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Trial registered on ANZCTR
Registration number
ACTRN12616001493437
Ethics application status
Approved
Date submitted
15/10/2016
Date registered
27/10/2016
Date last updated
1/08/2019
Date data sharing statement initially provided
1/08/2019
Date results provided
1/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
A comparison of videolaryngoscopes GlideScope and KingVision for tracheal intubation in obese patients
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Scientific title
A comparison of videolaryngoscope GlideScope Titan with videolaryngoscope KingVision (channeled blade) for tracheal intubation in obese patients undergoing elective surgical procedures
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Secondary ID [1]
289633
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Nil known
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Universal Trial Number (UTN)
U1111-1185-1683
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Trial acronym
Glidescope/KingVision
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
obesity
299422
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surgery requiring tracheal intubation
299423
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Condition category
Condition code
Anaesthesiology
299401
299401
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0
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Anaesthetics
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Surgery
299402
299402
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0
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Other surgery
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Diet and Nutrition
299403
299403
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0
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
ARM 1 - Tracheal intubation with the videolaryngoscope KingVision (channeled blade)
1. Participants receive Study Information Pack in advance at least 1 day prior to enrollment. This pack contains description of interventions, summary of risks associated with videolaryngoscopy,
1. Tracheal intubation using the KingVision videolaryngoscope with a channeled blade
a) after standardized induction to general anaesthesia - preoxygenation, 100% oxygen, CPAP 5 cmH20 for 5 min, propofol 2mg/kg, sufentanil 0,15 mcg/kg, rocuronium 0,6 mg/kg - the KingVision videolaryngoscope with a channeled blade is inserted to the patient mouth in order to visualize the vocal cords. Tracheal tube is subsequently introduced into trachea and cuff of the tube is inflated with small amount of air to form a seal. Pressure inside the cuff is meaured in order to achieve pressures 20-22 cmH20. Tracheal tube is kept in place for the duration of surgery.
b) time of device (KingVision videolaryngoscope) - the device is inserted after induction to general anaesthesia and removed after successful insertion of tracheal tube.
c) the device is inserted by a doctor with Board Certification in Anaesthesia - anaesthetist
d) approximate duration of the videolaryngoscope in place is one minute
e) features differing from the control/comparator videolaryngoscope - different shape of the blade, special channel incorporated within the blade for guiding the tracheal tube.
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Intervention code [1]
295247
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Treatment: Devices
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Comparator / control treatment
ARM 2 - Tracheal intubation with the videolaryngoscope GlideScope Titan
1. Participants receive Study Information Pack in advance at least 1 day prior to enrollment. This pack contains description of interventions, summary of risks associated with videolaryngoscopy,
1. Tracheal intubation using the GlideScope videolaryngoscope
a) after standardized induction to general anaesthesia - preoxygenation, 100% oxygen, CPAP 5 cmH20 for 5 min, propofol 2mg/kg, sufentanil 0,15 mcg/kg, rocuronium 0,6 mg/kg - the GlideScope Titan videolaryngoscope with a channeled blade is inserted to the patient mouth in order to visualize the vocal cords. Tracheal tube is subsequently introduced into trachea and cuff of the tube is inflated with small amount of air to form a seal. Pressure inside the cuff is meaured in order to achieve pressures 20-22 cmH20. Tracheal tube is kept in place for the duration of surgery.
b) time of device (GlideScope videolaryngoscope) - the device is inserted after induction to general anaesthesia and removed after successful insertion of tracheal tube.
c) the device is inserted by a doctor with Board Certification in Anaesthesia - anaesthetist
d) approximate duration of the videolaryngoscope in place is one minute
e) features of the control/comparator videolaryngoscope - specially designed videolaryngoscopic blade for difficult intubation scenarios
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to tracheal intubation (sec)
timer starts at discontinuation of face-mask ventilation and stops once successful insertion of endotracheal tube is confirmed by anaesthetist (first visible etCO2 tracking on the monitor).
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Assessment method [1]
299508
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Timepoint [1]
299508
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Measurement from discontinuation of face mask ventilation - after induction to general anaesthesia and confirmation of a sufficient muscle relaxation with "Train of four - TOF" zero to confirmation of successful tracheal intubation.
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Secondary outcome [1]
327364
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Total number of attempts for tracheal intubation (n)
Reported by study administrator(s) - independent person present in the operating room during tracheal intubation - to a study logbook
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Assessment method [1]
327364
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Timepoint [1]
327364
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Counted during the attempts for tracheal intubation after discontinuation of face-mask ventilation
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Secondary outcome [2]
327365
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Total success rate of tracheal intubation (%)
Reported by study administrator(s) - independent person present in the operating room during tracheal intubation - to a study logbook. Maximum three attempts allowed.
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Assessment method [2]
327365
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Timepoint [2]
327365
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Recorded after successful tracheal intubation.
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Secondary outcome [3]
327366
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Visualisation of the vocal cords (1-4 points)
Modified Cormack and Lehane score (MCLS) used (Yentis and Lee, Anaesthesia 1998): 1 - full view of glottis, 2a - partial view of glottis, 2b - only posterior extremity of glottis seen or only arytenoid cartilages, 3 - only epiglottis seen, none of glottis seen, 4 - neither glottis nor epiglottis seen.
Reported by study administrator(s) - independent person present in the operating room during tracheal intubation - to a study logbook. Maximum three attempts allowed.
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Assessment method [3]
327366
0
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Timepoint [3]
327366
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Recorded best score during attempt for tracheal intubation.
