COMPARISON OF ENDOTRACHEAL INTUBATION WITH THE AIRTRAQ AVANT® AND THE MACINTOSH LARYNGOSCOPE DURING INTERMITTENT OR CONTINUOUS CHEST COMPRESSION: A RANDOMIZED, CROSSOVER STUDY IN MANIKINS

Abstract

BACKGROUND: Endotracheal intubation (ETI) currently is the gold standard of securing an airway during cardio- pulmonary resuscitation.

PURPOSE: The aim of this study was to evaluate ETI with the Airtraq Avant (ATQ) compared to a conventional Macintosh laryngoscope when used by paramedics during resuscitation with and without chest compression (CC).

METHODS: Forty-seven paramedics were recruited into a randomized crossover trial in which each performed ETI with ATQ and MAC in both scenarios. The primary endpoint was time to successful intubation, while secondary endpoints included intubation success, laryngoscopic view on the glottis, dental compression, and rating of the given device.

RESULTS: In the manikin scenario without CC, nearly all participants performed ETI successfully both with ATQ and MAC, with a shorter intubation time using MAC 20.5 s [IQR, 17.5–22], compared to ATQ 24.5 s [IQR, 22–27.5] (p = 0.002). However, in the scenarios with continuous CC, the results with ATQ were signi cantly better than with MAC for all analyzed variables (success of rst attempt at ETI, time to intubation (TTI) [MAC 27 s [IQR, 25.5–34.5], compared to ATQ 25.7s [IQR, 21.5–28.5] (p=0.011), Cormack-Lehane grade and rating). The success rate in scenarios with CC was 82.9% vs. 91.5% for MAC Laryngoscope vs. ATQ, respectively (p=0.021).

CONCLUSIONS: The ATQ provides bene ts in terms of ETI success rate, TTI, and glottic view when compared to MAC during ETI with continuous CC.