Hyperangulated blades or direct epiglottis lifting to optimize glottis visualization in difficult Macintosh videolaryngoscopy: a non-inferiority analysis of a prospective observational study

• DOI: 10.3389/fmed.2023.1292056
• Publication Date: 2023-11-30T09:02:51Z
• Authors: Viktor A. Wünsch; Vera Köhl; Philipp Breitfeld; Marcus Bauer; Phillip B. Sasu; Hannah K. Siebert; Andre Dankert; Maria Stark; Christian Zöllner; Martin Petzoldt
• Keywords: Epiglottis

It is unknown if direct epiglottis lifting or conversion to hyperangulated videolaryngoscopes, even with may optimize glottis visualization in situations where Macintosh videolaryngoscopy turns out be more difficult than expected. This study aims determine the percentage of glottic opening (POGO) improvement achieved by non-inferior one accomplished a these situations.One optimization techniques were applied 129 cases this secondary analysis prospective observational study. Stored videos reviewed at least three independent observers who assessed POGO and six view grades. A linear mixed regression model fitted. Estimated marginal means used analyze differences between maneuvers.In study, 163 maneuvers (77 lifting, 57 29 videolaryngoscope) exclusively sequentially. Vocal cords not visible 91.5% videolaryngoscopy, 24.7% 36.8% 0% videolaryngoscope. Conversion improved (mean + 49.7%; 95% confidence interval [CI] 41.4 58.0; p < 0.001) 2.2 grades; CI 1.9 2.5; 0.001). 43.7%; 34.1 53.3; 1.6 2.2; The difference is: mean 6.0%; -6.5-18.5%; hence non-inferiority was confirmed.When turned difficult, exposure gathered videolaryngoscopy. combination both yields best result.ClinicalTrials.gov, NCT03950934.