Comparison of Macintosh, McCoy, and Glidescope video laryngoscope for intubation in morbidly obese patients: Randomized controlled trial

Nandakumar, Keerthi P; Bhalla, Amar P; Pandey, Ravindra K.; Baidya, Dalim Kumar; Subramaniam, Rajeshwari; Kashyap, Lokesh

doi:10.4103/sja.sja_754_17

Cited by 17 publications

(4 citation statements)

References 23 publications

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“…According to many authors, in the situation of a lack of clinical experience and anticipated occasional use of a given laryngoscope, it is definitely important to use such a device, which is characterized by relatively high simplicity and commonness of use. In this situation, the classic Macintosh laryngoscope is of primary importance, regardless of whether we are dealing with normal or difficult airways [31][32][33][34]. For investigators with extensive clinical experience in intubation, who perform hundreds or even thousands of intubations per year, the role of video laryngoscopes, especially in patients with difficult airways, definitely increases.…”

Section: Discussionmentioning

confidence: 99%

Comparison of UESCOPE VL 400, I-View, Non-Channeled Airtraq Videolaryngoscopes and Macintosh Laryngoscope for Tracheal Intubation in Simulated Out-of-Hospital Conditions: A Randomized Crossover Manikin Study

Ratajczyk,

Dolder,

Szmyd

et al. 2024

Healthcare

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The aim of the study was to test the hypothesis that the results obtained with three different types of video laryngoscopes (UESCOPE VL-400, I-View, Non-Channeled Aitraq) with and without an endotracheal stylet should be better than the results obtained with a Macintosh laryngoscope in a simulated out-of-hospital scenario by a person without clinical experience. Primary outcome measures were the time taken to successfully achieve tracheal intubation (TI). Secondary outcomes included the grade of glottic view (Cormack and Lehane grades 1–4), the incidence of successful TI, the number of audible dental clicks indicating potential dental damage, the level of effort required to perform TI, and the operator’s comfort during the procedure. The time required to achieve tracheal intubation successfully was significantly longer with the Macintosh laryngoscope and Airtraq than with the other video laryngoscopes. The use of the stylet significantly reduced the time required for tracheal intubation with the Macintosh laryngoscope (21.8 sec. vs. 24.0 sec., p = 0.026), UESCOPE VL 400 (18.1 sec. vs. 23.4 sec., p = 0.013), and Airtraq (22.7 sec. vs. 34.5 sec., p < 0.001). There were no significant differences in intubation time when using the I-View with or without stylets. No differences were observed in the Cormack–Lehane grading. The success rate of intubation was 100% for the Macintosh and I-View laryngoscopes used with or without stylets and for the UESCOPE VL 400 and Airtraq laryngoscopes used with stylets. Without stylets, the success rate of intubation was 96.6% for the UESCOPE VL 400 and 86.6% for the Airtraq. There were no significant differences in the risk of dental damage between the Macintosh, UESCOPE VL 400, I-View, and Airtraq laryngoscopes, regardless of the use of stylets (without and with stylets). The use of stylets significantly reduced dental damage only for the Airtraq laryngoscope: 8 (26.6%) vs. 2 (6.6%). Statistically significant differences in perceived exertion were observed between the mentioned laryngoscopes, both with and without stylets. However, there were no differences in the comfort of use between the laryngoscopes, regardless of the use of stylets (without and with stylets. The use of stylets led to better comfort in the case of the Macintosh (2.5 vs. 3, p = 0.043) and UESCOPE VL 400 (2 vs. 3, p = 0.008) laryngoscopes. In our study, the I-View and UESCOPE VL-400 video laryngoscopes provided better intubation results than the Macintosh laryngoscope in terms of time needed to intubate, glottis visibility, and reduction in dental damage. The use of the stylet did not significantly improve the intubation results compared to the results obtained in direct laryngoscopy. Due to the small study group and the manikin model, additional studies should be performed on a larger study group.

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Section: Discussionmentioning

confidence: 99%

Comparison of UESCOPE VL 400, I-View, Non-Channeled Airtraq Videolaryngoscopes and Macintosh Laryngoscope for Tracheal Intubation in Simulated Out-of-Hospital Conditions: A Randomized Crossover Manikin Study

Ratajczyk,

Dolder,

Szmyd

et al. 2024

Healthcare

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“…Other alternative or adjuvant devices might be helpful in facilitating airway management in obese patients, e.g., Combitube, gum elastic bougie. BMI (kg/m2) 44 [32] 43 [63] 40 [64] 41 [46] 43 [33] 43 [34] 44 [52] 41 [35] 42 [36] 47 [40] 46 [41] 47 [38] 45 [39] 43 [32] 44 [63] 43 [64] 42 [46] 41 [33] 44 [34] 43 [52] 40 [35] 41 [36] 46 [40] 46 [41] 46 [38] 47 [39]…”

Section: Obesity and Laryngoscopymentioning

confidence: 99%

“…More difficult [63] Similar to VL [46] Easy [63] Similar to DL [46] Easy 40 (0-100 scale) [33] 15% [35] 11% [40] 13% [38] 0% [39] 52 (0-100 scale) [33] 40% [35] 6% [40] 4% [38] 7% [39] Easier than DL [52]…”

