Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway
| dc.contributor.advisor | Hofmeyr, Ross | |
| dc.contributor.author | De Villiers, Christiaan Tertius | |
| dc.date.accessioned | 2022-01-20T09:15:24Z | |
| dc.date.available | 2022-01-20T09:15:24Z | |
| dc.date.issued | 2021 | |
| dc.date.updated | 2022-01-18T11:13:30Z | |
| dc.description.abstract | Background: Video laryngoscopy has directly impacted airway management, with numerous studies demonstrating its utility in clinical management of anatomically difficult airways. However, availability of video laryngoscopes in all clinical areas has been limited by cost. We used smartphone technology, miniature cameras and three-dimensional printing to design and create an innovative low-cost hyperangulated video laryngoscope. This has the potential to make the technique more widely available. Objectives: The aim of this study was to determine if time to intubation with the novel device was clinically equivalent to an existing gold-standard video laryngoscope (Storz CMAC with Dörges blade). Methods: We conducted a randomised, controlled, cross-over equivalence study with 100 skilled practitioners who had previous video laryngoscopy experience. Participants received instruction on the new device, and adequate opportunity to practice. Intubations were then performed in a randomised order on a mannikin simulating a difficult airway. Video recordings of each intubation were analysed by two independent investigators to determine time to intubation. A mean difference in intubation time of less than 10 seconds was determined a priori to denote clinical equivalence. Results: Mean difference in intubation time between the devices was 4.92 seconds, (two one-sided test 95%CI: 2.34 – 7.49 seconds). The innovative low-cost VL was thus clinically equivalent to the industry standard in a simulated difficult airway. Further testing in vivo in a clinical environment is needed. Conclusion: The results of this study show that a low-cost disposable hyperangulated video laryngoscope is clinically equivalent to the industry standard in a simulated difficult airway. In the context of the current global pandemic, video laryngoscopy has been advised in nearly all airway guidelines. Access to a low-cost VL which does not require reprocessing may be of great value. | |
| dc.identifier.apacitation | De Villiers, C. T. (2021). <i>Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/35535 | en_ZA |
| dc.identifier.chicagocitation | De Villiers, Christiaan Tertius. <i>"Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021. http://hdl.handle.net/11427/35535 | en_ZA |
| dc.identifier.citation | De Villiers, C.T. 2021. Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/35535 | en_ZA |
| dc.identifier.ris | TY - Master Thesis AU - De Villiers, Christiaan Tertius AB - Background: Video laryngoscopy has directly impacted airway management, with numerous studies demonstrating its utility in clinical management of anatomically difficult airways. However, availability of video laryngoscopes in all clinical areas has been limited by cost. We used smartphone technology, miniature cameras and three-dimensional printing to design and create an innovative low-cost hyperangulated video laryngoscope. This has the potential to make the technique more widely available. Objectives: The aim of this study was to determine if time to intubation with the novel device was clinically equivalent to an existing gold-standard video laryngoscope (Storz CMAC with Dörges blade). Methods: We conducted a randomised, controlled, cross-over equivalence study with 100 skilled practitioners who had previous video laryngoscopy experience. Participants received instruction on the new device, and adequate opportunity to practice. Intubations were then performed in a randomised order on a mannikin simulating a difficult airway. Video recordings of each intubation were analysed by two independent investigators to determine time to intubation. A mean difference in intubation time of less than 10 seconds was determined a priori to denote clinical equivalence. Results: Mean difference in intubation time between the devices was 4.92 seconds, (two one-sided test 95%CI: 2.34 – 7.49 seconds). The innovative low-cost VL was thus clinically equivalent to the industry standard in a simulated difficult airway. Further testing in vivo in a clinical environment is needed. Conclusion: The results of this study show that a low-cost disposable hyperangulated video laryngoscope is clinically equivalent to the industry standard in a simulated difficult airway. In the context of the current global pandemic, video laryngoscopy has been advised in nearly all airway guidelines. Access to a low-cost VL which does not require reprocessing may be of great value. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Anaesthesia and KW - Perioperative Medicine LK - https://open.uct.ac.za PY - 2021 T1 - Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway TI - Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway UR - http://hdl.handle.net/11427/35535 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/35535 | |
| dc.identifier.vancouvercitation | De Villiers CT. Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/35535 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Anaesthesia and Perioperative Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Anaesthesia and | |
| dc.subject | Perioperative Medicine | |
| dc.title | Innovation in low-cost video-laryngoscopy: Intubator V1-Indirect compared with Storz C-MAC in a simulated difficult airway | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MMed |