A randomised control study to compare glottic view between Macintosh laryngoscope and King Vision Video laryngoscope in patients requiring endotracheal intubation in intensive care unit

Endotracheal intubation is the first step in any resuscitation to maintain patency of airway and if it is not secured well all the other lifesaving manoeuvres can fail. Direct laryngoscopy has been the standard technique for tracheal intubation for almost a century which requires aligning the pharyngeal, laryngeal and oral axes to achieve a line of sight.

Airway management problems constitute 17% of anaesthesia closed claims, with difficult intubation being the most common at a rate of 5%. According to the American Society of Anaesthesiologists, the incidence of difficult intubation in the operating room is 1.2–3.8%; however, in emergency conditions, this rate is higher and reaches even 5.3%. Approximately 6% to 10% of patients undergoing surgical intervention are considered difficult laryngoscopy patients. The lack of first-pass success (FPS) in intubation has been associated with increased adverse events. Problems like delayed intubation, misplaced tracheal tube, or airway trauma are frequently encountered and can cause death or hypoxic brain damage.

However over the last decades, technological advances have enabled the development of different devices for airway management. One such device is King Vision Video Laryngoscope (KVVL) which is used for management of normal and difficult airway. It is an indirect laryngoscope that provides view of glottis without alignment of oral, pharyngeal and tracheal axes. Limited studies are available for comparing the efficacy of Macintosh Laryngoscope and King Vision Video Laryngoscope for intubation in intensive care unit.

Hence we aim at comparing the efficacy of Macintosh laryngoscope and King Vision Video laryngoscope for glottic view, first attempt success rate of intubation and time taken for intubation.