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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04743440
Other study ID # bronchoscope-sad-performance
Secondary ID
Status Completed
Phase
First received
Last updated
Start date January 18, 2021
Est. completion date August 20, 2022

Study information

Verified date January 2021
Source Nordsjaellands Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Prospective observational study with the primary objective is to assess technical competence in anaesthesiology specialists who perform bronchoscopic endotracheal intubation through a supraglottic airway device (SAD), by using a global rating assessment scale (GRS) and a procedure checklist. We will use an Objective Structured Assessment of Technical Skills (OSATS)-inspired GRS that previously have been validated for fiberoptic intubation and a novel clinical checklist developed for the procedure. Secondarily, we will examine potential predictor variables.


Description:

This study is a preplanned prospective observational substudy of a randomised controlled trial (RCT) with the primary aim to compare time to intubation when using two different supraglottic airway devices (SAD) as conduit for bronchoscopic intubation: the Ambu® AuraGain LMA as compared to the i-gel LMA (reference: I-gel vs AuraGain for Bronchoscopic Intubation Through SGA (ClinicalTrials.gov Identifier: NCT04680169)). We will include all physicians who provide the airway management in the RCT. The primary objective is to assess technical competence/performance by using a global rating assessment scale (GRS) and a procedure checklist. We will use an Objective Structured Assessment of Technical Skills (OSATS)-inspired GRS that previously have been validated for fiberoptic intubation and a novel clinical checklist developed for the procedure. Secondarily, we will examine potential predictor variables in multivariate analyses Airway management will be video recorded. Two anaesthesiologists specialists (assessors), not otherwise involved in the trial and not employed at the hospital, will watch the video recordings of each case of airway management, i.e., the complete airway management provided by a responsible physician participant for each of the included patient participants. For each case of airway management, they will access the physician's technical performance during the attempt to perform bronchoscopic endotracheal intubation through a SAD. Assessors will complete a checklist during the procedure. Each item is dichotomously evaluated: done correctly (score=1)/done incorrectly or not performed (score=0). The checklist score represents the sum score for the 30 items (potential sum score range 0-30). Assessors will evaluate the physician's technical performance using a validated GRS, scored from 8 to 40, for each case of airway management. The GRS is based on 8 items. Each item is scored from one (poor) to five (superior). A score of three is considered 'competent' for each item. The GRS score represent the sum score for all items.


Recruitment information / eligibility

Status Completed
Enrollment 100
Est. completion date August 20, 2022
Est. primary completion date August 20, 2022
Accepts healthy volunteers No
Gender All
Age group N/A and older
Eligibility Inclusion Criteria: - Anaesthetist specialists performing bronchoskopic tracheal intubation through a supraglottic airway device - The supraglottic airway device is either i-gelTM or a Ambu® AuraGainTM (4 in total, 2 of each i random order). Exclusion Criteria: - Refuse to participate - Any other involvement in the research project

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Bronchoscopic endotracheal intubation through a supraglottic airway device
Prior to trial commencement, participants will be asked to watch a video demonstrating preparation and conduction of the procedure (bronchoscopic endotracheal intubation through a supraglottic airway device) in a patient not involved in the project. Afterwards they will submit an online test, examining knowledge of the procedure relating to the procedure checklist. After participants have watched the demonstration video and submitted the online test, trial investigator will demonstrate the procedure in the manikin; subsequently, they have the opportunity to train the procedure in the manikin with both Igel and Auragain - training estimated to take less than 30 minutes. Afterwards, they will have the opportunity to train the procedure on manikins, on their own discretion, as per usual standards for maintaining airway competence at the Anaesthesiology Department.

Locations

Country Name City State
Denmark Nordsjaellands hospital Hilleroed Hillerød

Sponsors (1)

Lead Sponsor Collaborator
Nordsjaellands Hospital

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Other Time to intubation Time to intubation 6 months
Other Predictors for GRS scores We will investigate the influence of the following potential predictor variables:
Physician characteristics:
Self reported experience prior to trial commencement (years since anaesthesiology specialist certification)
Self-reported number of key difficult airway procedures/year in patients prior to trial commencement.
Self-reported confidence for conducting the procedure, prior to trial commencement (NRS score 0-10),
Number of patient participant (1-4),
Type of SAD (Ambu® AuraGainTM SAD or i-gelTM SAD);
Patient characteristics:
sex,
age,
SARI-score
6 months
Other Predictors for time to intubation We will investigate the influence of the following potential predictor variables:
Physician characteristics:
Self reported experience prior to trial commencement (years since anaesthesiology specialist certification)
Self-reported number of key difficult airway procedures/year in patients prior to trial commencement.
Self-reported confidence for conducting the procedure, prior to trial commencement (NRS score 0-10),
Number of patient participant (1-4),
Type of SAD (Ambu® AuraGainTM SAD or i-gelTM SAD);
Patient characteristics:
sex,
age,
SARI-score
6 months
Primary Physician performance Overall median physician performance score using an Objective Structured Assessment of Technical Skills (OSATS)-inspired validated global rating scale (GRS) 6 months
Secondary Checklist score Median checklist scores using a novel check list developed for the procedure 6 months
Secondary Pass rate Overall pass rate (every item in the GRS evaluation has been scored to 3 or more) 6 months
Secondary Self-reported confidence Median self-reported confidence score for the procedure during the trial (numeric rating scale (NRS) score 0-10) 6 months
Secondary GRS score progression Difference in GRS scores between the first and the last patient participant (expectedly the fourth patient) in whom the physician conduct airway management. 6 months
Secondary interrater-agreement for GRS evaluation interrater-agreement between assessors for the GRS evaluation 6 months
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