Comparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial.

BACKGROUND

Previous studies have shown the utility of indirect glottis viewing videolaryngoscopes for tracheal intubation during chest compression, but the efficacy of a videolaryngoscope with tube guide has not been sufficiently validated. We compared the utility of two videolaryngoscopes, the KingVISION(®) (KingV) with or without tube guide blade and Pentax-AWS Airwayscope(®) (AWS), which contain tube guide function, during chest compressions on an adult manikin.

METHODS

Twenty-five novice doctors and 22 experienced anesthesiologists performed tracheal intubation on an adult manikin using the AWS and KingV with or without chest compressions. The KingV trials were performed either with a tube guide 'channeled blade' (KingV-Guided) or without, using a 'standard blade' (KingV-Guideless).

RESULTS

In the KingV-Guideless trial, all novice doctors successfully secured the airway without chest compressions but seven failed with chest compressions (p < 0.05), while no experienced doctors failed without chest compression and two did during chest compression. In the AWS and KingV-Guided trials, all participants succeeded both with and without chest compressions performed by both novice doctors and experienced anesthesiologists. Intubation time was lengthened significantly by chest compressions in the KingV-Guideless trial (p < 0.05), but not in the AWS or KingV-Guided trials performed by both novice doctors and experienced anesthesiologists. The intubation time for KingV-Guided during chest compression was significantly smaller by experienced anesthesiologists compared to by novice doctors.

CONCLUSIONS

These findings suggest that the AWS and KingV-Guided devices are more effective than the KingV-Guideless for airway management with chest compressions in adult simulations, especially performed by novice doctors. The tube guide function may contribute to successful airway management during chest compression by the added videolaryngoscopy function.