Journal article
Predictors of difficult videolaryngoscopy with GlideScope® or C-MAC® with D-blade: secondary analysis from a large comparative videolaryngoscopy trial
British journal of anaesthesia : BJA, Vol.117(1), pp.118-123
07/2016
DOI: 10.1093/bja/aew128
PMCID: PMC4913400
PMID: 27317711
Abstract
Tracheal intubation using acute-angle videolaryngoscopy achieves high success rates, but is not without difficulty. We aimed to determine predictors of 'difficult videolaryngoscopy'.
We performed a secondary analysis of a data set (n=1100) gathered from a multicentre prospective randomized controlled trial of patients for whom difficult direct laryngoscopy was anticipated and who were intubated with one of two videolaryngoscopy devices (GlideScope(®) or C-MAC(®) with D-blade). 'Difficult videolaryngoscopy' was defined as 'first intubation time >60 s' or 'first attempt intubation failure'. A multivariate logistic regression model along with stepwise model selection techniques was performed to determine independent predictors of difficult videolaryngoscopy.
Of 1100 patients, 301 were identified as difficult videolaryngoscopies. By univariate analysis, head and neck position, provider, type of surgery, and mouth opening were associated with difficult videolaryngoscopy (P<0.05). According to the multivariate logistic regression model, characteristics associated with greater risk for difficult videolaryngoscopy were as follows: (i) head and neck position of 'supine sniffing' vs 'supine neutral' {odds ratio (OR) 1.63, 95% confidence interval (CI) [1.14, 2.31]}; (ii) undergoing otolaryngologic or cardiac surgery vs general surgery (OR 1.89, 95% CI [1.19, 3.01] and OR 6.13, 95% CI [1.85, 20.37], respectively); (iii) intubation performed by an attending anaesthestist vs a supervised resident (OR 1.83, 95% CI [1.14, 2.92]); and (iv) small mouth opening (OR 1.18, 95% CI [1.02, 1.36]).
This secondary analysis of an existing data set indicates four covariates associated with difficult acute-angle videolaryngoscopy, of which patient position and provider level are modifiable.
Details
- Title: Subtitle
- Predictors of difficult videolaryngoscopy with GlideScope® or C-MAC® with D-blade: secondary analysis from a large comparative videolaryngoscopy trial
- Creators
- M F Aziz - Oregon Health & Science University, Mail Code KPV 5A, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA azizm@ohsu.eduE O Bayman - The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USAM M Van Tienderen - Oregon Health & Science University, Mail Code KPV 5A, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USAM M Todd - The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USAA M Brambrink - Oregon Health & Science University, Mail Code KPV 5A, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USAStAGE Investigator Group
- Resource Type
- Journal article
- Publication Details
- British journal of anaesthesia : BJA, Vol.117(1), pp.118-123
- Publisher
- England
- DOI
- 10.1093/bja/aew128
- PMID
- 27317711
- PMCID
- PMC4913400
- ISSN
- 0007-0912
- eISSN
- 1471-6771
- Language
- English
- Date published
- 07/2016
- Academic Unit
- Biostatistics; Anesthesia
- Record Identifier
- 9983997314902771
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