Hemodynamic responses to tracheal intubation with Bonfils compared to C-MAC videolaryngoscope: a randomized trial
Bibliographic record
Abstract
BACKGROUND: Direct laryngoscopy (DL) produce tachycardia and hypertension that could be fatal in a patient with a brain injury. Bonfils fiberscope and C-MAC videolaryngoscope are associated with little hemodynamic instability compared to DL. Scientific evidence comparing these two alternatives does not exist. We conducted this study to determine the hemodynamic effects of Bonfils compared to C-MAC in patients undergoing elective surgery. METHODS: Fifty (50) patients listed for elective surgery were randomly assigned to endotracheal intubation with Bonfils or C-MAC. After a standardized induction, intubation was done via the retromolar approach (Bonfils group) or via videolaryngoscopy (C-MAC group). A research assistant, who was not blinded to the intervention, recorded heart rate (HR) and arterial blood pressure (systolic, diastolic and mean arterial blood pressure [MAP]) at induction and at every minute during the 5 min post intubation. The primary outcome was the hemodynamic response to intubation, as verified every minute for the first 5 min compared to baseline value. RESULTS: After randomization, the two groups were comparable except for ASA I/II ratio which was slightly higher in the C-MAC group (p = 0.046). Heart rate (p = 0.40) and MAP (p = 0.30) were comparable between the two groups within 5 min post intubation. Intubation time was shorter with C-MAC than with Bonfils (30 ± 2 s vs 38 ± 2 s; p = 0.02). CONCLUSION: Hemodynamic responses to tracheal intubation using the Bonfils fiberscope is comparable to the C-MAC videolaryngoscope among patients scheduled for an elective surgery. In light of these findings, using either technique appears to be a reasonable course of action. TRIAL REGISTRATION: ISRCTN #34923 , retrospectively registered, 26/03/2018.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".