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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Bibliographic Details
Published in:PloS one 2023-02, Vol.18 (2), p.e0281186-e0281186
Main Authors: Steffen, Richard, Hischier, Simon, Roten, Fredy-Michel, Huber, Markus, Knapp, Jürgen
Format: Article
Language:English
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
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Summary: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
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0281186