Videolaryngoscope versus conventional technique for insertion of a transesophageal echocardiography probe in intubated ICU patients (VIDLARECO trial): A randomized clinical trial - 17/02/24
, Agustín Cariñena a, Ana Estany-Gestal c, Diego Iglesias-Álvarez b, Sonia Veiras a, Adrián Martínez a, María Eiras a, Manuela De Miguel a, Salomé Selas a, Amparo Martínez-Monzonis b, Pedro Pereira a, María Bastos-Fernández b, Violeta González-Salvado b, María Álvarez-Barrado b, Esteban Ferreiroa a, Valentín Caruezo a, Jose Costa a, Alberto Naveira a, Pablo Otero a, Belén Adrio a, Jose Manuel Martínez-Cereijo a, Ángel Fernández a, José Ramón González-Juanatey b, Julián Álvarez a, Teresa Seoane-Pillado dHighlights |
• | Transesophageal echocardiogram probe insertion in intubated critically ill patients can be difficult, leading to complications. |
• | This clinical trial compared transesophageal echocardiogram probe insertion using either videolaryngoscope or conventional technique. |
• | Use of a videolaryngoscope improved first attempt insertion of the probe compared with a conventional technique. |
• | Most frequent site of pharyngeal injury in both groups was the posterior hypopharyngeal wall. |
Abstract |
Background |
Transesophageal echocardiogram probe insertion in intubated critically ill patients can be difficult, leading to complications, such as gastric bleeding or lesions in the oropharyngeal mucosa. We hypothesised that the use of a videolaryngoscope would facilitate the first attempt at insertion of the transesophageal echocardiogram probe and would decrease the incidence of complications compared to the conventional insertion technique.
Methods |
In this clinical trial, patients were randomly assigned the insertion of a transesophageal echocardiogram probe using a videolaryngoscope or conventional technique. The primary outcome was the successful transesophageal echocardiogram probe insertion on the first attempt. The secondary outcomes included total success rate, number of insertion attempts, and incidence of pharyngeal complications.
Results |
A total of 100 intubated critically ill patients were enrolled. The success rate of transesophageal echocardiogram probe insertion on the first attempt was higher in the videolaryngoscope group than in the conventional group (90% vs. 58%; absolute difference, 32%; 95% CI 16%–48%; p < 0.001). The overall success rate was higher in the videolaryngoscope group than in the conventional group (100% vs. 72%; absolute difference, 28%; 95% CI 16%–40%; p < 0.001). The incidence of pharyngeal mucosal injury was smaller in the videolaryngoscope group than in the conventional group (14% vs. 52%; absolute difference, 38%; 95% CI 21%–55%; p < 0.001).
Conclusions |
Our study showed that in intubated critically ill patients required transesophageal echocardiogram, the use of videolaryngoscope resulted in higher successful insertion on the first attempt with lower rate of complications when compared with the conventional insertion technique.
Trial registration |
ClinicalTrials.gov Identifier: NCT04980976.
Le texte complet de cet article est disponible en PDF.Keywords : Critical care, Videolaryngoscopy, Transesophageal echocardiography, Randomized clinical trial, Pharyngeal injury, Complications, Success rate
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Vol 43 - N° 2
Article 101346- avril 2024 Retour au numéro
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