La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh: une étude randomisée d’équivalence sur modèles cadavériques

Gemma Malpas; George Kovacs; Sean P. Mackinnon; Orlando Hung; Sarah Phipps; J. Adam Law

doi:10.1007/s12630-020-01647-y

La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh: une étude randomisée d’équivalence sur modèles cadavériques

Gemma Malpas, George Kovacs, Sean P. Mackinnon, Orlando Hung, Sarah Phipps, J. Adam Law

Medicine

Medicine

Résultat de recherche: Article › examen par les pairs

2 Citations (Scopus)

Résumé

Purpose: Videolaryngoscopy is widely believed to give a superior view to that obtained by direct laryngoscopy. Published literature suggests this benefit extends to both hyper-angulated and Macintosh-style videolaryngoscopes. Notwithstanding, our clinical experience shows that the videoscopic view with a Macintosh-style videolaryngoscope is often no different or only marginally better than the directly sighted peroral view. Methods: A human cadaver equivalence study was performed in which four experienced laryngoscopists obtained pre-assigned laryngeal views by direct sighting using the single-use Macintosh blades of the GlideScope® Spectrum™ (GS) DirectView Macintosh (DVM) and C-MAC®S videolaryngoscopes. Blinded to the laryngoscopist’s view, two independent observers rated the videoscopic view presented on the proximal video monitor at the same time. Directly sighted and videoscopic views obtained by the laryngoscopist and video scorers were recorded on a visual analogue scale (VAS) for each device as the primary outcome measures and compared. Results: On the VAS, the C-MAC®S videoscopic view revealed only approximately 0.9% more (99% confidence interval [CI], -2.5% to 4.3%) of the laryngeal inlet than the directly sighted view. Using GS DVM, the videoscopic view revealed 6.7% (99% CI, 2.3% to 11.0%) more of the laryngeal inlet than the directly sighted view. Although results for the GS DVM achieved statistical significance, neither device gave a clinically significantly improved videoscopic view compared with the directly sighted peroral view. Conclusion: This study failed to corroborate previously published findings of a clinically significantly improved videoscopic view compared with direct peroral sighting using Macintosh-style videolaryngoscopes. Further study of this class of device is warranted in human subjects.

Titre traduit de la contribution	The videoscopic view may not be significantly superior to the directly sighted peroral view during Macintosh-style videolaryngoscopy: a randomized equivalence cadaver trial
Langue d'origine	French
Pages (de-à)	827-835
Nombre de pages	9
Journal	Canadian Journal of Anaesthesia
Volume	67
Numéro de publication	7
DOI	https://doi.org/10.1007/s12630-020-01647-y
Statut de publication	Published - juill. 1 2020

Note bibliographique

Funding Information:
Support was provided from a Nova Scotia Health Authority grant as well as departmental sources.

Funding Information:
Karl Storz Endoscopy Canada Ltd (Mississauga, ON) loaned the C-MAC?S videolaryngoscopy equipment, and Verathon Medical (Canada) ULC (Burnaby, BC) loaned the GlideScope? Spectrum videolaryngoscopy equipment used for this study. We thank members of the MARTInI group?Maritime Airway Research and Teaching Investigators? Initiative (Dr Tim Mullen, Dr Edmund Tan, Dr Kirk MacQuarrie)?for helpful discussions, Robert Sandeski from the Human Donations Program, for procurement of four clinical-grade cadavers and Liz Craig and Jason Follett from the Skills Centre for their invaluable experience and assistance during the undertaking of the study. We thank Anne Belliveau for her knowledge and assistance in the preparation of research ethics board and grant submissions. Gemma Malpas contributed to study concept and design, ethics submission, grant application, study execution, interpretation of data, manuscript preparation, and validation of contents. George Kovacs contributed to study design, study execution, interpretation of data, and manuscript preparation. Sean P. Mackinnon contributed to data extraction and analysis, study design, and manuscript preparation. Orlando Hung contributed to study design, study execution, interpretation of data, and manuscript preparation. Sarah Phipps contributed to study execution, manuscript preparation, and validation of contents. J. Adam Law contributed to study concept and design, study execution, interpretation of data, manuscript preparation, and validation of contents. None. Support was provided from a Nova Scotia Health Authority grant as well as departmental sources. This submission was handled by Dr. Gregory L. Bryson, Deputy Editor-in-Chief, Canadian Journal of Anesthesia.

