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Videolaryngoscopy as a first-intention technique for tracheal intubation in unselected surgical patients: a before and after observational study.
De Jong, Audrey; Sfara, Thomas; Pouzeratte, Yvan; Pensier, Joris; Rolle, Amélie; Chanques, Gérald; Jaber, Samir.
  • De Jong A; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
  • Sfara T; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
  • Pouzeratte Y; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
  • Pensier J; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
  • Rolle A; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
  • Chanques G; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France.
  • Jaber S; Anesthesiology and Intensive Care, Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, Montpellier; Centre Hospitalier Universitaire Montpellier, Montpellier, France. Electronic address: s-jaber@chu-montpellier.fr.
Br J Anaesth ; 129(4): 624-634, 2022 10.
Article in English | MEDLINE | ID: covidwho-1926236
ABSTRACT

BACKGROUND:

Using a Macintosh-style videolaryngoscope as a first-intention device for tracheal intubation of unselected patients in the operating room has not often been studied. We hypothesised that using a Macintosh-style videolaryngoscope as a first-intention device is associated with an increased proportion of easy tracheal intubation.

METHODS:

In a quality improvement project for airway management aimed at implementing a Macintosh-style videolaryngoscope as a first-intention device, we included all consecutive tracheal intubations in adults from March, 2017 to September, 2020 in two French teaching hospitals. We divided the cohort into three temporal cohorts the pre-intervention, implementation, and post-intervention periods. The primary outcome was the proportion of easy airway management. The secondary outcomes were the rescue technique, Cormack-Lehane III or IV view, and operator-reported difficulty of intubation. Data from one hospital compliant with the quality improvement project were compared with data from a non-compliant hospital.

RESULTS:

A total of 26 692 tracheal intubations were performed. Among 11 938 intubations included in the compliant hospital, 5487 were included in the pre-intervention, 1845 in the implementation, and 4606 in the post-intervention periods. In comparison to the pre-intervention period, the proportions of easy tracheal intubation increased from 94.3% (5177 of 5487) to 98.7% (4547 of 4606)) in the post-intervention period (+4.4% [95% confidence interval 3.7-5.1%], P<0.001). In comparison to the pre-intervention period, all secondary outcome proportions were significantly lower in the post-intervention period. No significant changes were noted in the non-compliant hospital between the pre- and post-intervention periods.

CONCLUSIONS:

Using a Macintosh-style videolaryngoscope as a first-intention device for tracheal intubation in the operating room was associated with a significant increase in the proportion of easy tracheal intubation, compared with use of the standard Macintosh laryngoscope.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Laryngoscopes Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Br J Anaesth Year: 2022 Document Type: Article Affiliation country: J.bja.2022.05.030

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Laryngoscopes Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: Br J Anaesth Year: 2022 Document Type: Article Affiliation country: J.bja.2022.05.030