Tracheal intubation using a Macintosh laryngoscope or a GlideScope ® in 15 patients with cervical spine immobilization

Agrò, F.; Barzoi, G.; Montecchia, F.

doi:10.1093/bja/aeg560

Cited by 142 publications

(71 citation statements)

References 5 publications

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“…We believe that using a stylet and correctly shaping the tracheal tube is mandatory to assist tracheal intubation with the McGrath®, as with other videolaryngoscopes. 3,5,10,12,13 The rigidity of the stylet also seems to be important -we have found that a thicker, more rigid stylet makes tracheal intubation easier.…”

Section: Discussionmentioning

confidence: 88%

“…8,9 Until recently, three videolaryngoscopes have been commercially available -the Glidescope® (Saturn Biomedical Inc, Burnaby, BC, Canada), the Macintosh VideoLaryngoscope (Karl Storz GmBH and Co., Tuttlingen, Germany) and the X-lite® (Rusch Inc., Tuttlingen, Germany). Use of the Glidescope® has been most extensively reported, [1][2][3][4][5][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] and the Macintosh VideoLaryngoscope has been described recently. 23 Successful use of the X-lite® has also been reported 24 but this device is no longer produced.…”

Section: Résultats : Le Taux De Réussite Des Intubations Trachéales Pmentioning

confidence: 99%

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Case series: The McGrath® videolaryngoscope — an initial clinical evaluation

Shippey

Ray

McKeown

2007

Can J Anesth/J Can Anesth

127

100

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Purpose: To document tracheal intubation success rates and airway instrumentation times using the newly designed McGrath® videolaryngoscope. Methods:We prospectively recorded factors associated with difficult tracheal intubation, factors causing actual difficulty in tracheal intubation, as well as complications arising from use of the new McGrath® videolaryngoscope in a series of adult patients with normal preoperative airway examinations. All patients were undergoing scheduled or elective surgery. In the first 75 patients (phase I), experience with airway instrumentation was documented, while in the second 75 patients (phase II), the time required to obtain an optimal view of the larynx was recorded, as well as the time to complete tracheal intubation.Results: Ninety-eight percent of all tracheal intubations were successful using the McGrath® videolaryngoscope. Cormack and Lehane grade I views were obtained in 143 patients (95%) and grade II views were achieved in six (4%). In phase II, the median time required to obtain an adequate view was 6.3 sec [interquartile range 4.7-8.7 (range 2-26.3)], and to complete tracheal intubation was 24.7 sec [18.5-34.4 (11.4-286)]. Fortynine (65%) of the tracheal intubations were completed within 30 sec, and 72 (96%) were completed within one minute. No complications were encountered in any patient. Conclusions: The McGrath® videolaryngoscope is an effective aid to airway management in patients with normal airways, based upon intubation success rates and the ability to rapidly secure the airway. Its potential advantages of convenience and portability warrant further evaluation in comparison with other airway devices and in patients with difficult airways. de 6,3 sec [écart interquartile 4,7-8,7 (écart 2-26,3)], et de 24,7 sec avant intubation trachéale complète [18,5-34,4 (11,4-286) Méthode : Nous avons enregistré, de façon prospective, les facteurs associés à une intubation trachéale difficile, ceux causant une difficulté réelle de l'intubation trachéale ainsi que les complications dues à l'utilisation du nouveau vidéolaryngoscope McGrath® chez une série de patients adultes présentant une anatomie des voies aériennes normales avant l'opération. Tous les patients devaient subir une chirurgie élective. Nous avons documenté notre expérience de prise en charge des voies aériennes chez les 75 premiers patients (Phase I) et, chez les 75 autres patients (Phase II), nous avons mesuré le temps requis jusqu'à obtention d'une visualisation optimale du larynx ainsi que le temps jusqu'à l'intubation trachéale complète. Résultats

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Section: Discussionmentioning

confidence: 88%

Section: Résultats : Le Taux De Réussite Des Intubations Trachéales Pmentioning

confidence: 99%

Case series: The McGrath® videolaryngoscope — an initial clinical evaluation

Shippey

Ray

McKeown

2007

Can J Anesth/J Can Anesth

127

100

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“…Numerous reports of the use of indirect laryngoscopic devices in patients with known, suspected or simulated cervical spine pathology have been published [46,[48][49][50][51].…”

Section: Choice Of New Intubation Equipmentmentioning

confidence: 99%

Evidence for benefit vs novelty in new intubation equipment

Behringer

Kristensen

2011

Anaesthesia

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SummaryA myriad of new intubation equipment has been introduced commercially since the appearance of Macintosh ⁄ Miller blades in the 1940s. We review the role of devices that are relevant to current clinical practice based on their presence in the scientific literature. The comparative performance of new vs traditional direct laryngoscopes, their complications, their use in awake intubation techniques and the prediction of unsuccessful intubation with new devices are reviewed. Manikin studies are of limited value in this area. We conclude that in both predicted and unpredicted difficult or failed intubation, carefully selected new intubation equipment has a high success rate for tracheal intubation. Ideally, such devices should be available in all settings where tracheal intubation is performed. Most importantly, experience and competence with any of the new devices are critical for their successful use in any clinical setting.

