To Compare the Effect of Video Vs Direct Laryngoscopy during Urgent Endotracheal Intubation
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 9
Abstract
Abstract: Recent evidence has suggested an increasing role of video laryngoscopy (VL) for emergency airway management. Video laryngoscopy is a form of indirect laryngoscopy in which the clinician does not directly view the larynx. The present study was conducted to compare the effect of video vs direct laryngoscopy during urgent endotracheal intubation.This study was conducted in the department of Anesthesia in year 2015. It included 120 patients who required emergency intubation. Patients were divided into 2 groups. Group I consisted of 60 subjects in which direct laryngoscope was used for intubation while group II consists of 60 patients in which Glidescope video laryngoscope was used for intubation. Data in real time on the number of attempts, nadir systolic blood pressure, nadir oxygen saturations, time to intubation, and complications were recorded. The patient’s airway assessment, demographics, doses of sedatives used, and types of blades used was also recorded.Group I consisted of 60 subjects in which direct laryngoscope was used for intubation while group II consists of 60 patients in whom Glidescope video laryngoscope was used for intubation. The difference was non- significant (P-1). Average age in group I was 70 and in group II, it was 65. The average weight was 66.3 Kg and 64.5 Kg in both groups respectively. BMI was 24 and 22 in both groups. Acute Physiology and Chronic Health Evaluation II was 20.4 and 20 in both groups. Hypertension was seen in 32 in group I and 36 in group II patients. Diabetes mellitus was seen in 28 and 24 respectively. Asthma was seen in 5 and 2 patients. CAD was seen in 10 and 12 patients respectively. CHF was seen in 16 and 8 patients respectively.Renal failure was seen in 8 and 9 patients. Stroke was seen in 11 and 10 patients. COPD was seen in 18 and 16 patients. Cirrhosis was seen in 9 and 12 patients. HIV was seen in 2 and 3 patients. Malignancy was seen in 22 and 17 patients respectively.First-pass success was seen in 25 in group I and 42 in group II patients. 15 patients in group I and 6 in group II required > 2 attempts. Average number of attempts was 1.6 and 1.2 times in both groups. Time to intubation was 220 and 114 seconds. Need for attending intervention was 1 in both groups. Vomiting or aspiration was seen in 5 and 7 patients respectively. Esophageal intubation was required in 5 and 0 patients. Desaturation < 80% was seen in 6 and 3 patients respectively. Systolic blood pressure < 70 was seen in 7 and 5 patients. Cormack-Lehane grade 1 or 2 was 52% and 92% respectively. The difference was significant (P< 0.05).The Glidescope video laryngoscope showed improved glottic view and first-attempt success compared with direct laryngoscopes in nonparalyzed patients. Keywords:Aspiration, Directlaryngoscope, Glidescope video laryngoscope
Authors and Affiliations
Somnath Longani, Rajiv Lakhotia
Keywords
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