open access

Vol 5, No 1 (2020)
Research paper
Published online: 2020-02-12
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VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

Katarzyna Karczewska, Jacek Smereka, Marek Dabrowski, Adam Lisiecki, Dawid Golik, Dominika Dunder, Szymon Bialka, Lukasz Szarpak, Kurt Ruetzler
DOI: 10.5603/DEMJ.a2020.0011
·
Disaster Emerg Med J 2020;5(1):30-40.

open access

Vol 5, No 1 (2020)
ORIGINAL ARTICLES
Published online: 2020-02-12

Abstract

INTRODUCTION: Endotracheal intubation is one of the basic procedures performed in emergency medicine in patients with respiratory insufficiency, inability to maintain airway patency, or apnoea. Rapid performance of the procedure and implementation of ventilation are among the basic principles of rescue procedures. The primary aim of the present systematic review and meta-analysis was to compare the VivaSight SL tube-mounted camera with a standard endotracheal single-lumen tube and direct laryngoscope for endotracheal intubation based on randomised controlled trials of simulation or cadaver trials. The analysis was based on the hypothesis that the use of videolaryngoscopy based on VivaSight SL tube increases the effectiveness of endotracheal intubation, reducing the risk of ineffectiveness of the first intubation attempt and the risk of adverse events, such as dental compression. 

MATERIAL AND METHODS: We searched the MEDLINE, EMBASE, Scopus, Cochrane, and Google Scholar databases for randomised, controlled trials and observational studies from 1985 until October 2019, without language restrictions. Grey literature, clinicaltrials.gov, and reference lists of articles were hand searched. We conducted a meta-analysis with random-effects models to evaluate time to intubation, first-pass success rates, overall success rates, dental compression, and glottic view. 

RESULTS: The search located 12 eligible studies. The time of intubation using VivaSight was significantly shorter than that of direct laryngoscopy (MD = –11.29 [–13.10, –9.49], p < 0.001). The efficacy of the first intubation attempt was higher for VivaSight than for DL (96.0% vs. 61.7%; RR = 1.62 [1.40, 1.88], p < 0.001). The meta-analysis showed that the total efficacy of VivaSight intubation compared to direct laryngoscopy was statistically significantly higher (100% vs. 88.9%, RR = 1.11 [1.02, 1.20]; p = 0.02). The glottis visibility assessed as Cormack-Lehane grade I or II was better in VivaSight intubation compared to direct laryngoscopy (100% vs. 90.9%, RR = 1.05 [0.99, 1.12]; p = 0.08). 

CONCLUSIONS: Our meta-analysis suggests that the VivaSight SL provided better glottic visualisation and shorter intubation time, with improved success rates during different simulated intubation scenarios.

Abstract

INTRODUCTION: Endotracheal intubation is one of the basic procedures performed in emergency medicine in patients with respiratory insufficiency, inability to maintain airway patency, or apnoea. Rapid performance of the procedure and implementation of ventilation are among the basic principles of rescue procedures. The primary aim of the present systematic review and meta-analysis was to compare the VivaSight SL tube-mounted camera with a standard endotracheal single-lumen tube and direct laryngoscope for endotracheal intubation based on randomised controlled trials of simulation or cadaver trials. The analysis was based on the hypothesis that the use of videolaryngoscopy based on VivaSight SL tube increases the effectiveness of endotracheal intubation, reducing the risk of ineffectiveness of the first intubation attempt and the risk of adverse events, such as dental compression. 

MATERIAL AND METHODS: We searched the MEDLINE, EMBASE, Scopus, Cochrane, and Google Scholar databases for randomised, controlled trials and observational studies from 1985 until October 2019, without language restrictions. Grey literature, clinicaltrials.gov, and reference lists of articles were hand searched. We conducted a meta-analysis with random-effects models to evaluate time to intubation, first-pass success rates, overall success rates, dental compression, and glottic view. 

RESULTS: The search located 12 eligible studies. The time of intubation using VivaSight was significantly shorter than that of direct laryngoscopy (MD = –11.29 [–13.10, –9.49], p < 0.001). The efficacy of the first intubation attempt was higher for VivaSight than for DL (96.0% vs. 61.7%; RR = 1.62 [1.40, 1.88], p < 0.001). The meta-analysis showed that the total efficacy of VivaSight intubation compared to direct laryngoscopy was statistically significantly higher (100% vs. 88.9%, RR = 1.11 [1.02, 1.20]; p = 0.02). The glottis visibility assessed as Cormack-Lehane grade I or II was better in VivaSight intubation compared to direct laryngoscopy (100% vs. 90.9%, RR = 1.05 [0.99, 1.12]; p = 0.08). 

CONCLUSIONS: Our meta-analysis suggests that the VivaSight SL provided better glottic visualisation and shorter intubation time, with improved success rates during different simulated intubation scenarios.

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Keywords

VivaSight; ETView; tube-mounted camera; endotracheal intubation; medical simulation; meta-analyses

About this article
Title

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 5, No 1 (2020)

Article type

Research paper

Pages

30-40

Published online

2020-02-12

DOI

10.5603/DEMJ.a2020.0011

Bibliographic record

Disaster Emerg Med J 2020;5(1):30-40.

Keywords

VivaSight
ETView
tube-mounted camera
endotracheal intubation
medical simulation
meta-analyses

Authors

Katarzyna Karczewska
Jacek Smereka
Marek Dabrowski
Adam Lisiecki
Dawid Golik
Dominika Dunder
Szymon Bialka
Lukasz Szarpak
Kurt Ruetzler

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