Boviatsis Vasileios I, Triantopoulos Alexios, Pouliakis Abraham, Boviatsi Dimitra, Xanthos Theodoros, Iacovidou Nicoletta, Ekmektzoglou Konstantinos
Department of Anesthesiology, General Hospital of Patras, Patras, GRC.
Department of Pathology, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2025 Jul 23;17(7):e88566. doi: 10.7759/cureus.88566. eCollection 2025 Jul.
The technique of visualizing the vocal cords during direct laryngoscopy has made the Macintosh laryngoscope (HEINE Optotechnik GmbH & Co. KG, Gilching, Germany) the optimal choice for endotracheal intubation since the middle of the 20th century. On the other hand, the use of full personal protective equipment during the SARS-CoV-2 pandemic impeded the successful completion of medical procedures, such as endotracheal intubation during cardiopulmonary resuscitation in patients infected with COVID-19. These circumstances necessitated the development of a new type of laryngoscope, the Vie Scope (Adroit Surgical LLC, Oklahoma City, OK, USA).
A single-blind, randomized, prospective, superiority clinical trial was conducted. Patients with an expected easy airway were enrolled and allocated in a 1:1 ratio to either the Vie Scope or Macintosh. The first-attempt intubation success rate and the required intubation time were defined as primary outcome measures, while the overall intubation success rate and glottis visualization, as classified by the Cormack-Lehane scale, were considered secondary outcomes.
This study included 264 patients. The required intubation time was shorter with the Macintosh than with the Vie Scope (median (interquartile range (IQR)): 7.80 (1.50) and mean (standard deviation (SD)): 8.08 (5.34) seconds vs. median (IQR): 15.65 (3.90) and mean (SD): 16.65 (5.02) seconds, difference in means: 8.60 seconds, 95% CI: -∞ to 7.9, p<0.0001). The first-attempt intubation success rate was estimated at 100% (132/132) and 90.15% (119/132) using the Macintosh and Vie Scope, respectively (relative risk: 0.90 (=1/1.1, 95% CI: 0.85-0.95), p=0.0002). Furthermore, a higher overall intubation success rate was noted with the Macintosh (132/132, 100%) than with the Vie Scope (124/132, 93.94%), p=0.0041. No statistically significant difference was detected between the laryngoscopes regarding the degree of the glottis visualization (p=0.7895).
The first-attempt and overall intubation success rates, as well as the required intubation time with the Macintosh, were superior to those with the Vie Scope when used for the establishment of anticipated easy airways, without a statistically significant difference in glottis visualization grade.
自20世纪中叶以来，直接喉镜检查时可视化声带的技术使麦金托什喉镜（德国吉尔兴市海涅光学技术有限公司）成为气管插管的最佳选择。另一方面，在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行期间使用全套个人防护设备阻碍了医疗程序的顺利完成，例如对感染2019冠状病毒病（COVID-19）患者进行心肺复苏时的气管插管。这些情况促使一种新型喉镜——Vie Scope喉镜（美国俄克拉何马城阿卓特外科有限责任公司）的研发。
进行了一项单盲、随机、前瞻性、优效性临床试验。纳入预期气道情况简单的患者，并按1:1的比例分配至Vie Scope喉镜组或麦金托什喉镜组。首次尝试插管成功率和所需插管时间被定义为主要结局指标，而总体插管成功率和根据科马克-莱汉内分级标准分类的声门可视化情况被视为次要结局。
本研究纳入了264例患者。使用麦金托什喉镜时所需的插管时间比Vie Scope喉镜短（中位数（四分位间距（IQR））：7.80（1.50）秒，均值（标准差（SD））：8.08（5.34）秒，而使用Vie Scope喉镜时中位数（IQR）：15.65（3.90）秒，均值（SD）：16.65（5.02）秒，均值差异：8.60秒，95%置信区间：-∞至7.9，p<0.0001）。使用麦金托什喉镜和Vie Scope喉镜时首次尝试插管成功率分别估计为100%（132/132）和90.15%（119/132）（相对风险：0.90（=1/1.1，95%置信区间：0.85 - 0.95），p = 0.0002）。此外，麦金托什喉镜的总体插管成功率（132/132，100%）高于Vie Scope喉镜（124/132，93.94%），p = 0.0041。两种喉镜在声门可视化程度方面未检测到统计学显著差异（p = 0.7895）。
当用于建立预期的简单气道时，麦金托什喉镜的首次尝试和总体插管成功率以及所需插管时间均优于Vie Scope喉镜，且在声门可视化分级方面无统计学显著差异。
