A prospective, pragmatic non-inferiority study of emergency intubation success with the single-use i-view versus standard reusable video laryngoscope

Steven G. Schauer, Brit J. Long, Michael D. April, Daniel Resnick-Ault, Jessica Mendez, Allyson A. Arana, Jill J. Bastman, William T. Davis, Joseph K. Maddry, Adit A. Ginde, Vikhyat S. Bebarta

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Video laryngoscope (VL) technology improves first-pass success. The novel i-view VL device is inexpensive and disposable. We sought to determine the first-pass intubation success with the i-view VL device versus the standard reusable VL systems in routine use at each site. Methods: We performed a prospective, pragmatic study at two major emergency departments (EDs) when VL was used. We rotated i-view versus reusable VL as the preferred device of the month based on an a priori schedule. An investigator-initiated interim analysis was performed. Our primary outcome was a first-pass success with a non-inferiority margin of 10% based on the per-protocol analysis. Results: There were 93 intubations using the reusable VL devices and 81 intubations using the i-view. Our study was stopped early due to futility in reaching our predetermined non-inferiority margin. Operator and patient characteristics were similar between the two groups. The first-pass success rate for the i-view group was 69.1% compared to 84.3% for the reusable VL group. A non-inferiority analysis indicated that the difference (−15.1%) and corresponding 90% confidence limits (−25.3% to −5.0%) did not fall within the predetermined 10% non-inferiority margin. Conclusions: The i-view device failed to meet our predetermined non-inferiority margin when compared to the reusable VL systems with the study stopping early due to futility. Significant crossover occurred at the discretion of the intubating operator during the i-view month.

Original languageEnglish (US)
JournalTransfusion
DOIs
StateAccepted/In press - 2024

Keywords

  • airway
  • combat
  • disposable
  • emergency
  • i-view
  • laryngoscope
  • laryngoscopy
  • military
  • trauma
  • video

ASJC Scopus subject areas

  • Hematology
  • Immunology and Allergy
  • Immunology

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