Bacher Viktor, Németh Márton, Rendeki Szilárd, Tornai Balázs, Rozanovic Martin, Pankaczi Andrea, Oláh János, Farkas József, Chikhi Melánia, Schlégl Ádám, Maróti Péter, Nagy Bálint
Department of Anesthesiology and Intensive Medicine, Medical School, University of Pecs, H-7624 Pecs, Hungary.
Medical Skills Education and Innovation Centre, Medical School, University of Pécs, H-7624 Pecs, Hungary.
J Clin Med. 2024 May 30;13(11):3213. doi: 10.3390/jcm13113213.
Endotracheal intubation (ETI) is a cornerstone of airway management. The gold standard device for ETI is still the direct laryngoscope (DL). However, video laryngoscopes (VLs) are now also widely available and have several proven advantages. The VL technique has been included in the major airway management guidelines. During the COVID-19 pandemic, supply chain disruption has raised demand for 3D-printed medical equipment, including 3D-printed VLs. However, studies on performance are only sparsely available; thus, we aimed to compare 3D-printed VLs to the DL and other VLs made with conventional manufacturing technology. Forty-eight medical students were recruited to serve as novice users. Following brief, standardized training, students executed ETI with the DL, the King Vision (KV), the VividTrac (VT), the AirAngel Blade (AAB), and a custom-made 3D-printed VL (3DVL) on the Laerdal airway management trainer in normal and difficult airway scenarios. We evaluated the time to and proportion of successful intubation, the best view of the glottis, esophageal intubation, dental trauma, and user satisfaction. The KV and VT are proved to be superior ( < 0.05) to the DL in both scenarios. The 3DVL's performance was similar ( > 0.05) or significantly better than that of the DL and mainly non-inferior ( > 0.05) compared to the KV and VT in both scenarios. Regardless of the scenario, the AAB proved to be inferior ( < 0.05) even to the DL in the majority of the variables. The differences between the devices were more pronounced in the difficult airway scenario. The user satisfaction scores were in concordance with the aforementioned performance of the scopes. Based upon our results, we cannot recommend the AAB over the DL, KV, or VT. However, as the 3DVL showed, 3D printing indeed can provide useful or even superior VLs, but prior to clinical use, meticulous evaluation might be recommended.
气管插管（ETI）是气道管理的基石。ETI的金标准设备仍然是直接喉镜（DL）。然而，视频喉镜（VLs）现在也广泛可用且具有多项已被证实的优势。VL技术已被纳入主要的气道管理指南。在新冠疫情期间，供应链中断增加了对3D打印医疗设备的需求，包括3D打印的VLs。然而，关于其性能的研究却很少；因此，我们旨在将3D打印的VLs与DL以及其他采用传统制造技术制造的VLs进行比较。招募了48名医学生作为新手用户。经过简短的标准化培训后，学生们在Laerdal气道管理训练器上，在正常和困难气道情况下，使用DL、King Vision（KV）、VividTrac（VT）、AirAngel Blade（AAB）以及定制的3D打印VL（3DVL）进行ETI操作。我们评估了插管成功的时间和比例、声门的最佳视野、食管插管情况、牙齿损伤以及用户满意度。在两种情况下，KV和VT均被证明优于（<0.05）DL。在两种情况下，3DVL的性能与DL相似（>0.05）或明显优于DL，并且与KV和VT相比主要不劣于（>0.05）。无论在何种情况下，在大多数变量方面，AAB甚至被证明劣于（<0.05）DL。在困难气道情况下，不同设备之间的差异更为明显。用户满意度得分与上述喉镜的性能一致。基于我们的结果，我们不推荐AAB优于DL、KV或VT。然而，正如3DVL所显示的，3D打印确实可以提供有用甚至更优的VLs，但在临床使用之前，可能建议进行细致评估。
