CClinicalTrials.gg
CompletedNCT03341507Updated Apr 9, 2021Results posted

Tracheal Intubation With the Rigid Tube for Laryngoscopy- a New Method

An interventional study of classical laryngoscopy and rigid tube for laryngoscopy in Intubation;Difficult, sponsored by Iuliu Hatieganu University of Medicine and Pharmacy. Completed at 1 site in Romania. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2021-04-09.

Sponsored by Iuliu Hatieganu University of Medicine and Pharmacy · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
64
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This study evaluates the efficiency of the rigid tube for laryngoscopy for tracheal intubation in patients with presumed difficult airway and compare the classical laryngoscopy and this method in matter of glottis visualisation and tracheal intubation.

Read the detailed description

The rigid tube for laryngoscopy is a 15 to 30 cm long metallic tube with a bevel end and a diameter of 0.5-2.0 cm , an instrument used to inspect the larynx and surrounding areas. It resembles a rigid bronchoscope but it is shorter. When in use, it has to be attached to a light source.

The hypothesis of the study stands that the rigid tube for laryngoscopy could be more efficient in tracheal intubation for difficult airway patients when the classical intubation with a curved blade laryngoscope is unsatisfactory.

The retromolar approach in both sides together with bougie(intubating tube introducer) intubation is the technique of intubation used in this study.

02

Conditions studied

  • Intubation;Difficult

Keywords

  • laryngoscopy
  • retromolar
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • patients with criteria of anatomically difficult airway from SARI (The Simplified Airway Risk Index Scale) parameters analysis
  • patients with airway pathology which predicted difficult intubation: tumors or cervical masses, previous radiotherapy or surgery

Exclusion criteria

Exclusion Criteria:

  • stridor or marked laryngeal or tracheal stenosis, vocal cords polyps
  • emergency surgery, decompensated cardiac or pulmonary disease
  • grade 1 and 2a at classical laryngoscopy after Cormack- Lehane Classification
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
64 participants (actual)

Study arms

  • Experimental
    laryngoscopy and tracheal intubation

    Tracheal intubation with the rigid tube for laryngoscopy for patients with difficult airway. Prior the use of rigid tube for laryngoscopy, a classical laryngoscopy with a McIntosh laryngoscope will be performed.

    Device: classical laryngoscopy · Device: rigid tube for laryngoscopy

Interventions

  • Deviceclassical laryngoscopy

    the laryngoscopy with the McIntosh laryngoscope performed prior the use of rigid tube and the Cormack-Lehane glottis visualisation noted.

    Also known as: laryngoscopy with McIntosh curved blade laryngoscope

  • Devicerigid tube for laryngoscopy

    the view of glottis achieved with the rigid tub for laryngoscopy and tracheal intubation with an elastic gum bougie performed

05

What researchers measure

Primary outcomes

  1. Time to Tracheal Intubation With the Rigid Tube

    the time from starting to use the rigid tube for laryngoscopy until the airway was secured.

    Time frame: 120 seconds

Secondary outcomes

  1. Complications During Intubation With Rigid Tube

    complications noticed during the use of rigid tube - hypoxia defined as oxygen saturation less than 80%

    Time frame: 5 minutes

  2. Late Complications of Intubation With Rigid Tube

    complications noticed following the use of rigid tube - sore throat, upper lip injury.

    Time frame: 3 days

Other outcomes

  1. Conventional Laryngoscopy With the Curved Blade Laryngoscope ( MacIntosh) and Tracheal Intubation With the Curved Blade Laryngoscope if the Cormack-Lehane Glottis View Grade is 1 or 2a.

    Conventional laryngoscopy was performed with a MacIntosh curved blade laryngoscope, and the Cormack-Lehane grade of glottic visualization was registered. If the grade of glottis view according to Cormack-Lehane classification was less than 2b the patient was intubated using the curved blade laryngoscope. If the grade of glottic view was equal or more than 2b the tracheal intubation was carried further with the rigid tube.

    Time frame: 60 seconds

06

Results

Posted Mar 8, 2021
Limitations and caveats
This is an observational single-center study that relies on personal perception and the skill of a limited number of investigators. To master the rigid tube a period of training and regular use is needed. The major disadvantage of the rigid tube for laryngoscopy is the reduced visual field which can be improved by increasing the tube diameter. The bougie intubation carries the risk of vocal cords injury and impossibility of advancing the tracheal tube if the respiratory space is too narrow.

Participant flow

Participant flow — Overall Study
MilestoneLaryngoscopy and Tracheal Intubation
Started64
Completed30
Not completed34
Withdrew: Cormack-lehane grade 1 or 2a during conventional laryngoscopy34

Outcome measures

PrimaryTime to Tracheal Intubation With the Rigid Tube

the time from starting to use the rigid tube for laryngoscopy until the airway was secured.

