Videolaryngoscopy in the Critically Ill

NCT00911755 | Completed

• 1 other identifier: H08-02826
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Endotracheal Intubation (ETI) is done to place a plastic tube in a patient's trachea (windpipe) to assist with breathing. Patients admitted to the intensive care unit (ICU) are the sickest of patients and the majority of them require this life saving procedure. A critical illness can be sudden and ETI required urgently. The doctors performing ETI in these situations may not be experts at ETI. Studies have shown that if it takes more than one attempt to get the tube in the right position patients can have severe complications such as: decrease level of oxygen in the body, decrease blood pressure, and cardiac arrest. These complications can be life threatening and increase the length of time spent in an ICU. To perform ETI the doctor uses a metal tool called a laryngoscope that is placed through the patient's mouth to open the throat and then pass the tube into the trachea. The type of procedure that has been used for many years is called Direct Laryngoscopy (DL) which means that the doctor looks through the mouth directly into the throat. Newer technology is available and can be used at VGH called Video Laryngoscopy (VL). With VL there is a camera on the end of the laryngoscope and a video image is displayed on a monitor making it easier to see the entrance to the trachea. VL is not available for all cases at VGH and is unavailable in many other hospitals. In this study we will compare DL to VL. Patients will be randomly placed in one of two groups: first attempt at ETI done with DL or first attempt of ETI done with DL. Patients will only be considered eligible for this study if the doctor feels that either DL or VL would be appropriate for the patient. In this pilot study we hope show that conducting a larger study would be feasible. If a larger study were to show that VL decreases complications and shortens length of ICU stay we would be able to recommend this procedure for all ETI at VGH as well as other hospitals where it currently may not be available.

Conditions

Endotracheal Intubation

Keywords

Laryngoscopy; Glidescope

Outcome Measures

Primary Outcomes (1)

• risk of failure on the first attempt of endotracheal intubation

Secondary Outcomes (3)

• number of attempts at laryngoscopy

• time to successful intubation

• number of complications

Study Arms (2)

Laryngoscopy

OTHER

Procedure: Endotracheal Intubation

Videolaryngoscopy

OTHER

Procedure: Endotracheal Intubation

Interventions

Endotracheal Intubation PROCEDURE

This study is comparing 2 currently accepted methods of endotracheal intubation: laryngoscopy and videolaryngoscopy

Laryngoscopy

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Any patient over the age of 16 years, requiring urgent (within 30 minutes) endotracheal intubation, who are attended to by the critical care team will be eligible for enrolment

You may not qualify if:

• Patients who require intubation within 5 minutes or have contraindications to either of the study intubation technique will be ineligible
• cardiac arrest
• cardiopulmonary instability (oxygen saturation \<90% or systolic blood pressure \< 80 mmHg despite oxygen or fluid therapy)
• any clinical deterioration while awaiting randomization
• known prior or anticipated difficult intubation
• need for awake intubation (defined by sedation, topicalization and avoidance of neuromuscular blockade)
• pregnancy
• cervical spine precautions
• any patient deemed inappropriate for enrolment by the attending physician

Sponsors & Collaborators

• University of British Columbia: lead

Study Sites (1)

Vancouver General Hospital, Intensive Care Unit

Vancouver, British Columbia, V5Z 1M9, Canada

Location

Related Publications (1)

• Griesdale DE, Chau A, Isac G, Ayas N, Foster D, Irwin C, Choi P; Canadian Critical Care Trials Group. Video-laryngoscopy versus direct laryngoscopy in critically ill patients: a pilot randomized trial. Can J Anaesth. 2012 Nov;59(11):1032-9. doi: 10.1007/s12630-012-9775-8. Epub 2012 Aug 30.

  PMID: 22932944 DERIVED

MeSH Terms

Interventions

Intubation, Intratracheal

Intervention Hierarchy (Ancestors)

Airway Management; Therapeutics; Intubation; Investigative Techniques

Study Officials

• Donald EG Griesdale, MD

  University of British Columbia

  PRINCIPAL INVESTIGATOR

• P Choi

  University of British Columbia

  STUDY DIRECTOR

• G Isac

  University of British Columbia

  STUDY DIRECTOR

• V Dhingra

  University of British Columbia

  STUDY DIRECTOR

• A Chau

  University of British Columbia

  STUDY DIRECTOR

• C Menon

  University of British Columbia

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 29, 2009
• First Posted: June 2, 2009
• Study Start: July 1, 2009
• Primary Completion: August 1, 2012
• Study Completion: August 1, 2012
• Last Updated: February 19, 2014

Record last verified: 2014-02

Locations

CA (1)