Video Classification of Intubation in Spain (VCI) (VCI)

Video Classification of Intubation in Spain

Use of VCI in Spain

Study Overview

• Status: Recruiting
• Conditions: Difficult Intubation
• Intervention / Treatment: Other: Compare VCI scale

Detailed Description

The clinical importance of airway management has gained relevance over the last decade in most scientific societies with the objective of improving the standard of care.

The WHO has focused its guidelines on "Safe Surgery," aiming to encompass all methods that predict and recognize the risk of difficult airway management or aspiration, which must be applied by the surgical team. To this end, it has created and implemented a surgical safety checklist that can be useful in reducing the risk of unidentified difficulties.

The same suggestion has been included in the Helsinki Declaration on Patient Safety in Anesthesiology, endorsed by most European entities in cooperation with the European Society of Anesthesiology (ESA), the European Board of Anesthesiology (EBA-UEMS), the World Federation of Societies of Anesthesiology (WFA), and the European Patients' Federation (EPF). The protocol for difficult airway management and the implications of the Helsinki Declaration were published in 2013 in the Spanish Journal of Anesthesiology and Resuscitation.

Airway management today is perhaps the field that most concerns anesthesiologists, as decisions and actions must be taken quickly and effectively when facing a potential difficult airway (DA). Failure to do so would result in significant morbidity and mortality for patients.

The incidence of difficulty in orotracheal intubation (OTI) ranges between 1.5% and 13%. Most errors in airway management are due to ignorance and the low reliability of traditional protocols, algorithms, and combinations of detection tools to identify a potentially difficult airway.

This field is constantly evolving, and in the last 20 years, we have witnessed the emergence of a large number of devices: Supraglottic Devices (SGDs) or Extraglottic Devices (EGDs) in the past decade, and Optical Devices (videolaryngoscopes) in this last decade.

The existence of a large number of new devices in this field implies a deep understanding of these, both theoretically and practically, during scheduled surgery. Once this is achieved, practitioners should know how to use them appropriately in DA situations.

Since 1993, when the American Society of Anesthesiology (ASA) published its "Recommendations for Difficult Airway Management," many countries and scientific societies have created their protocols, guidelines, and algorithms that we must know and apply, always adapting them to our environment and the available devices.

In Spain, since the mid-1990s, DA training programs for specialist doctors have been launched, gradually expanding and covering all personnel involved in airway management. Today, training in this field has become part of the knowledge and skills acquisition in various specialties, notably Anesthesiology and Resuscitation.

The phrase "prevention is better than cure" is an intuitive, acceptable, and politically correct concept. This is applicable in our field since, although there are not many patient factors we can modify (anatomy is intrinsic), there are possible modifications in our actions that can determine the success or failure in airway management.

Currently, there is no universally accepted method for describing tracheal intubation via videolaryngoscopy. It is important that this information is communicated and documented accurately to plan airway management procedures for the patient, thereby improving care safety. The Intubation Classification Scale or Video Intubation Classification (VCI) score has been proposed to succinctly describe the key practical elements of tracheal intubation via videolaryngoscopy in the order they are performed. This classification consists of three sections: the first describes the type of blade used (Macintosh or hyperangulated), the second describes the POGO (Percentage of Glottic Opening) at the time of intubation, and finally, the ease/difficulty or impossibility of inserting the tube through the glottis.

• Study Type: Observational
• Enrollment (Estimated): 1500

Contacts and Locations

• Study Contact: Name: Miguel Angel Fernandez-Vaquero, MD, PhD; Phone Number: 7633 0034913531920; Email: mfvaquero@unav.es

Study Locations

• Spain
  • Madrid
    • Madrid, Madrid, Spain, 28027
      • Recruiting
      • Clínica Universidad de Navarra
      • Contact: Miguel Angel Fernandez Vaquero, MD; Phone Number: 7633 +34913531920; Email: mfvaquero@unav.es
    • Madrid, Madrid, Spain, 28027
      • Recruiting
      • Miguel Angel Fernandez-Vaquero
      • Contact: Miguel Angel Fernandez-Vaquero, MD, PhD; Phone Number: 7633 0034913531920; Email: mfvaquero@unav.es

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Patients from any geographical area of the Iberian Peninsula who decide to undergo scheduled surgery at our hospital during a period of 6 months (2024-25).

Description

Inclusion Criteria:

• Patients from any geographical area of the Iberian Peninsula who decide to undergo scheduled surgery at our hospital during a period of 6 months (2024-25).

Exclusion Criteria:

• Age <18

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients; Patients from any geographical area of the Iberian Peninsula who decide to undergo scheduled surgery at our hospital during a period of 6 months (2024-25).	Other: Compare VCI scale; Compare VCI scale

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
VCI scale from observer (1-4)	VCI scale from observer(1-4)	2 minutes
VCI scale from intubator (1-4)	VCI scale from intubator (1-4)	2 minutes

Collaborators and Investigators

• Sponsor: Clinica Universidad de Navarra, Universidad de Navarra

Publications and helpful links

General Publications

• Fernandez-Vaquero MA, Charco-Mora P, Sastre-Rincon JA, Gomez-Rios MA, Cardenas-Gomez J, Martinez-Hurtado E, Aracil-Escoda N, Vallejo-Tarrat A, Thion-Soriano I, Peral-Sanchez D, Castaneda-Pascual M, Rodriguez Del Rio M, de Luis-Cabezon N, Gonzalez-Garcia J, Acosta-Martinez J, Gonzalez-Santos S, Onrubia-Fuertes X, Martinez-Gonzalez E, Roca de Togores-Lopez A, Gonzalez-Mendibil I, Banos-Maestro A, Mariscal-Flores M, Lluch-Oltra A, Emazabel-Yunta I, Rodriguez-Sanabria DM, Alvarez-Avello JM, Melendez Salinas DA, Lopez-Correa T, Sanchez-Merchante M, Bermudez-Lopez M, Martinez-Gallego E, Martinez-Segovia MC, Martin-Andres AB, Molero-Diez Y, Garcia-Aroca MA, Tapia-Salinas B, Puig-Bernabe J, Piano A, Hernandez-Fernandez G, Mingote-Llado A, Garcia-Fernandez J, Mata-Estevez J, Reviriego-Agudo L, Ruiz-Cordoba G, Moya-Moradas J, Marques-Asin FJ, Santacana MV; VCISpain Trial Investigators Group. VCISpain: protocol for a prospective multicenter observational study to validate a standardized classification tool for tracheal intubation using videolaryngoscopy. Braz J Anesthesiol. 2025 Sep-Oct;75(5):844653. doi: 10.1016/j.bjane.2025.844653. Epub 2025 Jun 18.

Study record dates

Study Major Dates

• Study Start (Actual): July 26, 2024
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: July 26, 2024
• First Submitted That Met QC Criteria: July 31, 2024
• First Posted (Actual): August 5, 2024

Study Record Updates

• Last Update Posted (Actual): January 6, 2026
• Last Update Submitted That Met QC Criteria: January 5, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Videolaryngoscopy; Airway; Difficult intubation; Score
• Other Study ID Numbers: 2022.079

Drug and device information, study documents

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