Airway management during ongoing chest compressions-direct vs. video laryngoscopy. A randomised manikin study
Tracheal intubation is used for advanced airway management during cardiac arrest, particularly when basic airway techniques cannot ensure adequate ventilation. However, minimizing interruptions of chest compressions is of high priority. Video laryngoscopy has been shown to improve the first-pass suc...
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| creator | Steffen, Richard Hischier, Simon Roten, Fredy-Michel Huber, Markus Knapp, Jürgen |
| description | Tracheal intubation is used for advanced airway management during cardiac arrest, particularly when basic airway techniques cannot ensure adequate ventilation. However, minimizing interruptions of chest compressions is of high priority. Video laryngoscopy has been shown to improve the first-pass success rate for tracheal intubation in emergency airway management. We aimed to compare first-pass success rate and time to successful intubation during uninterrupted chest compression using video laryngoscopy and direct laryngoscopy.
A total of 28 anaesthetists and 28 anaesthesia nurses with varied clinical and anaesthesiological experience were recruited for the study. All participants performed a tracheal intubation on a manikin simulator during ongoing chest compressions by a mechanical resuscitation device. Stratified randomisation (physicians/nurses) was performed, with one group using direct laryngoscopy and the other using video laryngoscopy.
First-pass success rate was 100% (95% CI: 87.9% - 100.0%) in the video laryngoscopy group and 67.8% (95% CI: 49.3% - 82.1%) in the direct laryngoscopy group [difference: 32.2% (95% CI: 17.8% - 50.8%), p |
| doi_str_mv | 10.1371/journal.pone.0281186 |
| format | Article |
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A total of 28 anaesthetists and 28 anaesthesia nurses with varied clinical and anaesthesiological experience were recruited for the study. All participants performed a tracheal intubation on a manikin simulator during ongoing chest compressions by a mechanical resuscitation device. Stratified randomisation (physicians/nurses) was performed, with one group using direct laryngoscopy and the other using video laryngoscopy.
First-pass success rate was 100% (95% CI: 87.9% - 100.0%) in the video laryngoscopy group and 67.8% (95% CI: 49.3% - 82.1%) in the direct laryngoscopy group [difference: 32.2% (95% CI: 17.8% - 50.8%), p<0.001]. The median time for intubation was 27.5 seconds (IQR: 21.8-31.0 seconds) in the video laryngoscopy group and 30.0 seconds (IQR: 26.5-36.5 seconds) in the direct laryngoscopy group (p = 0.019).
This manikin study on tracheal intubation during ongoing chest compressions demonstrates that video laryngoscopy had a higher first-pass success rate and shorter time to successful intubation compared to direct laryngoscopy. Experience in airway management and professional group were not significant predictors. A clinical randomized controlled trial appears worthwhile.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0281186</identifier><identifier>PMID: 36757942</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Airway (Medicine) ; Airway management ; Airway Management - methods ; Analysis ; Anesthesia ; Anesthesiology ; Biology and Life Sciences ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - methods ; Chest ; Compression ; Confidence intervals ; CPR ; Evaluation ; Humans ; Intubation ; Intubation, Intratracheal - methods ; Laryngoscopes ; Laryngoscopy ; Laryngoscopy - methods ; Manikins ; Medical instruments ; Medical personnel ; Medicine and Health Sciences ; Nurses ; People and Places ; Randomization ; Regression analysis ; Research and Analysis Methods ; Respiratory tract ; Simulation methods ; Ventilation ; Video compression</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0281186-e0281186</ispartof><rights>Copyright: © 2023 Steffen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Steffen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Steffen et al 2023 Steffen et al</rights><rights>2023 Steffen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-ef89ac2befaf0f895ce7f57928641d34d1884213f6a2728abd68ced99b7393063</citedby><cites>FETCH-LOGICAL-c692t-ef89ac2befaf0f895ce7f57928641d34d1884213f6a2728abd68ced99b7393063</cites><orcidid>0000-0002-3144-3731 ; 0000-0002-6686-4456</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910718/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910718/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36757942$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Tsima, Billy Morara</contributor><creatorcontrib>Steffen, Richard</creatorcontrib><creatorcontrib>Hischier, Simon</creatorcontrib><creatorcontrib>Roten, Fredy-Michel</creatorcontrib><creatorcontrib>Huber, Markus</creatorcontrib><creatorcontrib>Knapp, Jürgen</creatorcontrib><title>Airway management during ongoing chest compressions-direct vs. video laryngoscopy. A randomised manikin study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Tracheal intubation is used for advanced airway management during cardiac arrest, particularly when basic airway techniques cannot ensure adequate ventilation. However, minimizing interruptions of chest compressions is of high priority. Video laryngoscopy has been shown to improve the first-pass success rate for tracheal intubation in emergency airway management. We aimed to compare first-pass success rate and time to successful intubation during uninterrupted chest compression using video laryngoscopy and direct laryngoscopy.
