Evidence map›Paper›PMID 27195693›Full record

ArticlePloS one2016

Hands-Off Time for Endotracheal Intubation during CPR Is Not Altered by the Use of the C-MAC Video-Laryngoscope Compared to Conventional Direct Laryngoscopy. A Randomized Crossover Manikin Study.

Philipp Schuerner, Bastian Grande, Tobias Piegeler, Martin Schlaepfer, Leif Saager, Matthew T Hutcherson, Donat R Spahn, Kurt Ruetzler

Open access · goldAbstract readComparative StudyEvaluation Study
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Philipp SchuernerInstitute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
Bastian GrandeInstitute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
Tobias PiegelerInstitute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
Martin SchlaepferInstitute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
Leif SaagerDepartments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, United States of America.
Matthew T HutchersonDepartments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, United States of America.
Donat R SpahnInstitute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
Kurt RuetzlerInstitute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland.ORCID 0000-0003-0467-1736
University Hospital of Zurich · CHCleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR). Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success. Therefore, we aimed to compare hands-off time and intubation success of direct laryngoscopy with videolaryngoscopy (C-MAC, Karl Storz, Tuttlingen, Germany) in a randomized, cross-over manikin study.

methodsTwenty-six anesthesia residents and twelve anesthesia consultants of the University Hospital Zurich were recruited through a voluntary enrolment. All participants performed endotracheal intubation using direct laryngoscopy and C-MAC in a random order during ongoing chest compressions. Participants were strictly advised to stop chest compression only if necessary.

resultsThe median hands-off time was 1.9 seconds in direct laryngoscopy, compared to 3 seconds in the C-MAC group. In direct laryngoscopy 39 intubation attempts were recorded, resulting in an overall first intubation attempt success rate of 97%, compared to 38 intubation attempts and 100% overall first intubation attempt success rate in the C-MAC group.

conclusionAs a conclusion, the results of our manikin-study demonstrate that video laryngoscopes might not be beneficial compared to conventional, direct laryngoscopy in easily accessible airways under CPR conditions and in experienced hands. The benefits of video laryngoscopes are of course more distinct in overcoming difficult airways, as it converts a potential "blind intubation" into an intubation under visual control.

Indexed as

AdultCardiopulmonary ResuscitationCross-Over StudiesFemaleHumansIntubation, IntratrachealLaryngoscopyMaleManikinsOperative TimeRandom AllocationVideo-Assisted Surgery

Identifiers

PMID27195693
PMCPMC4873178
OpenAlexW2397041105

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.