Effect of Real-Time Carbon Dioxide Sensing Stylet Assisted Endotracheal Intubation: A Pilot Study Using the Porcine Model

Introduction: Safe and prompt endotracheal intubation is crucial to prevent morbidity and mortality in patients requiring airway management. The aim of this pilot study was to test the effect of real-time carbon dioxide (CO2) sensing stylet assisted intubation compared with conventional intubation in porcine experiment. Methods: Thirty-four swine were assigned to either the intervention or control group in a 1:1 ratio. Real-time CO2 sensing stylet was manually manufactured and used for assisting intubation in the intervention group. Conventional intubation using direct laryngoscopy was performed in the control group. The primary outcome was total procedure time and the secondary outcome was first attempt success rate. Cumulative hazard curves were obtained by analyzing the total procedure time to successful intubation for each swine, and the log-rank test was used to compare between the two groups. Results: Compared to the control group, a trend of shorter total procedure time was observed in the intervention group (mean ± standard deviation, 59.8 ± 34.6 s vs. 92.2 ± 68.2 s; p-value = 0.09). The cumulative hazard plot showed a consistent trend of shorter total procedure time in the intervention group compared to the control group (p-value = 0.16). The first attempt success rate showed a higher trend (70.6% vs. 52.9%; p-value = 0.29) in the intervention group. Conclusion: The real-time CO2 sensing stylet assisted endotracheal intubation has potential to reduce the time to successful intubation and improve first attempt success rate.