• J. Cardiothorac. Vasc. Anesth. · Dec 2022

    Randomized Controlled Trial Multicenter Study

    Use of a Video Laryngoscope to Reduce Complications of Transesophageal Echocardiography Probe Insertion: A Multicenter Randomized Study.

    • Deepak Borde, Kumar C, Amish Jasapara, Vijay Shetty, Nilesh Juvekar, Vinayak Desurkar, Jyoti Gaidu, Pooja Joshi, Balaji Asegaonkar, Unnikrihnan Kp, Vipinraj V, Shreedhar Joshi, and Thomas Koshy.
    • Department of Cardiac Anesthesia, Ozone Anesthesia Group, Aurangabad, Maharashtra, India. Electronic address: deepakborde2482@gmail.com.
    • J. Cardiothorac. Vasc. Anesth. 2022 Dec 1; 36 (12): 428942954289-4295.

    ObjectiveThe objective of this multicenter study was to test the hypothesis of whether the use of a video laryngoscope (VL) reduces complications related to transesophageal echocardiography (TEE) probe insertion.DesignA multicenter randomized control study.SettingAt 5 tertiary care level hospitals.ParticipantsThree hundred sixty-three adult patients undergoing elective cardiac surgery.InterventionsThe patients were randomized into 2 groups-the conventional group (C group; n = 177) and the VL group (n = 186) for TEE probe insertion.Measurements And Main ResultsThe primary endpoint of the study was the incidence of oropharyngeal injury, which was defined as blood at the tip of the TEE probe at the end of surgery and/or evidence of injury on VL examination at the end of surgery. The secondary endpoints of the study were the number of attempts required for successful TEE probe insertion and the relation between the esophageal inlet and the larynx. There was a higher incidence of injuries in the C group (n = 26; 14.7%) compared to the VL group (n = 14; 7.5%; p = 0.029). The number of attempts for probe insertion was significantly lower in the VL group (p = 0.0023). The most common relation between the esophageal inlet and the larynx was posterolateral (n = 88; 47%), followed by posterior (n = 77; 41%) and lateral (n = 21;12%).ConclusionThe use of VL was associated with a lesser incidence of injury compared to the conventional technique, and its use for this purpose is recommended. The use of VL for probe insertion resulted in fewer attempts compared with the conventional technique. Significant variations do exist in the relation between the esophageal inlet and the larynx, and direct visualization with VL may contribute to better safety.Copyright © 2022 Elsevier Inc. All rights reserved.

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