Predictors of Difficult Videolaryngoscopy

Determination of Factors Leading to Failure of Videolaryngoscopy

The primary goal of this study was to identify parameters affecting the failure of videolaryngoscopy in clinical practice; secondly, the incidence of videolaryngoscopy use and the most frequently used patient groups.

Study Overview

• Status: Completed
• Conditions: Videolaryngoscopy
• Intervention / Treatment: Device: Videolaryngoscopy

Detailed Description

Videolaryngoscopy is widely used in the management of patients with presumed difficult airway. It offers an improved laryngeal view compared with direct laryngoscopy and increases the likelihood of successful intubation in patients for whom direct laryngoscopy is anticipated to be difficult. It is among the most frequently preferred difficult airway devices due to its ease of use, portability and direct laryngoscopy resemblance. The use of videolaryngoscopy has been shown to improve intubation success in many cases associated with difficult intubation, such as morbid obesity, pregnancy, limitation of cervical motility, and poor mouth opening.

• Study Type: Observational
• Enrollment (Actual): 1159

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey, 06100
    • Hacettepe University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 day to 95 years (ADULT, OLDER_ADULT, CHILD)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients who will undergo surgery under general anesthesia will be followed in Hacettepe University Hospital's operating room. All patients aged 0-95 years who used videolaryngoscopy will be included in the study.

Description

Inclusion Criteria:

• All patients who used videolaryngoscopy for intubation

Exclusion Criteria:

-

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Videolaryngoscopy patients; The patients who were attempted to be intubated with videolaryngoscopy	Device: Videolaryngoscopy; Videolaryngoscopy device type

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intubation success	The success of intubation attempt with videolaryngoscopy (yes/no)	15 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The reason of videolaryngoscopy	Why videolaryngoscopy is preferred instead of standard direct laryngoscopy	15 minutes
The type of videolaryngoscopy blade	acute angled/macintosh/miller blade	15 minutes
The rescue technique	The rescue technique used for patients who could not be intubated with videolaryngoscopy	30 minutes
Factors affecting success of videolaryngoscopy	Mallampati score, thyromental distance, neck movements, upper lip bite test, mouth opening	30 minutes

Collaborators and Investigators

• Sponsor: Hacettepe University
• Investigators: Study Director: Aysun Ankay Yilbas, MD, Turkish Society of Anesthesiology and Reanimation; Principal Investigator: Sevilay Kivrakoglu, MD, Turkish Society of Anesthesiology and Reanimation

Publications and helpful links

General Publications

• Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984 Nov;39(11):1105-11.
• Aziz MF, Bayman EO, Van Tienderen MM, Todd MM; StAGE Investigator Group; Brambrink AM. Predictors of difficult videolaryngoscopy with GlideScope(R) or C-MAC(R) with D-blade: secondary analysis from a large comparative videolaryngoscopy trial. Br J Anaesth. 2016 Jul;117(1):118-23. doi: 10.1093/bja/aew128.
• Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985 Jul;32(4):429-34. doi: 10.1007/BF03011357.
• el-Ganzouri AR, McCarthy RJ, Tuman KJ, Tanck EN, Ivankovich AD. Preoperative airway assessment: predictive value of a multivariate risk index. Anesth Analg. 1996 Jun;82(6):1197-204. doi: 10.1097/00000539-199606000-00017.
• Aziz MF, Healy D, Kheterpal S, Fu RF, Dillman D, Brambrink AM. Routine clinical practice effectiveness of the Glidescope in difficult airway management: an analysis of 2,004 Glidescope intubations, complications, and failures from two institutions. Anesthesiology. 2011 Jan;114(1):34-41. doi: 10.1097/ALN.0b013e3182023eb7.
• Toshniwal G, McKelvey GM, Wang H. STOP-Bang and prediction of difficult airway in obese patients. J Clin Anesth. 2014 Aug;26(5):360-7. doi: 10.1016/j.jclinane.2014.01.010. Epub 2014 Jul 28.
• Nakao K, Komasawa N, Kusaka Y, Minami T. Rapid-Sequence Intubation in the Left-Lateral Tilt Position in a Pregnant Woman with Premature Placental Abruption Utilizing a Videolaryngoscope. AJP Rep. 2015 Apr;5(1):e30-2. doi: 10.1055/s-0034-1544109. Epub 2015 Feb 25.
• Kleine-Brueggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler LG. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth. 2016 May;116(5):670-9. doi: 10.1093/bja/aew058.
• Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth. 1988 Aug;61(2):211-6. doi: 10.1093/bja/61.2.211.
• Nath G, Sekar M. Predicting difficult intubation--a comprehensive scoring system. Anaesth Intensive Care. 1997 Oct;25(5):482-6. doi: 10.1177/0310057X9702500505.
• Benumof JL. Management of the difficult adult airway. With special emphasis on awake tracheal intubation. Anesthesiology. 1991 Dec;75(6):1087-110. doi: 10.1097/00000542-199112000-00021. Erratum In: Anesthesiology 1993 Jan;78(1):224.
• Williamson JA, Webb RK, Szekely S, Gillies ER, Dreosti AV. The Australian Incident Monitoring Study. Difficult intubation: an analysis of 2000 incident reports. Anaesth Intensive Care. 1993 Oct;21(5):602-7. doi: 10.1177/0310057X9302100518.
• Nichol HC, Zuck D. Difficult laryngoscopy--the "anterior" larynx and the atlanto-occipital gap. Br J Anaesth. 1983 Feb;55(2):141-4. doi: 10.1093/bja/55.2.141.
• Oates JD, Macleod AD, Oates PD, Pearsall FJ, Howie JC, Murray GD. Comparison of two methods for predicting difficult intubation. Br J Anaesth. 1991 Mar;66(3):305-9. doi: 10.1093/bja/66.3.305.
• Charters P, Perera S, Horton WA. Visibility of pharyngeal structures as a predictor of difficult intubation. Anaesthesia. 1987 Oct;42(10):1115. doi: 10.1111/j.1365-2044.1987.tb05182.x. No abstract available.

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 17, 2018
• Primary Completion (ACTUAL): March 1, 2020
• Study Completion (ACTUAL): March 1, 2020

Study Registration Dates

• First Submitted: April 5, 2018
• First Submitted That Met QC Criteria: April 5, 2018
• First Posted (ACTUAL): April 12, 2018

Study Record Updates

• Last Update Posted (ACTUAL): April 12, 2022
• Last Update Submitted That Met QC Criteria: April 5, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: Videolaryngoscopy

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No