Randomized controlled trial of intubation with the McGrath® Series 5 videolaryngoscope by inexperienced anaesthetists

Walker, Lisa; Brampton, William; Halai, M.; Hoy, Carol; Lee, E.; Scott, Ian; McLernon, David J.

doi:10.1093/bja/aep191

Cited by 86 publications

(59 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,5 Nevertheless, sometimes this can be at the expense of needing a longer time for tracheal intubation. 4,6,7 In general, tracheal intubation using DL is facilitated with a full view of the glottis. Although this is often the assumption when using indirect VL, to date this approach has not been clinically validated.…”

Section: Introductionmentioning

confidence: 99%

A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial

Robert

Kovács

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

A deliberately restricted laryngeal view with the GlideScopeÒ video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial Une vue laryngée délibérément restreinte à l'aide du vidéolaryngoscope GlideScopeÒ est associée à une intubation trachéale plus rapide et plus aisée qu ' Abstract Introduction During video laryngoscopy (VL) with angulated or hyper-curved blades, it is sometimes difficult to complete tracheal intubation despite a full view of the larynx. When using indirect VL, it has been suggested that it may be preferable to obtain a deliberately restricted view of the larynx to facilitate passage of the endotracheal tube. We used the GlideScopeÒ GVL video laryngoscope (GVL) to test whether deliberately obtaining a restricted view would result in faster and easier tracheal intubation than with a full view of the larynx.Methods We recruited 163 elective surgical patients and randomly allocated the participants to one of two groups: Group F, where a full view of the larynx was obtained and held during GVL-facilitated tracheal intubation, and Group R, with a restricted view of the larynx (\50% of glottic opening visible). Study investigators experienced in indirect VL performed the intubations. The intubations were recorded and the video recordings were subsequently assessed for total time to intubation, ease of intubation using a visual analogue scale (VAS; where 0 = easy and 100 = difficult), first-attempt success rate, and oxygen saturation after intubation. Complications were also assessed. Results The median [interquartile range (IQR)] time to intubation was faster in Group R than in sec vs 36 [27-48] sec, respectively; median difference, 9 sec; 95% confidence interval [CI], 5 to 13; P\0.001). The median [IQR] VAS rating for ease of intubation was also better in Group R than in Group F (14 [6-42) mm vs 50 mm , respectively; median difference, 20 mm; 95% CI, 10 to 31; P \ 0.001). There was no difference between groups regarding the first-attempt success rate, oxygen saturation immediately after intubation, or complications. Conclusions Using the GVL with a deliberately restricted view of the larynx resulted in faster and easier tracheal intubation than with a full view and with no additional complications. Our study suggests that obtaining a full or Cormack-Lehane grade 1 view may not be desirable when using the GVL. This trial was registered at ClinicalTrials.gov: NCT02144207. , respectivement, différence médiane, 20 mm, IC 95 %, 10 à 31, P\0,001). Aucune différence n'a été observée entre les deux groupes quant au taux de réussite à la première tentative, à la saturation en oxygène immédiatement après l'intubation, ou aux complications. Conclusion En obtenant une vue délibérément restreinte du larynx avec un vidéolaryngoscope GlideScopeÒ, on a observé une intubation trachéale plus rapide et plus aisée qu'en obtenant une vue d'ensemble et ce, sans complications supplémentaires. Notre étude suggère que l'obtention d'une vu...

show abstract

Section: Introductionmentioning

confidence: 99%

A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial

Robert

Kovács

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Straight blades are normally designed with a slight anterior curve at the tip, which is used to elevate the epiglottis directly. Video-assisted devices have become popular, allowing a better view of the larynx, and may be potentially useful in difficult tracheal intubations [9][10][11][12][13].…”

mentioning

confidence: 99%

A randomised controlled trial comparing the McGrath^® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*

Sim

et al. 2011

Anaesthesia

View full text Add to dashboard Cite

SummaryStudies show that both straight blade laryngoscopy and videolaryngoscopy can improve the view of the larynx when compared with the Macintosh blade laryngoscopy. However, no study has compared these two devices. A total of 80 patients with Mallampati grade ≥ 3 were randomly assigned to either have orotracheal intubation with the McGrath® videolaryngoscope or the Henderson straight blade. The primary outcome was laryngoscopic view. Time to intubation, number of attempts, ease of intubation and complications were also recorded. Thirty‐nine out of 40 patients had grade‐1 views in the McGrath group, compared with 29 out of 40 cases in the Henderson group (p = 0.003). There were no statistically significant differences in the secondary outcomes. Two patients suffered from minor oropharyngeal injuries in the Henderson group. Apart from offering significantly more grade‐1 laryngoscopic views, the McGrath videolaryngoscope did not improve other clinical outcomes compared with the straight blade, when used in patients with poor Mallampati scores.

show abstract

“…In addition to the low success rates of multiple intubation attempts, complications such as airway trauma, hypoxia, tachycardia, increase in blood pressure and intraocular pressure, aspiration, and cardiac arrest may arise 7,8 . Available data suggest that the new intubation equipment may play a crucial role in advanced airway management [9][10][11] . Recently, video and optic laryngoscopic assisted tracheal intubation has been used widely in patients with difficult airways or as rescue in field intubation attempts.…”

Section: Device Video and Optic Variabilitymentioning

confidence: 99%

“…Thus, unanticipated difficult intubations may be less frequent if video laryngoscopy is used as the first-line approach. In adult patients with an 'easy airway', direct laryngoscopy was found to be faster and cheaper than intubation using new devices 10,11 . Despite different shapes and characteristics of video laryngoscopes, there is little information about which video laryngoscope design could be more advantageous in various clinical situations.…”

Section: Key Pointsmentioning

confidence: 99%

Alternative Devices in Airway Visualization

Maldini

Hodzovic

Goranović

2016

ACC

View full text Add to dashboard Cite

SUMMARY -The Macintosh laryngoscope has been the most widely used device for intubation since its invention by Foregger in the 1940s. Recently, video and optic laryngoscopy assisted tracheal intubation has been used widely in patients with difficult airways. Their routine use, however, is not widely practiced. This review will summarize some of the newly available devices to assist tracheal intubation, with their advantages and disadvantages when compared with conventional laryngoscopes. It also presents the reasons to support their use in both elective and emergency airway management.

show abstract

Randomized controlled trial of intubation with the McGrath® Series 5 videolaryngoscope by inexperienced anaesthetists

Abstract: There were no advantages to using the McGrath laryngoscope for uncomplicated tracheal intubation and duration of intubation was longer, so it should not be used as a first-line laryngoscope instrument by inexperienced anaesthetists.

Cited by 86 publications

References 15 publications

A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial

A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial

A randomised controlled trial comparing the McGrath^® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*

Alternative Devices in Airway Visualization

Contact Info

Product

Resources

About

Randomized controlled trial of intubation with the McGrath® Series 5 videolaryngoscope by inexperienced anaesthetists

Abstract: There were no advantages to using the McGrath laryngoscope for uncomplicated tracheal intubation and duration of intubation was longer, so it should not be used as a first-line laryngoscope instrument by inexperienced anaesthetists.

Cited by 86 publications

References 15 publications

A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial

A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial

A randomised controlled trial comparing the McGrath® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*

Alternative Devices in Airway Visualization

Contact Info

Product

Resources

About

A randomised controlled trial comparing the McGrath^® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*