A total of 28 anaesthetists and 28 anaesthesia nurses with varied clinical and anaesthesiological experience were recruited for the study. All participants performed a tracheal intubation on a manikin simulator during ongoing chest compressions by a mechanical resuscitation device. Stratified randomisation (physicians/nurses) was performed, with one group using direct laryngoscopy and the other using video laryngoscopy.
First-pass success rate was 100% (95% CI: 87.9% - 100.0%) in the video laryngoscopy group and 67.8% (95% CI: 49.3% - 82.1%) in the direct laryngoscopy group [difference: 32.2% (95% CI: 17.8% - 50.8%), p<0.001]. The median time for intubation was 27.5 seconds (IQR: 21.8-31.0 seconds) in the video laryngoscopy group and 30.0 seconds (IQR: 26.5-36.5 seconds) in the direct laryngoscopy group (p = 0.019).
This manikin study on tracheal intubation during ongoing chest compressions demonstrates that video laryngoscopy had a higher first-pass success rate and shorter time to successful intubation compared to direct laryngoscopy. Experience in airway management and professional group were not significant predictors. A clinical randomized controlled trial appears worthwhile.</description><subject>Airway (Medicine)</subject><subject>Airway management</subject><subject>Airway Management - methods</subject><subject>Analysis</subject><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Biology and Life Sciences</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - methods</subject><subject>Chest</subject><subject>Compression</subject><subject>Confidence intervals</subject><subject>CPR</subject><subject>Evaluation</subject><subject>Humans</subject><subject>Intubation</subject><subject>Intubation, Intratracheal - methods</subject><subject>Laryngoscopes</subject><subject>Laryngoscopy</subject><subject>Laryngoscopy - methods</subject><subject>Manikins</subject><subject>Medical instruments</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Nurses</subject><subject>People and Places</subject><subject>Randomization</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Respiratory tract</subject><subject>Simulation methods</subject><subject>Ventilation</subject><subject>Video compression</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12P1CAUhhujcdfVf2C0iYnRixkLtBRuTCYbPybZZBO_bgmF0w5jC7PQjs6_lzrdzdTsheECAs95D-eFkyTPUbZEpETvtm7wVrbLnbOwzDBDiNEHyTniBC8ozsjDk_VZ8iSEbZYVhFH6ODkjtCxKnuPzpFsZ_0se0k5a2UAHtk_14I1tUmcbN85qA6FPlet2HkIwzoaFNh5Un-7DMt0bDS5tpT9EPCi3OyzTVeql1a4zAfQobH4am4Z-0IenyaNatgGeTfNF8v3jh2-XnxdX15_Wl6urhaIc9wuoGZcKV1DLOovrQkFZxwtjRnOkSa4RYzlGpKYSl5jJSlOmQHNelYSTjJKL5OVRd9e6ICangsBlmTNccIYjsT4S2smt2HnTxRKEk0b83XC-EdL3RrUgyooqRThHGcicAq-wLApUk2hgThAftd5P2YaqA62iiV62M9H5iTUb0bi9GDVLxKLAm0nAu5sh2i2idwraVlpww3RvzhgeK3v1D3p_dRPVyFiAsbWLedUoKlYliSYSzPJILe-h4tDQGRW_VW3i_izg7SwgMj387hs5hCDWX7_8P3v9Y86-PmE3INt-E1w79ONvm4P5EVTeheChvjMZZWLsils3xNgVYuqKGPbi9IHugm7bgPwBcd4Ibg</recordid><startdate>20230209</startdate><enddate>20230209</enddate><creator>Steffen, Richard</creator><creator>Hischier, Simon</creator><creator>Roten, Fredy-Michel</creator><creator>Huber, Markus</creator><creator>Knapp, Jürgen</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3144-3731</orcidid><orcidid>https://orcid.org/0000-0002-6686-4456</orcidid></search><sort><creationdate>20230209</creationdate><title>Airway management during ongoing chest compressions-direct vs. video laryngoscopy. 