Success of Pediatric Anesthesiologists in Learning to Use Videolaryngoscopes

Completed

• Conditions: Tracheal Intubation Morbidity
• Interventions: Procedure: timed intubation

• Registration Number: NCT01215422
• Lead Sponsor: University of Alberta

Brief Summary

There are two new instruments on the market that anesthesiologists use when putting a breathing tube into the lungs of patients. The purpose of this study is to see how easily anesthesiologists can learn to use them in children.

Detailed Description

Each anesthesiologist performed 20 timed baseline intubations. They were then randomized to perform 20 timed intubations with one of the two new videolaryngoscopes followed by 20 with the other new videolaryngoscope. The goal was to see how quickly they could become proficient.

Study Timeline

• Study Start: 2007-01
• Study First Submitted: 2010-10-04
• Study First Submitted QC: 2010-10-04
• Study First Posted: 2010-10-06
• Primary Completion: 2011-07
• Study Completion: 2011-07
• Results First Submitted: 2012-02-03
• Status Verified: 2012-10
• Results First Submitted QC: 2012-10-05
• Last Update Submitted: 2012-10-05
• Results First Posted: 2012-10-08
• Last Update Posted: 2012-10-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 646

Inclusion Criteria

Not provided

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Exclusion Criteria

• Children with raised intracranial pressure
• Children with potential cervical spine injuries
• Children at risk for regurgitation because of a full stomach
• Children who were anticipated to have a difficult airway based on their physical appearance or previous experience were excluded.

Inclusion Criteria for Anesthesiologist Population:

*Anesthesiologists who care for children at Stollery Children's Hospital

Exclusion Criteria for Anesthesiologist Population:

*None

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
children intubated with Glidescope	timed intubation	children intubated with Glidescope
children intubated with DCI	timed intubation	children intubated with DCI

Primary Outcome Measures

Name	Time	Method
Success in Learning to Use a Videolaryngoscope(VLS)	Up to 5 minutes per intubation	Anesthesiologists were to perform 20 intubations with each videolaryngoscopes. #1-10 were for practice. "Rapid Success" was no failed intubation attempts on #11-20 and a median time-to-intubation no more than 50% longer than their baseline median time-to-intubation on #11-15 . "Delayed Success" was achieving these same parameters on #16-20 if they were not achieved on #11-15. Operators who did not achieve either goal were labeled as having "No Success".

Secondary Outcome Measures

Name	Time	Method
Cormack & Lehane Score	reported during intubation (up to 5 minutes)	This Outcome was designed to determine if the view of the airway as determined by the Cormack \& Lehane grading system is improved by use of the GlideScope (GS) video laryngoscope and/or the Karl Storz Direct Coupled Interface (DCI) (KS) video laryngoscope as this would be a surrogate marker for utility in a difficult airway. Score is reported as a whole number from I to IV with I being an easy intubation and IV being one where the larynx cannot be visualized at all.
Time to Intubation, Analyzed by Order of Laryngoscopes Used	4 years	To determine if the learning curve was altered by the order in which the two new laryngoscopes were learned by the anesthesiologist,mean and median times on intubations #16-20 were compared for the two videolaryngoscopes.
Time to Intubation, Stratified by Weight of Patients	4 years	To compare the time-to-intubation for these laryngoscopes in children of different weights.
Mean Years Since Completion of Anesthesiology Residency	Baseline (assessed as of 2008)	To investigate whether there was a correlation between the years since completion of anesthesiology residency to the mid-point of study (2008)and median time-to-intubation for all first attempt intubations for the study. Years since completion of anesthesiology residency reported in the data table, correlation reported in the statistical analysis below
Number of Intubation Attempts to Reach "Best Obtainable Time to Intubation"	less than 5 minutes per intubation	For each anesthesiologist, the median time-to-intubation for patients #1-5, #6-10, #11-15, and #16-20 was determined. The anesthesiologist was considered to have reached "Best Obtainable Time (BOT) to Intubation" once the median time on any group of 5 consecutive patients was less than 3 seconds faster than the median time in the previous group of 5 consecutive patients, provided that there were no failed intubations or subsequent failed intubations using the same device.

Trial Locations

Locations (1)

Stollery Children's Hospital; 🇨🇦 Edmonton, Alberta, Canada