Publisher Copyright:
© 2020, Canadian Anesthesiologists' Society.

ASJC Scopus Subject Areas

Anesthesiology and Pain Medicine

Accès au document

10.1007/s12630-020-01647-y

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Citer

Malpas, G., Kovacs, G., Mackinnon, S. P., Hung, O., Phipps, S., & Law, J. A. (2020). La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh: une étude randomisée d’équivalence sur modèles cadavériques. Canadian Journal of Anaesthesia, 67(7), 827-835. https://doi.org/10.1007/s12630-020-01647-y

La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh: une étude randomisée d’équivalence sur modèles cadavériques. / Malpas, Gemma; Kovacs, George; Mackinnon, Sean P. et al.
Dans: Canadian Journal of Anaesthesia, Vol. 67, N° 7, 01.07.2020, p. 827-835.

Résultat de recherche: Article › examen par les pairs

Malpas, G, Kovacs, G, Mackinnon, SP, Hung, O, Phipps, S & Law, JA 2020, 'La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh: une étude randomisée d’équivalence sur modèles cadavériques', Canadian Journal of Anaesthesia, vol. 67, n° 7, pp. 827-835. https://doi.org/10.1007/s12630-020-01647-y

Malpas G, Kovacs G, Mackinnon SP, Hung O, Phipps S, Law JA. La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh: une étude randomisée d’équivalence sur modèles cadavériques. Canadian Journal of Anaesthesia. 2020 juill. 1;67(7):827-835. doi: 10.1007/s12630-020-01647-y

Malpas, Gemma ; Kovacs, George ; Mackinnon, Sean P. et al. / La visualisation vidéoscopique pourrait ne pas être significativement supérieure à la visualisation per-orale directe pendant une vidéolaryngoscopie de style Macintosh : une étude randomisée d’équivalence sur modèles cadavériques. Dans: Canadian Journal of Anaesthesia. 2020 ; Vol. 67, N° 7. pp. 827-835.

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abstract = "Purpose: Videolaryngoscopy is widely believed to give a superior view to that obtained by direct laryngoscopy. Published literature suggests this benefit extends to both hyper-angulated and Macintosh-style videolaryngoscopes. Notwithstanding, our clinical experience shows that the videoscopic view with a Macintosh-style videolaryngoscope is often no different or only marginally better than the directly sighted peroral view. Methods: A human cadaver equivalence study was performed in which four experienced laryngoscopists obtained pre-assigned laryngeal views by direct sighting using the single-use Macintosh blades of the GlideScope{\textregistered} Spectrum{\texttrademark} (GS) DirectView Macintosh (DVM) and C-MAC{\textregistered}S videolaryngoscopes. Blinded to the laryngoscopist{\textquoteright}s view, two independent observers rated the videoscopic view presented on the proximal video monitor at the same time. Directly sighted and videoscopic views obtained by the laryngoscopist and video scorers were recorded on a visual analogue scale (VAS) for each device as the primary outcome measures and compared. Results: On the VAS, the C-MAC{\textregistered}S videoscopic view revealed only approximately 0.9% more (99% confidence interval [CI], -2.5% to 4.3%) of the laryngeal inlet than the directly sighted view. Using GS DVM, the videoscopic view revealed 6.7% (99% CI, 2.3% to 11.0%) more of the laryngeal inlet than the directly sighted view. Although results for the GS DVM achieved statistical significance, neither device gave a clinically significantly improved videoscopic view compared with the directly sighted peroral view. Conclusion: This study failed to corroborate previously published findings of a clinically significantly improved videoscopic view compared with direct peroral sighting using Macintosh-style videolaryngoscopes. Further study of this class of device is warranted in human subjects.",

author = "Gemma Malpas and George Kovacs and Mackinnon, {Sean P.} and Orlando Hung and Sarah Phipps and Law, {J. Adam}",

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