Comparative multicenter blind study of domestic (BV-1) and imported (D-Blade) videolaryngoscopes for tracheal intubation on a mannequin

Introduction. Videolaryngoscopes with hyperangulated blades are regarded as effective tools for airway management, especially in difficult tracheal intubation. The development of domestic alternatives is of practical interest in view of the need to expand the range of available medical devices. One such device is the KV-1 blade.
The objective was to compare the effectiveness of the KV-1 and D-Blade videolaryngoscopes on a manikin in novice and experienced anesthesiologists- intensivists during simulation of standard and difficult tracheal intubation.
Materials and methods. A prospective multicenter partially blinded controlled study was conducted and included 194 participants. The participants were divided into two groups: novice (with up to 2 years of work experience) and experienced (more than 2 years of experience) specialists. Each participant sequentially performed laryngoscopy and tracheal intubation using the D-Blade and KV-1 blades in two scenarios: normal airways and simulated difficult airways created by increasing the manikin tongue volume. The assessed outcomes included intubation success, laryngoscopy time, intubation time, number of attempts, frequency of BURP maneuver use (extraglottic manual maneuver to facilitate visualization of the glottis), and signs of potentially traumatic manipulation.
Results. Among novice specialists, no statistically significant differences were found between KV-1 and D-Blade in laryngoscopy time, intubation time, or number of attempts in either normal or difficult airway scenarios. Similar findings were obtained in experienced specialists under normal airway conditions. In the group of experienced specialists under simulated difficult airway conditions, intubation time with KV-1 was significantly shorter than with D-Blade. The frequency of BURP maneuver use, signs of potentially traumatic manipulation and the rate of failed intubations did not differ between the blades.
Conclusions. In manikin-based tracheal intubation, KV-1 demonstrated effectiveness comparable to that of D-Blade across most studied parameters. In experienced specialists under simulated difficult airway conditions, the use of KV-1 was associated with shorter intubation time. These findings support the rationale for further clinical evaluation of the KV-1 blade.

1. Andreenko A. A., Bratishchev I. V., Gavrilov S. V. et al. Difficult Airways in Adults in a Hospital Setting (Fourth Revision, 2025). Guidelines of the All-Russian Public Organization “Federation of Anesthesiologists and Re suscitation Specialists”. Vestnik intensivnoi terapii imeni A. I. Saltanova, 2025, vol. 3, pp. 7–50. http://doi.org/10.21320/1818-474X-2025-3-7-50. (In Russ.).

2. Zaitsev A. Yu., Dubrovin K. V., Usikyan E. G. et al. Applicant: Federal State Budgetary Scientific Institution Russian Scientific Center of Surgery named after Academician B.V. Petrovsky, LLC EON-Medicine. Utility Model Patent № 236915 U1 Russian Federation, МПК A61B 1/267, A61B 1/04. Videolaryngoscope : decl. 03.04.2025 : publ. 28.08.2025. (In Russ.).

3. Saul S. A., Ward P. A., McNarry A. F. Airway management: the current role of videolaryngoscopy. Journal of Personalized Medicine, 2023, vol. 13, no. 9, pp. 1327. http://doi.org/10.3390/jpm13091327.

4. Pieters B. M. A., Maas E. H. A., Knape J. T. A. et al. Videolaryngoscopy vs. direct laryngoscopy use by experienced anaesthetists in patients with known difficult airways: a systematic review and meta-analysis. Anaesthesia, 2017, vol. 72, no. 12, pp. 1532–1541. http://doi.org/10.1111/anae.14057.

5. Köhl V., Wünsch V. A., Mülleret M.-C. al. Hyperangulated vs. Macintosh videolaryngoscopy in adults with anticipated difficult airway management: a randomised controlled trial. Anaesthesia, 2024, vol. 79, no. 9, pp. 957–966. http://doi.org/10.1111/anae.16326.

6. Avidan A., Shapira Y., Cohen A. et al. Difficult airway management practice changes after introduction of the GlideScope videolaryngoscope: A retrospective cohort study. European Journal of Anaesthesiology| EJA, 2020, vol. 37, no. 6, pp. 443–450. http://doi.org/10.1097/EJA.0000000000001199.

7. Gоmez-Ríos M. А., van Zundert A. A. J., Mcnarry A. et al. Guidelines on strategies for the universal implementation of videolaryngoscopy. European Journal of Anaesthesiology EJA, 2025, vol. 42, no. 10, pp. 872–888. http://doi.org/10.1097/EJA.0000000000002210.

8. Kılıçaslan A., Topal A., Erol A. et al. Comparison of the C-MAC D-Blade, conventional C-MAC, and Macintosh laryngoscopes in simulated easy and difficult airways. Turkish journal of anaesthesiology and reanimation, 2014, vol. 42, no. 4, pp. 182. http://doi.org/10.5152/TJAR.2014.59672.