Analysis of the 3D printing open-source video laryngoscope for orotracheal intubation

Isadora Juliana Opolski, Samuel da Rosa Sousa, Claudio Luciano Franck

Cite

Opolski IJ, Sousa SdR, Franck CL. Analysis of the 3D printing open-source video laryngoscope for orotracheal intubation. J Mech Vent 2023; 4(1):10-17.

Abstract

Introduction

Orotracheal intubation becomes a challenge for the anesthesiologist when the glottis is not visualized with direct laryngoscopy. Videolaryngoscopes emerged as an alternative in these situations, but the costs of these devices restrict their popularization. Doubts remain as to whether low-cost devices would be safe and effective, such as the 3D printing Open-Source video laryngoscope.

Aim

To analyze the 3D printing Open-Source video laryngoscope for orotracheal intubation for general anesthesia in its the rate of achieving, glottis visualization time, intubation time and its correlation with the order of execution.

Methods

Clinical, prospective, analytical study of a questionnaire carried out after the procedure. Statistical analysis was performed using Spearman’s correlation, Kruskal-Wallis test, and chi-square test.

Results

There was a total of 64 uncomplicated orotracheal intubation procedures with an overall success rate of 93.8%. Mean time for viewing the glottis (16.4”), mean times of endotracheal intubation with Mallampati I (26.5”), ll (33.7”), lll (57.3”), lV (38.5”) were obtained with no statistical significance (P 0.170) and overall mean time of orotracheal intubation (36.4”) with a moderate negative correlation of –0.36 across the orotracheal intubation execution order.

Conclusion

In the analysis of endotracheal intubation with the 3D printing Open-Source video laryngoscope a high success rate was demonstrated without any complications. The time to obtain endotracheal intubation tends to reduce with subsequent experiences and learning, but it is more than twice the time required to adequately visualize the glottis and the Mallampati classification was not a relevant time predictor.

Keywords

Orotracheal intubation; Videolaryngoscopy, Airway management

References

1. Saracoglu KT, Eti Z, Gogus FY. Airtraq optical laryngoscope: advantages and disadvantages. Middle East J Anaesthesiol 2013; 22(2):135-141.
2. Miller RA. A new laryngoscope. Anesthesiology 1941; 2(3):317-320.
https://doi.org/10.1097/00000542-194105000-00008
3. Macintosh RR. New inventions: a new laryngoscope. Lancet 1943; 1(6):205.
https://doi.org/10.1016/S0140-6736(00)89390-3
4. Heidegger T, Gerig HJ, Ulrich B, et al. Validation of a simple algorithm for tracheal intubation: daily practice is the key to success in emergencies-an analysis of 13248 intubations. Anesth Analg 2001; 92(2):517-522.
https://doi.org/10.1213/00000539-200102000-00044
5. Adnet F, Racine SX, Borron SW, et al. A survey of tracheal intubation difficulty in the operating room: a prospective observational study. Acta Anaesthesiol Scand. 2001; 45(3):327-332.
https://doi.org/10.1034/j.1399-6576.2001.045003327.x
PMid:11207469
6. Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice Guidelines for Management of the Difficult Airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2013; 118(2):251-270.
https://doi.org/10.1097/ALN.0b013e31827773b2
PMid:23364566
7. Lee A, Fan LT, Gin T, et al. A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth Analg 2006; 102(6):1867-1878.
https://doi.org/10.1213/01.ane.0000217211.12232.55
PMid:16717341
8. Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984; 39(11):1105-1111.
https://doi.org/10.1111/j.1365-2044.1984.tb08932.x
9. Berkow LC, Morey TE, Urdaneta F. The technology of video laryngoscopy. Anesthesia and Analgesia2018; 126(5):1527-1534.
https://doi.org/10.1213/ANE.0000000000002490
PMid:28961559
10. Pott LM, Murray WB. Review of video laryngoscopy and rigid fiberoptic laryngoscopy. Curr Opin Anaesthesiol 2008; 21:750-758.
https://doi.org/10.1097/ACO.0b013e3283184227
PMid:18997526
11. Kaplan MB, Ward D, Hagberg CA, et al. Seeing is believing: the importance of video laryngoscopy in teaching and in managing the difficult airway. Surg Endosc 2006; 20 (Suppl 2): S479-S483.
https://doi.org/10.1007/s00464-006-0038-z
PMid:16544062
12. Amundson AW, Weingarten TN. Traumatic GlideScope® video laryngoscopy resulting in perforation of the soft palate. Can J Anesth/J Can Anesth 2013; 60:210-211.
https://doi.org/10.1007/s12630-012-9824-3
PMid:23180060
13. Angadi SP, Frerk C. Videolaryngoscopy and Cormack and Lehane grading. Anaesthesia 2011; 66(7):628-629.
https://doi.org/10.1111/j.1365-2044.2011.06777.x
PMid:21682715
14. Guimarães HP, Schuber DU, Rodrigues RdR, et al. Recommendations for Orotracheal Intubation in patients with COVID-19 Version N. 3/2020. Updated 4/10/2020. Available at: http://abramede.com.br/wp-content/uploads/2020/04/Recomendacoes-IOT-FINAL-REVISAO-100420.pdf. Accessed on: 01/10/2022.
15. Hoshijima H, Mihara T, Maruyama K, et al. McGrath videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis. J Clin Anesth 2018; 46:25-32.
https://doi.org/10.1016/j.jclinane.2017.12.030
PMid:29414609
16. Lu Y, Jiang H, Zhu YS. Airtraq laryngoscope versus conventional Macintosh laryngoscope: a systematic review and meta-analysis. Anaesthesia 2011; 66(12),1160-1167.
https://doi.org/10.1111/j.1365-2044.2011.06871.x
PMid:21883130
17. Erdivanli B, Sen A, Batcik S, et al. Comparison between the King Vision video laryngoscope and the Macintosh laryngoscope: a prospective randomized controlled clinical trial. Braz J Anesthesiology 2018; 68(5) 499-506..
https://doi.org/10.1016/j.bjane.2018.04.008
PMCid:PMC9391737
18. Savoldelli G, Schiffer E, Abegg C, et al. Learning curves of the GlideScope, the McGrath and the Airtraq laryngoscopes: a manikin study. Eur J Anaesthesiol 2009; 26(7):554-558.
https://doi.org/10.1097/EJA.0b013e3283269ff4
PMid:19522050
19. Glick DB, Cooper RM, Ovassapian A, et al. Role of rigid video laryngoscopy. In: Glick DB, Cooper RM, Ovassapian A, editors. The difficult airway: an atlas of tools and techniques for clinical management. New York: Springer 2013: 77-111.
https://doi.org/10.1007/978-0-387-92849-4
20. Adnet F, Borron SW, Racine SX, et al. The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology 1997: 87(6):1290-1297.
https://doi.org/10.1097/00000542-199712000-00005
PMid:9416711