A prospective, pragmatic non-inferiority study of emergency intubation success with the single-use i-view versus standard reusable video laryngoscope.

Autor: Schauer SG; US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, USA.; Brooke Army Medical Center, JBSA, JBSA Fort Sam Houston, Texas, USA.; Uniformed Service University of the Health Sciences, Bethesda, Maryland, USA., Long BJ; Brooke Army Medical Center, JBSA, JBSA Fort Sam Houston, Texas, USA.; Uniformed Service University of the Health Sciences, Bethesda, Maryland, USA.; 59th Medical Wing, JBSA Lackland, Texas, USA., April MD; Uniformed Service University of the Health Sciences, Bethesda, Maryland, USA.; 14th Field Hospital, Fort Stewart, Georgia, USA., Resnick-Ault D; University of Colorado School of Medicine, Aurora, Colorado, USA., Mendez J; US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, USA., Arana AA; 59th Medical Wing, JBSA Lackland, Texas, USA., Bastman JJ; University of Colorado School of Medicine, Aurora, Colorado, USA., Davis WT; Brooke Army Medical Center, JBSA, JBSA Fort Sam Houston, Texas, USA.; Uniformed Service University of the Health Sciences, Bethesda, Maryland, USA.; 59th Medical Wing, JBSA Lackland, Texas, USA., Maddry JK; US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, USA.; Brooke Army Medical Center, JBSA, JBSA Fort Sam Houston, Texas, USA.; Uniformed Service University of the Health Sciences, Bethesda, Maryland, USA.; 59th Medical Wing, JBSA Lackland, Texas, USA., Ginde AA; University of Colorado School of Medicine, Aurora, Colorado, USA.; University of Colorado Center for COMBAT Research, Aurora, Colorado, USA., Bebarta VS; 59th Medical Wing, JBSA Lackland, Texas, USA.; University of Colorado School of Medicine, Aurora, Colorado, USA.; University of Colorado Center for COMBAT Research, Aurora, Colorado, USA.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2024 May; Vol. 64 Suppl 2, pp. S201-S209. Date of Electronic Publication: 2024 Mar 28.
DOI: 10.1111/trf.17790
Abstrakt: Introduction: Video laryngoscope (VL) technology improves first-pass success. The novel i-view VL device is inexpensive and disposable. We sought to determine the first-pass intubation success with the i-view VL device versus the standard reusable VL systems in routine use at each site.
Methods: We performed a prospective, pragmatic study at two major emergency departments (EDs) when VL was used. We rotated i-view versus reusable VL as the preferred device of the month based on an a priori schedule. An investigator-initiated interim analysis was performed. Our primary outcome was a first-pass success with a non-inferiority margin of 10% based on the per-protocol analysis.
Results: There were 93 intubations using the reusable VL devices and 81 intubations using the i-view. Our study was stopped early due to futility in reaching our predetermined non-inferiority margin. Operator and patient characteristics were similar between the two groups. The first-pass success rate for the i-view group was 69.1% compared to 84.3% for the reusable VL group. A non-inferiority analysis indicated that the difference (-15.1%) and corresponding 90% confidence limits (-25.3% to -5.0%) did not fall within the predetermined 10% non-inferiority margin.
Conclusions: The i-view device failed to meet our predetermined non-inferiority margin when compared to the reusable VL systems with the study stopping early due to futility. Significant crossover occurred at the discretion of the intubating operator during the i-view month.
(Published 2024. This article is a U.S. Government work and is in the public domain in the USA.)
Databáze: MEDLINE
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