Croatian national audit on videolaryngoscopes and alternative intubation devices in the era of COVID-19 pandemic

Marijana Matas; Martina Miklić Bublić; Ante Sekulić; Renata Curić Radivojević; Bálint Nagy

doi:10.1371/journal.pone.0280236

Croatian national audit on videolaryngoscopes and alternative intubation devices in the era of COVID-19 pandemic

PLoS One. 2023 Jan 11;18(1):e0280236. doi: 10.1371/journal.pone.0280236. eCollection 2023.

Authors

Marijana Matas¹, Martina Miklić Bublić¹, Ante Sekulić², Renata Curić Radivojević¹, Bálint Nagy^{3

4}

Affiliations

¹ Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Center Zagreb, Zagreb, Croatia.
² School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
³ Department of Anesthesiology and Intensive Therapy, Medical School, University of Pécs, Pécs, Hungary.
⁴ Medical Skills Lab, Medical School, University of Pécs, Pécs, Hungary.

Abstract

Introduction: Videolaryngoscopy (VL) is the recommended strategy for airway management in COVID-19 patients and guidelines recommends that all anesthesiologists should be trained to use and have immediate access to the device. However, the availability of VL in hospitals and its use may vary, as well as the choice of the device and necessary training. Our primary aim was to investigate data on availability of VL in Croatia, its use, the choice of the device and its implementation, with special consideration of COVID-19 management.

Materials and methods: An electronic survey was sent to all Croatian hospitals that have anesthesiology service available. The survey was designed to examine data on availability and use of VL with special consideration of COVID-19 wards. The survey was conducted between 1.03.2021 and 30.08.2021.

Results: Response rate was 83%. VL was available in 86% of hospitals and the best supplied areas were intensive care units, general surgery and gynecology/obstetrics. The most common VL devices were Bonfils, C-MAC and C-MAC D-blade. The choice of VL was mainly based on centralized hospital procurement and informal introduction was found to be the most frequent training method. The VL was mainly used in Croatian hospitals in cases of difficult airway or as a backup method after failed intubation. Only 16% of hospitals reported regular use in everyday practice. Even though, VL was available in 64% of COVID-19 wards, only 21% of hospitals reported routine use.

Conclusion: Although VL is available in the majority of Croatian hospitals, its use is still mainly restricted to difficult airway scenarios. Use of VL in COVID-19 management is also low and education on the method is still mainly informal. Based upon our results better implementation in practice should be targeted, as well as formal skill trainings especially regarding COVID-19 care.

Copyright: © 2023 Matas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Croatia / epidemiology
Humans
Intubation, Intratracheal / methods
Laryngoscopes*
Laryngoscopy / methods
Pandemics

Grants and funding

Bálint Nagy was supported by the Thematic Excellence Program 2020—National Excellence Subprogram; Biomedical Engineering Project (“2020-4.1.1-TKP2020”), the EFOP-3.6.1-16-2016-00004 and the TKP2021-NVA-06 of the University of Pécs. None of the funders had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.