title: A comparison of videolaryngoscopes for tracheal intubation in predicted difficult airway: a feasibility study.
abstract: Videolaryngoscopy has become increasingly attractive for the routine management of the difficult airway. Glidescope® is well studied in the literature while imago V-Blade® is a recent videolaryngoscope. This is a feasibility study with 1:1 case-control sequential allocation comparing Imago V-Blade ® and Glidescope® in predicted difficult airway settings.
  
  
  
  Two senior anesthesiologists with no clinical experience in video assisted intubation but previously trained in a simulated scenario, performed the endotracheal intubations with Imago V-Blade® and Glidescope®. A third experienced anesthesiologist supervised the procedures. Forty-two patients, 21 for each group, with the presence of predicted difficult airway according to the Italian guideline were included. The primary end point is the feasibility of intubation. The secondary end-points are the success to intubate in the first attempt, the intubation time, the Cormack and Lehane score view, the comparison of the intubation difficulty scale (IDS) score and the need for maneuvers to aid the endotracheal intubation comparing Imago V-Blade® and Glidescope®.
  
  
  
  The intubation was achieved in 100% of cases in both groups. No differences were found in the first-attempt success rate (p = 0.383), intubation time (p = 0.280), Cormack and Lehane score view (p = 0.799) and IDS score (p = 0.252). Statistical differences were found in external laryngeal pressure (p = 0.005), advancement of the blade (p = 0.024) and use of increasing lifting force (p = 0.048).
  
  
  
  This feasibility study showed that the intubation with the newly introduced Imago V-Blade® is feasible. Further randomized and/or non-inferiority trials are needed to evaluate the benefit of Imago V-Blade® in this procedure.
  
  
  
  Clinicaltrials.gov NCT02897518 . Retrospectively registered 25 August 2016.
authors.affiliation: Section of Anesthesia and Intensive care, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Pansini 16, Naples, Italy. vargas.maria82@gmail.com.|Section of Anesthesia and Intensive care, Anesthesia and Intensive Care Unit, IRCCS Neuromed, Pozzilli, IS, Italy. vargas.maria82@gmail.com.
authors.forename: Maria
authors.identifier: 0000-0001-7652-970X
authors.initials: M
authors.lastname: Vargas
authors.affiliation: Section of Anesthesia and Intensive care, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Pansini 16, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pastore
authors.affiliation: Section of Anesthesia and Intensive care, Anesthesia and Intensive Care Unit, IRCCS Neuromed, Pozzilli, IS, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Aloj
authors.affiliation: Section of Anesthesia and Intensive care, Department of Anesthesia, Critical Illness and Injury Research Centre, Keenan Research Centre for Biomedical Science, St Michael's Hospital, University of Toronto, Toronto, Canada.
authors.forename: John G
authors.initials: JG
authors.lastname: Laffey
authors.affiliation: Section of Anesthesia and Intensive care, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Via Pansini 16, Naples, Italy.|Section of Anesthesia and Intensive care, Anesthesia and Intensive Care Unit, IRCCS Neuromed, Pozzilli, IS, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Servillo
mesh_terms: D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D020704:Laryngoscopes; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D014741:Video Recording
keywords: Glidescope; Imago V-blade; Intubation difficulty scale; Predicted difficult intubation; Videolaryngoscopes