Research Article

Sanyar Video Laryngoscope Improved Time and First Pass Success of Tracheal Intubation in Intensive Care Unit in Compared to Direct Laryngoscopy

Abstract

Background: Airway management and tracheal intubation in the ICU is a difficult procedure that may be concomitant with major complications. The purpose of this study was to evaluate the effect of the SANYAR ® video laryngoscope(S-VL) on laryngeal view and first Pass Success of tracheal Intubation compared with direct laryngoscopy.
Methods: This comparative, prospective clinical study was conducted on 120 adult patients in a single-center, in a surgical ICU under the supervision of an anesthesiologist in a university hospital. Difficult airway predictors, glottic view, first Pass Success of tracheal Intubation and time of intubation were evaluated with Macintosh laryngoscopy (ML) or the SANYAR® Video Laryngoscope(S-VL).
Results: Tracheal intubation was performed in 58 critically ill patients using ML and 62 patients using S-VL. According to Cormack and Lehane (C&L) grading glottic visualization was more difficult using ML (41%, C&L grade 3 and 4) compared with S-VL (13%, C&L grade 3 and 4) p<0.001. Intubation of trachea was more successful in the first attempt, in patients with at least one difficult airway predictor with a S-VL compared to ML (87% vs. 38%; P = 0.001), time of intubation was also shorter by using S-VL.
Conclusion: Among critically ill patients in the intensive care unit, who require intubation, the SANYAR video laryngoscopy improved glottis view compared to the Macintosh direct laryngoscopy and first-pass orotracheal intubation rate especially in patients with potentially difficult airways.

[1] Lavery GG, McCloskey BV. The difficult airway in adult critical care. Crit Care Med. 2008; 36:2163-73.
[2] Cavus E, Kieckhaefer J, Doerges V, Moeller T, Thee C, Wagner K. The C-MAC videolaryngoscope: first experiences with a new device for videolaryngoscopy-guided intubation. Anesth Analg. 2010; 110(2): 473-7.
[3] Noppens RR, Geimer S, Eisel N, David M, Piepho T. Endotracheal intubation using the C-MAC® video laryngoscope or the Macintosh laryngoscope: a prospective, comparative study in the ICU. Crit Care. 2012; 16(3): R103.
[4] Jaber S, De Jong A, Pelosi P, Cabrini L, Reignier J, Lascarrou JB. Videolaryngoscopy in critically ill patients. Crit Care. 2019; 23(1):1-7.
[5] Jaber S, Amraoui J, Lefrant JY, Arich C, Cohendy R, Landreau L, et al. Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Crit Care Med. 2006; 34:2355-2361
[6] Simpson GD, Ross MJ, McKeown DW, Ray DC. Tracheal intubation in the critically ill: A multi-centre national study of practice and complications. Br J Anaesth. 2012; 108:792–9
[7] Mort TC. Complications of emergency tracheal intubation: Immediate airway-related consequences: Part II. J Intensive Care Med. 2007; 22:208–15
[8] Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011; 114(1):42-8.
[9] Wilcox SR, Bittner EA, Elmer J, Seigel TA, Nguyen NT, Dhillon A, et al. Neuromuscular blocking agent administration for emergent tracheal intubation is associated with decreased prevalence of procedure-related complications. Crit Care Med. 2012; 40:1808–13
[10] Lascarrou JB, Boisrame-Helms J, Bailly A, Le Thuaut A, Kamel T, Mercier E, et al. Clinical Research in Intensive Care and Sepsis (CRICS) Group: Video laryngoscopy vs direct laryngoscopy on successful first-pass orotracheal intubation among intensive care unit patients: A randomized clinical trial. JAMA. 2017; 317:483–93
[11] Griesdale DE, Chau A, Isac G, Ayas N, Foster D, Irwin C, et al. Video-laryngoscopy versus direct laryngoscopy in critically ill patients: A pilot randomized trial. Can J Anaesth. 2012; 59:1032–9
[12] De Jong A, Molinari N, Conseil M, Coisel Y, Pouzeratte Y, Belafia F, et al. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the intensive care unit: A systematic review and meta-analysis. Intensive Care Med. 2014; 40:629–39
[13] Pieters BMA, Maas EHA, Knape JTA, van Zundert AAJ. Videolaryngoscopy vs. direct laryngoscopy use by experienced anaesthetists in patients with known difficult airways: a systematic review and meta-analysis. Anaesthesia. 2017; 72(12):1532-1541.
[14] Huang HB, Peng JM, Xu B, Liu GY, Du B. Video laryngoscopy for endotracheal intubation of critically ill adults: A systemic review and meta-analysis. Chest. 2017; 152:510–7
[15] Khajavi MR, Mohammadyousefi R, Neishaboury M, Moharari RS, Etezadi F, Pourfakhr P. Early clinical experience with a new video laryngoscope (SANYAR®) for tracheal intubation in adults: a comparison clinical study. Front Emerg Med. 2022; 6(3):e35.
Files
IssueVol 9 No 3 (2023): Summer QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/aacc.v9i3.13111
Keywords
Video laryngoscope Intensive care unit Glottic view Tracheal intubation Difficult intubation

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How to Cite
1.
Khajavi MR, Ramezani R, Sharifnia HR, Najafi A, Barkhordari K. Sanyar Video Laryngoscope Improved Time and First Pass Success of Tracheal Intubation in Intensive Care Unit in Compared to Direct Laryngoscopy. Arch Anesth & Crit Care. 2023;9(3):190-194.