Protocol and Statistical Analysis Plan for the Hyperangulated versus Standard Geometry Laryngoscope Blade (ANGLE) Trial

In a pragmatic multicenter randomized trial in 2,500 critically ill U.S. adults, a hyperangulated video laryngoscope blade is being tested for first-attempt successful emergency intubation versus a standard-geometry blade.

• Why it matters: Emergency tracheal intubation is common and high risk, and it is unclear whether blade geometry improves first-attempt success despite guideline preference for video laryngoscopy.
• What they did: The ANGLE trial is unblinded and parallel-group across 28 U.S. sites (10 emergency departments, 18 intensive care units), comparing hyperangulated versus standard-geometry blades on video laryngoscopes, with first-attempt success as the primary outcome.
• The result: The trial is expected to generate evidence on whether hyperangulated versus standard-geometry blades change first-attempt success and hypoxemia incidence during intubation, improving rigor via a pre-specified protocol and analysis plan.

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