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Trial registered on ANZCTR
Registration number
ACTRN12618000439246
Ethics application status
Approved
Date submitted
2/02/2016
Date registered
27/03/2018
Date last updated
27/03/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluation of disposable C-MAC videolaryngoscopic blades performance with randomised comparison to reusable C-MAC videolaryngoscopic blades performance on patients
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Scientific title
Clinical evaluation of single-use vs reusable Macintosh and D-BLADE blades for the C-MAC videolaryngoscope performance on patients
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Secondary ID [1]
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None
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Universal Trial Number (UTN)
U1111-1156-5240
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
general anesthesia, videolaryngoscopy
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airway management
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Condition category
Condition code
Anaesthesiology
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A total of 180 adult patients of both genders are included in this randomized controlled clinical trial, conducted at Sestre milosrdnice Clinical University Hospital in Zagreb, Croatia.. We are comparing C-MAC S, C-MAC, D-BLADE and D-BLADE S videolaryngoscopic blades using seven point intubation difficulty scores (IDS) as our primary outcome measure. Patients with predicted difficult airway are excluded. We are recording success rate, time to optimal glottic view, time to tube placement, total time to intubation, POGO score and seven point IDS. Failure of the procedure is declared if intubation is not successful after 120 seconds or if SaO2 dropped <90%. Intubations are being performed by anesthetists and residents of anesthesiology.
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
Four groups are being compared: one intubated using reusable C-MAC blade, one intubated using single-use C-MAC blade, one intubated using reusable D-BLADE blade, and one intubated using single-use D-BLADE blade.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome measure is the total time to successful intubation. The successful intubation is confirmed by end-tidal carbon dioxide partial pressure monitoring,
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Assessment method [1]
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Timepoint [1]
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To be measured during and immediately after airway instrumentation.
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Primary outcome [2]
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Another primary outcome is seven point intubation difficulty scores (IDS), which is used for objective evaluation.
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Assessment method [2]
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Timepoint [2]
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IDS is to be determined during and immediately after airway instrumentation.
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Secondary outcome [1]
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Tube placement success rate. This is going to be determined as a ratio between attempted and total intubation attempts using a particular device.
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Assessment method [1]
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Timepoint [1]
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To be measured during and immediately after airway instrumentation.
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Secondary outcome [2]
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Time to optimal glottic view. This time is going to be assessed using a video editing software when reviewing videolaryngoscopic footage. Time to optimal glottic view is the time from the blade passing the lips until best achieved visualisation of the glottis.
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Assessment method [2]
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Timepoint [2]
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To be obtained during and immediately after airway instrumentation.
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Secondary outcome [3]
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Time to tube placement. This time is going to be assessed using a video editing software when reviewing videolaryngoscopic footage. Time to tube placement the time from the blade passing the lips until completion of tracheal intubation.
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Assessment method [3]
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Timepoint [3]
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To be measured during and immediately after airway instrumentation.
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Secondary outcome [4]
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POGO (percentage of glottic opening) score. This score is going to be assessed using a video editing software when reviewing videolaryngoscopic footage. POGO score will be determined by the person who reviews the video by visual approximation.
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Assessment method [4]
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Timepoint [4]
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To be measured during and immediately after airway instrumentation.