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“…For example, due to cervical spine immobilization, the intubating laryngeal mask (ILMA)® (LMA Deutschland GmbH, Bonn, Germany) allows blind insertion of an endotracheal tube, 2 while the Trachlight® stylet (Laerdal Medical Co., Wappingers Falls, NY, USA) facilitates intubation based upon the principle of transillumination of the soft tissues of the neck. 3,4 Devices which apply the principle of indirect visualization of the laryngeal structures include the GlideScope® (Verathon Inc., Bothell, WA, USA), a video laryngoscope with a digital camera located at the blade tip, and a small, separate LCD-monitor connected to the laryngoscope handle with a short cable. 3,4 The rigid Bonfils® intubation fibrescope (Karl Storz GmbH and Co. KG, Tuttlingen, Germany), 5 which has been shown to be effective for difficult airway management, 6 allows visualization of the glottic aperture and the trachea, and thus endotracheal tube placement under vision.…”

mentioning

confidence: 99%

“…3,4 Devices which apply the principle of indirect visualization of the laryngeal structures include the GlideScope® (Verathon Inc., Bothell, WA, USA), a video laryngoscope with a digital camera located at the blade tip, and a small, separate LCD-monitor connected to the laryngoscope handle with a short cable. 3,4 The rigid Bonfils® intubation fibrescope (Karl Storz GmbH and Co. KG, Tuttlingen, Germany), 5 which has been shown to be effective for difficult airway management, 6 allows visualization of the glottic aperture and the trachea, and thus endotracheal tube placement under vision. Although the efficacy of the Bonfils intubation fibrescope has been demonstrated in patients with anticipated difficult airway based on predictors, 7 its use has not been prospectively evaluated in patients with documented difficult airways.…”

mentioning

confidence: 99%

Brief report: Tracheal intubation using the Bonfils intubation fibrescope or direct laryngoscopy for patients with a simulated difficult airway

Byhahn

Nemetz

Breitkreutz

et al. 2008

Can J Anesth/J Can Anesth

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Background:The Bonfils intubation fibrescope (BIF), a rigid, straight and reusable fibreoptic device, is being used increasingly to facilitate endotracheal intubation after direct laryngoscopy has failed. We tested the hypothesis that, with the BIF compared to direct laryngoscopy, the rate of failed endotracheal intubation could be reduced in patients with a difficult airway, simulated by means of a rigid cervical immobilization collar.Methods: Seventy-six adults undergoing elective gynecological surgery under general anesthesia were randomly assigned to have endotracheal intubation, facilitated with either a standard size 3 Macintosh laryngoscope blade, or the BIF. A rigid cervical immobilization collar was used to simulate a difficult airway, by reducing mouth opening and limiting neck extension. If endotracheal intubation could not be achieved within two attempts, the cervical collar was removed, and direct laryngoscopy was performed thereafter, using a Macintosh blade in all subjects. The success rate of endotracheal tube placement was the primary outcome variable. Results: Patient characteristics were similar in the two groups. After neck immobilization, the inter-incisor distance was reduced to 2.6 ± 0.7 cm (Macintosh) and 2.6 ± 0.8 cm (BIF). Tube placement was successful in 15/38 (39.5%) patients with a Macintosh blade, and in 31/38 patients with the BIF (81.6%; P = 0.0003). Time required for tube placement was 53 ± 22 sec (Macintosh) and 64 ± 24 sec (BIF; P = 0.15). Conclusion:The Bonfils intubation fibrescope is a more effective intubating device for patients with immobilized cervical spine and significantly limited inter-incisor distance, when compared to direct laryngoscopy.

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Tracheal intubation using a Macintosh laryngoscope or a GlideScope ® in 15 patients with cervical spine immobilization

Cited by 142 publications

References 5 publications

Case series: The McGrath® videolaryngoscope — an initial clinical evaluation

Case series: The McGrath® videolaryngoscope — an initial clinical evaluation

Evidence for benefit vs novelty in new intubation equipment

Brief report: Tracheal intubation using the Bonfils intubation fibrescope or direct laryngoscopy for patients with a simulated difficult airway

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