Time frame:
120 seconds
Reported as:
Median · seconds
Time to Tracheal Intubation With the Rigid Tube
secondsLaryngoscopy and Tracheal Intubation
Time to Tracheal Intubation With the Rigid Tube50.5 (38 to 67)
SecondaryComplications During Intubation With Rigid Tube

complications noticed during the use of rigid tube - hypoxia defined as oxygen saturation less than 80%

Time frame:
5 minutes
Reported as:
Count of participants · Participants
Complications During Intubation With Rigid Tube
ParticipantsLaryngoscopy and Tracheal Intubation
Complications During Intubation With Rigid Tube1
SecondaryLate Complications of Intubation With Rigid Tube

complications noticed following the use of rigid tube - sore throat, upper lip injury.

Time frame:
3 days
Reported as:
Count of participants · Participants
Late Complications of Intubation With Rigid Tube
ParticipantsLaryngoscopy and Tracheal Intubation
Late Complications of Intubation With Rigid Tube8
Other pre-specifiedConventional Laryngoscopy With the Curved Blade Laryngoscope ( MacIntosh) and Tracheal Intubation With the Curved Blade Laryngoscope if the Cormack-Lehane Glottis View Grade is 1 or 2a.

Conventional laryngoscopy was performed with a MacIntosh curved blade laryngoscope, and the Cormack-Lehane grade of glottic visualization was registered. If the grade of glottis view according to Cormack-Lehane classification was less than 2b the patient was intubated using the curved blade laryngoscope. If the grade of glottic view was equal or more than 2b the tracheal intubation was carried further with the rigid tube.

Time frame:
60 seconds
Reported as:
Count of participants · Participants
Conventional Laryngoscopy With the Curved Blade Laryngoscope ( MacIntosh) and Tracheal Intubation With the Curved Blade Laryngoscope if the Cormack-Lehane Glottis View Grade is 1 or 2a.
ParticipantsLaryngoscopy and Tracheal Intubation
Conventional Laryngoscopy With the Curved Blade Laryngoscope ( MacIntosh) and Tracheal Intubation With the Curved Blade Laryngoscope if the Cormack-Lehane Glottis View Grade is 1 or 2a.34

Adverse events

Collected over complications noticed during and following the use of rigid tube : time frame-3 days. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Laryngoscopy and Tracheal Intubation0/64 (0%)1/64 (1.6%)5/64 (7.8%)
Most frequent serious events
Most frequent serious events
EventLaryngoscopy and Tracheal Intubation
hypoxiaRespiratory, thoracic and mediastinal disorders1/64
Most frequent other events
Most frequent other events
EventLaryngoscopy and Tracheal Intubation
sore throatRespiratory, thoracic and mediastinal disorders5/30
upper lip injurySkin and subcutaneous tissue disorders3/30

Baseline characteristics

Patients with difficult airway criteria according to SARI score schedulled for ear nose and throat (ENT) surgery under general anesthesia and tracheal intubation.

Age, Continuous
Age, Continuous(years)Tracheal Intubation With the Rigid Tube for Laryngoscopy
Mean47.8 ± 10.5
Sex: Female, Male
Sex: Female, Male(Participants)Tracheal Intubation With the Rigid Tube for Laryngoscopy
Female8
Male56
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Tracheal Intubation With the Rigid Tube for Laryngoscopy
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White64
More than one race0
Unknown or Not Reported0
The Simplified Airway Risk Index Scale(SARI) score ≥ 5.
The Simplified Airway Risk Index Scale(SARI) score ≥ 5.(units on a scale)Tracheal Intubation With the Rigid Tube for Laryngoscopy
Median6 (5 to 7)
07

Study locations

1 site
  • Cluj County Emergency Hospital- ENT Clinic
    Cluj Napoca, Cluj 400006, Romania
08

References and documents

Publications

  • Norskov AK, Rosenstock CV, Wetterslev J, Lundstrom LH. Incidence of unanticipated difficult airway using an objective airway score versus a standard clinical airway assessment: the DIFFICAIR trial - trial protocol for a cluster randomized clinical trial. Trials. 2013 Oct 23;14:347. doi: 10.1186/1745-6215-14-347. PubMed 24152537 ↗
  • Rutter JM, Murphy PG. Cormack and Lehane revisited. Anaesthesia. 1997 Sep;52(9):927. No abstract available. PubMed 9349093 ↗

Study documents

  • Protocol and statistical analysis plan · May 11, 2017

Documents are hosted by the registry — open the source record to download them.

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Registry details

Key details

Study ID
NCT03341507
Lead sponsor
Iuliu Hatieganu University of Medicine and Pharmacy
Responsible party
Marchis Ioan Florin (Principal Investigator, Iuliu Hatieganu University of Medicine and Pharmacy) — Principal investigator
First posted
Nov 14, 2017
Start date
Feb 1, 2017
Primary completion
Dec 1, 2019
Completion
Dec 7, 2019
Results posted
Mar 8, 2021
Last update
Apr 9, 2021

Study contacts

Ioan Florin Marchis, Md
principal investigator · University of Medicine and Pharmacy Iuliu Hatieganu- Cluj Napoca, Romania

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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