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Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.

Introduction Optic stylets are safe, efficient airway tools, with improved intubation success rates compared to direct laryngoscopy. Economic constraints often limit access to costly difficult airway equipment. The Hyperangulated Video Intubation Stylet (HiVIS) is a novel, low-cost, stainless-steel...

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Main Author: Jacobs, Jan
Other Authors: Roodt, Francois
Format: Thesis
Language:English
Published: Department of Anaesthesia and Perioperative Medicine 2024
Subjects:
Anaesthesia
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access_status_str Open Access
author Jacobs, Jan
author2 Roodt, Francois
author_browse Jacobs, Jan
Roodt, Francois
author_facet Roodt, Francois
Jacobs, Jan
author_sort Jacobs, Jan
collection Thesis
description Introduction Optic stylets are safe, efficient airway tools, with improved intubation success rates compared to direct laryngoscopy. Economic constraints often limit access to costly difficult airway equipment. The Hyperangulated Video Intubation Stylet (HiVIS) is a novel, low-cost, stainless-steel stylet with a Wi-Fi camera connecting to a smartphone. We aim to demonstrate that performance of the HiVIS, as an alternative low-cost device, is non-inferior to the Bonfils. Methods We performed a randomised, cross-over non-inferiority study following institutional and ethics approval (UCT HREC 816/2020). Randomised participants received training (instructional video and practice intubations on a Laerdel airway manikin™) and subsequently intubated a Trucorp Airsim manikin™ simulating a difficult airway with the Bonfils and HiVIS alternately. Our primary outcome was time-to-intubation with a pre-specified non-inferiority margin of 5 seconds. Secondary outcomes were best laryngeal view, airway trauma, and number of attempts. Participants completed a questionnaire regarding device preference and overall satisfaction. Results Thirty doctors participated: 33% interns and 54% medical officers from various specialties. 63% performed ≤1 intubation per week, and 10% had optical stylet experience. Both devices had 100% first-pass intubation success: 10.4 seconds Bonfils versus 11.2 seconds HiVIS (p<0.0001). The mean difference in time-to-intubation was 0.8 seconds (90% CI -0.4; 2.1). All Bonfils intubations had a grade 1 laryngeal view compared to 83% of HiVIS intubations (27% grade 2). The Bonfils had the only incident of airway trauma. Two-thirds of participants preferred HiVIS, with similar user satisfaction scores for both devices. Conclusion The HiVIS is non-inferior to Bonfils in a single attempt difficult airway manikin simulation with predominantly novice, non-anaesthesia users. The HiVIS could be a cost-effective tool for difficult airway management in resource-constrained settings.
format Thesis
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:31:50.330Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2024
publishDateRange 2024
publishDateSort 2024
publisher Department of Anaesthesia and Perioperative Medicine
publisherStr Department of Anaesthesia and Perioperative Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/39513 Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study. Jacobs, Jan Roodt, Francois Anaesthesia Introduction Optic stylets are safe, efficient airway tools, with improved intubation success rates compared to direct laryngoscopy. Economic constraints often limit access to costly difficult airway equipment. The Hyperangulated Video Intubation Stylet (HiVIS) is a novel, low-cost, stainless-steel stylet with a Wi-Fi camera connecting to a smartphone. We aim to demonstrate that performance of the HiVIS, as an alternative low-cost device, is non-inferior to the Bonfils. Methods We performed a randomised, cross-over non-inferiority study following institutional and ethics approval (UCT HREC 816/2020). Randomised participants received training (instructional video and practice intubations on a Laerdel airway manikin™) and subsequently intubated a Trucorp Airsim manikin™ simulating a difficult airway with the Bonfils and HiVIS alternately. Our primary outcome was time-to-intubation with a pre-specified non-inferiority margin of 5 seconds. Secondary outcomes were best laryngeal view, airway trauma, and number of attempts. Participants completed a questionnaire regarding device preference and overall satisfaction. Results Thirty doctors participated: 33% interns and 54% medical officers from various specialties. 63% performed ≤1 intubation per week, and 10% had optical stylet experience. Both devices had 100% first-pass intubation success: 10.4 seconds Bonfils versus 11.2 seconds HiVIS (p<0.0001). The mean difference in time-to-intubation was 0.8 seconds (90% CI -0.4; 2.1). All Bonfils intubations had a grade 1 laryngeal view compared to 83% of HiVIS intubations (27% grade 2). The Bonfils had the only incident of airway trauma. Two-thirds of participants preferred HiVIS, with similar user satisfaction scores for both devices. Conclusion The HiVIS is non-inferior to Bonfils in a single attempt difficult airway manikin simulation with predominantly novice, non-anaesthesia users. The HiVIS could be a cost-effective tool for difficult airway management in resource-constrained settings. 2024-04-30T12:39:39Z 2024-04-30T12:39:39Z 2023 2024-04-30T08:16:59Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/39513 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences
spellingShingle Anaesthesia
Jacobs, Jan
Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.
thesis_degree_str Master's
title Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.
title_full Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.
title_fullStr Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.
title_full_unstemmed Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.
title_short Comparison of a novel low-cost hyperangulated video intubation stylet with the Bonfils fiberscope: a simulated difficult airway manikin study.
title_sort comparison of a novel low cost hyperangulated video intubation stylet with the bonfils fiberscope a simulated difficult airway manikin study
topic Anaesthesia
url http://hdl.handle.net/11427/39513
work_keys_str_mv AT jacobsjan comparisonofanovellowcosthyperangulatedvideointubationstyletwiththebonfilsfiberscopeasimulateddifficultairwaymanikinstudy

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