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Eligibility
Key inclusion criteria
general anesthesia, elective surgery, non-difficult airway, ASA 1-3
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
age less than 18 years, difficult airway, emergency surgery, ASA 4
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/01/2015
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Date of last participant enrolment
Anticipated
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Actual
31/12/2015
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Date of last data collection
Anticipated
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Actual
4/01/2016
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Sample size
Target
180
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Accrual to date
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Final
180
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Recruitment outside Australia
Country [1]
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Croatia
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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University Hospital Centre Sestre milosrdnice
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Address [1]
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Vinogradska 29, 10000 Zagreb
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Country [1]
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Croatia
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Primary sponsor type
Hospital
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Name
University Hospital Centre Sestre milosrdnice
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Address
Vinogradska 29, 10000 Zagreb
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Country
Croatia
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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KARL STORZ GmbH & Co. KG
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Address [1]
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Mittelstrasse 8, 78532 Tuttlingen
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Country [1]
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Germany
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Eticko povjerenstvo KBC Sestre milosrdnice
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Ethics committee address [1]
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Vinogradska cesta 29, 10000 Zagreb
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Ethics committee country [1]
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Croatia
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Date submitted for ethics approval [1]
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05/05/2014
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Approval date [1]
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19/05/2014
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Ethics approval number [1]
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Summary
Brief summary
Videolaryngoscopy is a simple and effective alternative to direct laryngoscopy. To our knowledge, there are no clinical studies on patients evaluating reusable metal and single-use videolaryngoscopic blades. A total of 180 adult patients of both genders were included in this randomized controlled clinical trial. We compared C-MAC S, C-MAC, D-BLADE and D-BLADE S videolaryngoscopic blades using seven point intubation difficulty scores (IDS) as our primary outcome measure. Patients with predicted difficult airway were excluded. We recorded success rate, time to optimal glottic view, time to tube placement, total time to intubation, POGO score and seven point IDS. Failure of the procedure was declared if intubation was not successful after 120 seconds or if SaO2 dropped <90%. Our study has shown that C-MAC blade provides better results in terms of the total time used to complete the intubation, better view of the glottis and intubation difficulty in comparison to disposable C-MAC S blade, without any differences in overall success or incidence of complications. Regarding the difference between D-BLADE and D-BLADE S, our results have shown that the use of both blades achieves similar times to successful intubation, overall success rate and complication incidence, with a statistical difference in respect of quality of laryngeal view and intubation difficulty in favour of the reusable blade. Our results suggest that there is more difference between C-MAC and C-MAC S than D-BLADE and D-BLADE S blades, which could be the result of differences in the blade design.
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Trial website
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Trial related presentations / publications
Paolini JB, Donati F. Review article: Video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management? Can J Anesth/J Can Anesth 2013; 60 : 184–91 Ožegic O, Maldini B, Hostic V, Hodžovic I. Clinical Evaluation Of C-MAC S And D-BLADE S Disposable Videolaryngoscope Blades. Randomised Comparison To C-MAC Non-disposable Blades. Abstract Book of the World Airway Management Meeting (WAAM). Dublin: 2015; 85. Hostic V, Maldini B, Novotny Z, Hodžovic I. Clinical evaluation of C-Mac D-Blade video laryngoscope: randomized comparison with C-Mac Blade and direct laryngoscopy. Abstracts from the Difficult Airway Society meeting 2014 (Br J Anaesth). Stratford-upon-Avon, UK: 2014; e894-e911. doi:10.1093/bja/aev258. Jabre P, Leroux B, Brohon S. Comparison of Plastic Single-Use With Metallic Reusable Laryngoscope Blades for Out-of-Hospital Tracheal Intubation. Ann Emerg Med 2007; 50 : 258-63. Greenland KB. Disposable C-MAC videolaryngoscope blade – not the same as the re-usable blade. Anaesthesia 2014; 69 : 1402-3. Cortellazzi P, Caldiroli D, Byrne A, Sommariva A, Orena EF, Tramacera I. Defining and developing expertise in tracheal intubation using a GlideScope for anaesthetists with expertise in Macintosh direct laryngoscopy: an in-vivo longitudinal study. Anaesthesia 2014; 70 : 290-5. Van Zundert TC, Van Zundert AA. Tracheal intubation of patients in non-standard positions requires training. Minerva Anestesiol 2013; 79 : 679-82. Lee RA, van Zundert AA, Maassen RL et al. Forces applied to the maxillary incisors during video-assisted intubation. Anesth Analg 2009; 108 : 187-91.
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Public notes
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Contacts
Principal investigator
Name
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Dr Ognjen Ozegic
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Address
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University Hospital Centre Sestre milosrdnice,
Vinogradska 29
10000 Zagreb
Croatia
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Country
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Croatia
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Phone
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+385915621469
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Iljaz Hodzovic
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Address
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Anaesthetics, Intensive Care and Pain Medicine
Cardiff University and Aneurin Bevan University Health Board
Royal Gwent Hospital
Cardiff Rd, Newport NP20 2UB
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Country
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United Kingdom
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Phone
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+442920743109
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Iljaz Hodzovic
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Address
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Anaesthetics, Intensive Care and Pain Medicine
Cardiff University and Aneurin Bevan University Health Board
Royal Gwent Hospital
Cardiff Rd, Newport NP20 2UB
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Country
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United Kingdom
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Phone
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+442920743109
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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