Vie Scope® versus videolaryngoscopy in expected difficult airways: a randomized controlled trial

Area of Science:

• Anesthesiology
• Airway Management
• Medical Devices

Background:

• Managing patients with anticipated difficult airways presents ongoing clinical challenges.
• Laryngeal visualization and tracheal intubation are critical steps in airway management.
• New laryngoscopes are continuously developed to improve visualization and intubation success.

Purpose of the Study:

• To evaluate the laryngeal visualization capabilities of the Vie Scope, a novel illuminated straight blade laryngoscope.
• To compare the Vie Scope with the standard Macintosh videolaryngoscope for bougie-facilitated intubation in patients with anticipated difficult airways.
• To assess secondary outcomes including time to successful intubation and first-attempt success rates.

Main Methods:

• A prospective, randomized controlled noninferiority trial was conducted.
• Patients undergoing elective surgery with anticipated difficult airways were randomized to either the Vie Scope or Macintosh videolaryngoscope (C-MAC®).
• The primary outcome was laryngeal visualization assessed by the Percentage of Glottis Opening (POGO) scale; secondary outcomes included time to intubation and success rates.

Main Results:

• The Vie Scope was noninferior to videolaryngoscopy for laryngeal visualization (mean POGO scores: 71% vs. 64%).
• Time to successful intubation (TTI) was significantly longer with the Vie Scope (125 sec) compared to videolaryngoscopy (51 sec).
• First-attempt and overall success rates were similar between groups (76% and 93%, respectively), with two esophageal intubations in the Vie Scope group attributed to bougie misplacement.

Conclusions:

• The Vie Scope provides comparable laryngeal visualization to standard videolaryngoscopy in patients with anticipated difficult airways.
• Despite similar visualization, the Vie Scope is associated with a significantly longer time to tracheal intubation.
• Further research may be needed to optimize techniques and reduce intubation time with the Vie Scope.