• Background and Goal of Study: in obese patients’ airway management is essential to prevent early
arterial oxygen desaturation related to a reduced functional residual capacity (FRC) and atelectasis
formation during induction and after tracheal intubation.
The Macintosh laryngoscope is the standard method for endotracheal intubation. However, sometimes is
ineffective and poorly tolerated by the obese patient.
The Totaltrack VLM® (TT VLM) (MedComflow S.A., Spain) is a hybrid device, between a supraglottic airway
and a videolaryngoscope.
However, despite its use in clinical practice, there are no comparative studies regarding direct laryngoscopy
in obese patients.
• Materials and Methods: OVESION is an interventional randomized clinical study (NCT03106974).
Primary Outcome Measure is saturation of blood oxygen at the end of orotracheal intubation, established
with a curve of Capnography.
Secondary Outcome Measures are total time of successful intubation, total time of successful intubation,
number of maneuvers needed, IDS Scale, POGO Score, number of attempts of endotracheal intubation,
hemodynamic response, degree of satisfaction of the researcher in a Visual Analogic Scale (0-5), adverse
effects encountered during intubation.
Estimated enrollment is 1.440 adult patients.
Inclusion criteria are BMI >30, ASA 1-3, scheduled surgeries that require orotracheal intubation, general
anesthesia with neuromuscular relaxation before intubation and patients who sign informed consent.
Exclusion criteria are ASA 4, difficult airway already known, alterations of airway documented, allergies to
device components and urgent surgery.
• Results and Discussion: in a retrospective 96 case-series analysis of hemodynamic (systolic and
diastolic pressure) and ventilation efficiency (pulsioximetry) were measured before inserting the device in
the mouth of the patient, and 1 and 5 minutes later. Patients mean BMI was 26, and ASA status was 2 in
84%, and 3 in 17%. There no exists important incidences in 77.5% patients, difficulties not avoided
intubation, and successful ventilation after intubation was in 100% patients. 74% of researchers said they
were satisfied, and 15% very satisfied.
• Conclusion(s): we believe TT VLM facilitates oxygenation during tracheal intubation, under safe
conditions and uninterrupted ventilation. In cases of a failed intubation attempt, TT VLM can continue
optimal ventilation/oxygenation while the operator thinks about the next step of the strategy.

11 / Totaltrack VLM vs. Macintosh laryngoscope for orotracheal intubation in obese patients (OVESION RCT)