Impact of pillow height on double-lumen endotracheal tube intubation with McGRATH MAC: a prospective randomized clinical trial

Deguchi, Shiho; Komasawa, Nobuyasu; Kido, Haruki; Ueno, Takeshi; Minami, Toshiaki

doi:10.1016/j.jclinane.2016.05.024

Cited by 13 publications

(1 citation statement)

References 16 publications

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“…If the laryngeal axis is tilted upward, the angle of incidence between the laryngoscope blade and the trachea is increased, thereby making advancement of the tube into the trachea more difficult 5 . A previous study comparing the impact of pillow height (4 vs. 12 cm) on double-lumen tracheal tube intubation using a McGRATH MAC video laryngoscope suggested that intubation with a high pillow significantly provided easier progression of the tube through glottis and lower incidence of postoperative hoarseness than that with a low pillow, whereas the POGO score was similar with both pillows 16 . Different head and neck positions can affect the tube advancement into the trachea during video laryngoscopy; however, we did not evaluate it in this study.…”

Section: Discussionmentioning

confidence: 99%

Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope

Kim

Chang

Won

et al. 2023

European Journal of Anaesthesiology

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BACKGROUND Different head and neck positions may affect video laryngoscopy in terms of laryngeal exposure, intubation difficulty, advancement of the tracheal tube into the glottis and the occurrence of palatopharyngeal mucosal injury. OBJECTIVE We investigated the effects of simple head extension, head elevation without head extension and the sniffing position on tracheal intubation using a McGRATH MAC video laryngoscope. DESIGN A randomised, prospective study. SETTING Medical centre governed by a university tertiary hospital. PATIENTS A total of 174 patients undergoing general anaesthesia. METHODS Patients were randomly allocated to one of three groups: simple head extension (neck extension without a pillow), head elevation only (head elevation with a pillow of 7 cm and no neck extension) and sniffing position (head elevation with a pillow of 7 cm and neck extension). MAIN OUTCOMES During tracheal intubation using a McGRATH MAC video laryngoscope in three different head and neck positions, we assessed intubation difficulty by several methods: a modified intubation difficulty scale score, time taken for tracheal intubation, glottic opening, number of intubation attempts, requirements for other manoeuvres (lifting force or laryngeal pressure) for laryngeal exposure and advancement of the tracheal tube into the glottis. The occurrence of palatopharyngeal mucosal injury was evaluated after tracheal intubation. RESULTS Tracheal intubation was significantly easier in the head elevation group than in the simple head extension (P = 0.001) and sniffing positions (P = 0.011). Intubation difficulty did not differ significantly between the simple head extension and sniffing positions (P = 0.252). The time taken for intubation in the head elevation group was significantly shorter than that in the simple head extension group (P < 0.001). A lifting force or laryngeal pressure was required less frequently for tube advancement into the glottis in the head elevation group than in the simple head extension (P = 0.002) and sniffing position groups (P = 0.012). The need for a lifting force or laryngeal pressure for tube advancement into the glottis was not significantly different between the simple head extension and sniffing positions (P = 0.498). Palatopharyngeal mucosal injury occurred less frequently in the head elevation group than in the simple head extension group (P = 0.009). CONCLUSION The head elevation position facilitated tracheal intubation using a McGRATH MAC video laryngoscope compared with a simple head extension or sniffing position. TRIAL REGISTRY NUMBER ClinicalTrials.gov (NCT05128968)

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Section: Discussionmentioning

confidence: 99%

Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope

Kim

Chang

Won

et al. 2023

European Journal of Anaesthesiology

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Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review

Dean

Kerrey

2022

JACEP Open

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Objective Published studies of video laryngoscopes are often limited by the lack of a clear definition of video laryngoscopy (VL). We performed a systematic review to determine how often published studies of VL report on video screen visualization. Methods We searched PubMed, EMBASE and Scopus for interventional and observational studies in which a video laryngoscope equipped with a standard geometry blade was used for tracheal intubation. We excluded simulation based studies. Our primary outcome was data on video laryngoscope screen visualization. Secondary outcomes were explicit methodology for screen visualization. Results We screened 4838 unique studies and included 207 (120 interventional and 87 observational). Only 21 studies (10% of 207) included any data on video screen visualization by the proceduralist, 19 in a yes/no fashion only (ie, screened viewed or not) and 2 with detail beyond whether the screen was viewed or not. In 11 more studies, visualization patterns could be inferred based on screen availability and in 16 more studies, the methods section stated how screen visualization was expected to be performed without reporting data collection on how the proceduralist interacted with the video screen. Risk of bias was high in the majority of included studies. Conclusions Published studies of VL, including many clinical trials, rarely include data on video screen visualization. Given the nuances of using a video laryngoscope, this is a critical deficiency, which largely prevents us from knowing the treatment effect of using a video laryngoscope in clinical practice. Future studies of VL must address this deficiency.

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Video Laryngoscopes in Thoracic Surgery

Tahan

Villalonga

2020

Anesthesia in Thoracic Surgery

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Impact of pillow height on double-lumen endotracheal tube intubation with McGRATH MAC: a prospective randomized clinical trial

Cited by 13 publications

References 16 publications

Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope

Effect of head and neck positions on tracheal intubation using a McGRATH MAC video laryngoscope

Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review

Video Laryngoscopes in Thoracic Surgery

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