Using King Vision video laryngoscope with a channeled blade prolongs time for tracheal intubation in different training levels, compared to non-channeled blade

Marc Kriege, Christian Alflen, Ruediger R Noppens, Marc Kriege, Christian Alflen, Ruediger R Noppens

Abstract

Purpose: It is generally accepted that using a video laryngoscope is associated with an improved visualization of the glottis. However, correctly placing the endotracheal tube might be challenging. Channeled video laryngoscopic blades have an endotracheal tube already pre-loaded, allowing to advance the tube once the glottis is visualized. We hypothesized that use of a channel blade with pre-loaded endotracheal tube results in a faster intubation, compared to a curved Macintosh blade video laryngoscope.

Methods: After ethical approval and informed consent, patients were randomized to receive endotracheal Intubation with either the King Vision® video laryngoscope with curved blade (control) or channeled blade (channeled). Success rate, evaluation of the glottis view (percentage of glottic opening (POGO), Cormack&Lehane (C&L)) and intubating time were evaluated.

Results: Over a two-month period, a total of 46 patients (control n = 23; channeled n = 23) were examined. The first attempt success rates were comparable between groups (control 100% (23/23) vs. channeled 96% (22/23); p = 0.31). Overall intubation time was significantly shorter with control (median 40 sec; IQR [24-58]), compared to channeled (59 sec [40-74]; p = 0.03). There were no differences in glottis visualization between groups.

Conclusion: Compared with the King Vision channeled blade, time for tracheal intubation was shorter with the control group using a non-channeled blade. First attempt success and visualization of the glottis were comparable. These data do not support the hypothesis that a channeled blade is superior to a curved video laryngoscopic blade without tube guidance.

Trial registration: ClinicalTrials.gov NCT02344030.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. CONSORT flow diagram.
Fig 1. CONSORT flow diagram.
Fig 2. King Vision with non-channeled and…
Fig 2. King Vision with non-channeled and channeled blades.
Fig 3. Time sequnce of intubation.
Fig 3. Time sequnce of intubation.
Time steps of (A) differences in Time to view (B) differences in Time for place the TT (C) differences in overall intubation time; Data are given in Kaplan-Meier curve and median.
Fig 4. Insertion technique and view.
Fig 4. Insertion technique and view.
(A) typical Macintosh-blade technique: blade tip placed in the vallecula (B) view from the monitor display using the channeled blade (★: epiglottic; ✪: ET leave the channeled; ✹: right arytenoid).

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