Section: Subjective Difficulty Of Intubationmentioning

confidence: 99%

Routine Use of Styletubation for Oro-Tracheal Intubation in Obese Patients Undergoing Bariatric Surgeries-A Case Series Report

Lee,

Wu,

Chen

et al. 2024

Preprint

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The aim of this case-series report article is to provide a new topical view of the styletubation (video intubating stylet technique) in obese patients undergoing bariatric surgeries. In contrast to various conventional direct laryngoscopes (DLs), videolaryngoscopes (VLs) have been applied in such obese population with potentially difficult airway populations. The safety and effectiveness of VLs have been repeatedly studied and the superiority of VLs then has been observed and is advocated as a routine use. In this article, among our vast use experiences of the styletubation (more than 54,998 patients since 2016) for routine tracheal intubation, we present such unique experience to apply such intubating technique in obese patient undergoing bariatric surgery. Consistent with the experiences applied in other patient populations, we found the styletubation technique to be swift (the time to intubate from 5 s to 24 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satisfaction). The learning curve can be steep but is easily overcome if technical pitfalls are avoided. We, therefore, propose that the styletubation technique can be feasibly applied for tracheal intubation in obese patients undergoing bariatric surgery.

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“…В целом показатель сложности интубации и гемодинамический ответ на интубацию статистически значимо не отличались между группами. McCoy настолько же эффективен, как ЛС Макинтоша, и, следовательно, последний должен быть предпочтительным ларингоскопом из-за его широкой доступности и привычности [67].…”

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Videolaryngoscopy for Tracheal Intubation: Current State of the Problem

Гудный,

Илюкевич

2024

Хирургия. Восточная Европа

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Введение. В настоящее время данные об эффективности и безопасности использования различных видеоларингоскопов для интубации трахеи по-прежнему противоречивы и неоднозначны, зависят от многочисленных клинических факторов и обстоятельств их использования. Цель. На основании литературных данных представить сравнительный анализ эффективности и безопасности видеоларингоскопов для интубации трахеи у пациентов при различных клинических ситуациях. Материалы и методы. Были проанализированы результаты рандомизированных контролируемых исследований с оценкой использования видеоларингоскопов и ларингоскопа Макинтоша, выполненных до 2022 г. и опубликованных в свободном доступе сети Интернет в электронных ресурсах (Pubmed, Кокрановской библиотеке). Основными критериями эффективности и безопасности вышеуказанных устройств были процент успешной интубации трахеи с первой попытки, время выполнения последней, степень визуализации голосовой щели, а также болевой синдром в горле. Результаты. Широкому использованию видеоларингоскопии в анестезиологии и интенсивной терапии способствует целый ряд преимуществ видеоларингоскопии по сравнению с традиционной ларингоскопией, позволяющих безопасно и эффективно обеспечить проходимость верхних дыхательных путей, адекватную вентиляцию и оксигенацию, снизить риск развития возможных осложнений вплоть до фатальных. Заключение. Видеоларингоскопы являются более эффективными и безопасными устройствами, чем ларингоскоп Макинтоша, для выполнения интубации трахеи в ряде клинических ситуаций вне зависимости от опыта специалиста. Introduction. Currently, the data on the effectiveness and safety of using various videolaryngoscopes for tracheal intubation are still contradictory and ambiguous, depending on numerous clinical factors and circumstances of their use. Purpose. Based on the literature data, to present a comparative analysis of the effectiveness and safety of videolaryngoscopes for tracheal intubation in patients in various clinical situations. Materials and methods. The results of randomized controlled trials with an assessment of the use of video laryngoscopes and a Macintosh laryngoscope performed before 2022 and published freely on the Internet in electronic resources (Pubmed, the Cochrane Library) were analyzed. The main criteria for the effectiveness and safety of the above devices were: the percentage of successful tracheal intubation on the first attempt, the time of the last one, the degree of visualization of the glottis, and also the pain syndrome in the throat. Results. The wide use of video laryngoscopy in anesthesiology and intensive care is facilitated by a number of advantages of video laryngoscopy compared to traditional laryngoscopy, which allow to safely and effectively ensure the patency of the upper respiratory tract, adequate ventilation and oxygenation, reduce the risk of possible complications up to fatal. Conclusion. Video laryngoscopes are more effective and safer devices than the Macintosh laryngoscope for performing tracheal intubation in a number of clinical situations, regardless of the specialist’s experience.

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Comparison of Macintosh, McCoy, and Glidescope video laryngoscope for intubation in morbidly obese patients: Randomized controlled trial

Cited by 17 publications

References 23 publications

Comparison of UESCOPE VL 400, I-View, Non-Channeled Airtraq Videolaryngoscopes and Macintosh Laryngoscope for Tracheal Intubation in Simulated Out-of-Hospital Conditions: A Randomized Crossover Manikin Study

Comparison of UESCOPE VL 400, I-View, Non-Channeled Airtraq Videolaryngoscopes and Macintosh Laryngoscope for Tracheal Intubation in Simulated Out-of-Hospital Conditions: A Randomized Crossover Manikin Study

Routine Use of Styletubation for Oro-Tracheal Intubation in Obese Patients Undergoing Bariatric Surgeries-A Case Series Report

Videolaryngoscopy for Tracheal Intubation: Current State of the Problem

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