intubation with GlideScope or MAC.
• Participants stated a better Cormack & Lehane Score with VieScope, compared to direct laryngoscopy.

Thus, the researchers concluded that the rate of correct tracheal tube position was comparable between the three devices. Time to intubation and ventilation was shorter with conventional Macintosh laryngoscopy (MAC) and Glidescope compared to VieScope. It did however show a comparable handling time to video laryngoscopy and conventional Macintosh laryngoscopy (MAC). It also did show a better visualization of the airway in the Cormack & Lehane Score compared to conventional Macintosh laryngoscopy (MAC).

Reference:

Comparison of the novel VieScope with conventional and video laryngoscope in a difficult airway scenario – a randomized, controlled simulation trial by Ecker H et. al published in the BMC Emergency Medicine.

DOI: https://doi.org/10.1186/s12873-021-00484-6