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A randomised manikin study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-09</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0281186</spage><epage>e0281186</epage><pages>e0281186-e0281186</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Tracheal intubation is used for advanced airway management during cardiac arrest, particularly when basic airway techniques cannot ensure adequate ventilation. However, minimizing interruptions of chest compressions is of high priority. Video laryngoscopy has been shown to improve the first-pass success rate for tracheal intubation in emergency airway management. We aimed to compare first-pass success rate and time to successful intubation during uninterrupted chest compression using video laryngoscopy and direct laryngoscopy.
A total of 28 anaesthetists and 28 anaesthesia nurses with varied clinical and anaesthesiological experience were recruited for the study. All participants performed a tracheal intubation on a manikin simulator during ongoing chest compressions by a mechanical resuscitation device. Stratified randomisation (physicians/nurses) was performed, with one group using direct laryngoscopy and the other using video laryngoscopy.
First-pass success rate was 100% (95% CI: 87.9% - 100.0%) in the video laryngoscopy group and 67.8% (95% CI: 49.3% - 82.1%) in the direct laryngoscopy group [difference: 32.2% (95% CI: 17.8% - 50.8%), p<0.001]. The median time for intubation was 27.5 seconds (IQR: 21.8-31.0 seconds) in the video laryngoscopy group and 30.0 seconds (IQR: 26.5-36.5 seconds) in the direct laryngoscopy group (p = 0.019).
This manikin study on tracheal intubation during ongoing chest compressions demonstrates that video laryngoscopy had a higher first-pass success rate and shorter time to successful intubation compared to direct laryngoscopy. Experience in airway management and professional group were not significant predictors. A clinical randomized controlled trial appears worthwhile.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36757942</pmid><doi>10.1371/journal.pone.0281186</doi><tpages>e0281186</tpages><orcidid>https://orcid.org/0000-0002-3144-3731</orcidid><orcidid>https://orcid.org/0000-0002-6686-4456</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Airway (Medicine) Airway management Airway Management - methods Analysis Anesthesia Anesthesiology Biology and Life Sciences Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - methods Chest Compression Confidence intervals CPR Evaluation Humans Intubation Intubation, Intratracheal - methods Laryngoscopes Laryngoscopy Laryngoscopy - methods Manikins Medical instruments Medical personnel Medicine and Health Sciences Nurses People and Places Randomization Regression analysis Research and Analysis Methods Respiratory tract Simulation methods Ventilation Video compression |
| title | Airway management during ongoing chest compressions-direct vs. video laryngoscopy. A randomised manikin study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T14%3A39%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Airway%20management%20during%20ongoing%20chest%20compressions-direct%20vs.%20video%20laryngoscopy.%20A%20randomised%20manikin%20study&rft.jtitle=PloS%20one&rft.au=Steffen,%20Richard&rft.date=2023-02-09&rft.volume=18&rft.issue=2&rft.spage=e0281186&rft.epage=e0281186&rft.pages=e0281186-e0281186&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0281186&rft_dat=%3Cgale_plos_%3EA736413284%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2774825982&rft_id=info:pmid/36757942&rft_galeid=A736413284&rft_doaj_id=oai_doaj_org_article_7b6cc39910ea46e9b2a551f379443192&rfr_iscdi=true |