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Eligibility
Key inclusion criteria
1. elective procedure requiring airway management with tracheal intubation
2. elective surgery - gynaecology, general surgery, urology, maxillofacial surgery, ENT, orthopaedics
2. obesity with Body Mass Index (BMI) more than 35 kg/m2
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Minimum age
18
Years
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Maximum age
90
Years
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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
Mouth opening less than 2 cm
History of difficult intubation
Emergency surgery
Increased risk for gastric content regurgitation and/or aspiration
Body Mass Index (BMI) less than 35 kg/m2
Inability to communicate in Czech language
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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)
1. Patient will be given study information pack at least 24h prior to commencing the study
2. Randomization will be performed using the randomization freeware (www.graphad.com). Generated numbers and codes will be placed into the sealed envelopes.
3. After signing the informed consent the patient will be taken to the operating room and the sealed envelopes with the group allocation will be open.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
1. randomization freeware (www.graphad.com)
2. generation of 110 codes in total (A = GlideScope, B = KingVision),
3. putting the codes into sealed envelopes
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
Two parallel groups (A, B) with the equal number of patients in each group. 55 participants in the group A, 55 participants in the group B, 110 participants in total.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Statistical software will be used - GraphPad InStat (GraphPad Software, La Jolla, CA, USA)
1. Data will be checked for normal distribution (Shapiro-Wilk test)
2. According to data distribution, data will be analyzed using Fisher´s exact test (for binomial data), unpaired T-test or Mann-Whitney U test.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/01/2017
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Actual
4/01/2017
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Date of last participant enrolment
Anticipated
3/05/2018
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Actual
21/05/2018
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Date of last data collection
Anticipated
4/05/2018
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Actual
22/05/2018
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Sample size
Target
110
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Accrual to date
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Final
110
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Recruitment outside Australia
Country [1]
8321
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Czech Republic
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State/province [1]
8321
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Funding & Sponsors
Funding source category [1]
294721
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Hospital
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Name [1]
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General University Hospital in Prague
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Address [1]
294721
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U nemocnice 2, 128 08, Prague
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Country [1]
294721
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Czech Republic
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Funding source category [2]
294722
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University
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Name [2]
294722
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1st Medical Faculty, Charles University in Prague
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Address [2]
294722
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Katerinska 32, 121 08, Prague 2
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Country [2]
294722
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Czech Republic
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Primary sponsor type
Hospital
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Name
General University Hospital (Vseobecna fakultni nemocnice)
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Address
U nemocnice 2, 128 08, Prague
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Country
Czech Republic
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Secondary sponsor category [1]
293565
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None
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Name [1]
293565
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Not applicable
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Address [1]
293565
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Not applicable
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Country [1]
293565
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296140
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Ethics Committee, General University Hospital
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Ethics committee address [1]
296140
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Na bojisti 1, 128 08, Prague 2
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Ethics committee country [1]
296140
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Czech Republic
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Date submitted for ethics approval [1]
296140
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09/05/2016
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Approval date [1]
296140
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19/05/2016
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Ethics approval number [1]
296140
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826/16 S-IV
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Summary
Brief summary
Background: Videolaryngoscopy (VL) may improve intubation conditions in patients, where the classical laryngoscopy is difficult or even fails. Current videolaryngoscopes have smaller screens, they are more portable and could be used outside the operating room. Current videolaryngoscopes follow two concepts - a specially curved blade with optics allowing visualization of the anatomically shifted larynx (tracheal tube is usually introduced with a stylet). The second type uses an insertion channel, which allows direct placement of endotracheal tube into the trachea. VL GlideScope Titan uses the first concept while VL KingVision is a portable tool that uses both types of blades (both concepts described above). A blade with integrated intubating channel will be used in this study. Design: A randomized, interventional, single-blinded trial Objective: To evaluate in obese patients (BMI more than 35 kg / m2) whether the application of different videolaryngoscopes in the operating room has a different time to the successful placement of endotracheal tube. Primary outcome: time to successful intubation (sec) Secondary outcomes: total number of attempts, total success rate, visualization of the larynx Methodology and sample size calculation: The average time intubation using GlideScope VL was reported as 49 (SD +/- 9) sec. Statistically significant difference was set as 5 sec (10%) - sample size was calculated using freeware: http://powerandsamplesize.com, with a power of 80% and type I error of 5%, Minimum number of patients in one group was calculated as 51. Including patients who do not complete the study for various reasons we decided to enroll total number of 110 patients (55 per group).
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
1177
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/AnzctrAttachments/371050-Ethical Approval Brozek.pdf
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Contacts
Principal investigator
Name
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A/Prof Pavel Michalek
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Address
67258
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U nemocnice 2, 128 08, Prague 2
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Country
67258
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Czech Republic
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Phone
67258
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+420224962243
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Fax
67258
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Email
67258
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[email protected]
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Contact person for public queries
Name
67259
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Tomas Brozek
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Address
67259
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U nemocnice 2, 128 08, Prague 2
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Country
67259
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Czech Republic
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Phone
67259
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+420224962243
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Fax
67259
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Email
67259
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[email protected]
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Contact person for scientific queries
Name
67260
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Pavel Michalek
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Address
67260
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U nemocnice 2, 128 08, Prague 2
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Country
67260
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Czech Republic
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Phone
67260
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+420224962243
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Fax
67260
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Email
67260
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Plain language summary
No
Intubation time was slightly shorter in Glidescope...
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More Details
]
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A randomized comparison of non-channeled glidescopetm titanium versus channeled kingvisiontm videolaryngoscope for orotracheal intubation in obese patients with bmi > 35 kg.m-2.
2020
https://dx.doi.org/10.3390/diagnostics10121024
N.B. These documents automatically identified may not have been verified by the study sponsor.
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