Video‐laryngoscopes in the adult airway management: a topical review of the literature

Abstract

The aim of the present paper is to review the literature regarding video-laryngoscopes (Storz V-Mac and C-Mac, Glidescope, McGrath, Pentax-Airway Scope, Airtraq and Bullard) and discuss their clinical role in airway management. Video-laryngoscopes are new intubation devices, which provide an indirect view of the upper airway. In difficult airway management, they improve Cormack-Lehane grade and achieve the same or a higher intubation success rate in less time, compared with direct laryngoscopes. Despite the very good visualization of the glottis, the insertion and advancement of the endotracheal tube with video-laryngoscopes may occasionally fail. Each particular device's features may offer advantages or disadvantages, depending on the situation the anaesthesiologist has to deal with. So far, there is inconclusive evidence indicating that video-laryngoscopy should replace direct laryngoscopy in patients with normal or difficult airways.

Comparison of the laryngeal mask airway - CTrachTM and direct coupled interface-video laryngoscope for endotracheal intubation: A prospective, randomized, clinical study

“…This conventional approach may facilitate the insertion of the video laryngoscope into the mouth and so provide a short glottic time. However, an improved laryngeal view does not always match with a higher intubation success rate (14). Despite the clear visualization of the glottis, the insertion and advancement of the ETT with video laryngoscopes may occasionally fail (15).…”

‘From darkness into light’: time to make awake intubation with videolaryngoscopy the primary technique for an anticipated difficult airway?

“…Not all videolaryngoscopes would be suitable for the technique of awake intubation described in the published paper. The common feature of videolaryngoscopes is they can 'see' around corners and provide a clear view of the glottic opening [25,34]. However, they differ in the blade design and method of use [34].…”

“…The common feature of videolaryngoscopes is they can 'see' around corners and provide a clear view of the glottic opening [25,34]. However, they differ in the blade design and method of use [34]. For example, videolaryngoscopes with a Macintosh-like curved blade without a tube channel (such as the C-MAC D-blade used in Kramer et al's study) are quite likely to require some form of airway adjunct, such as a stylet [2,11], tracheal tube introducer [35,36] or fibrescope [6] to aid tracheal tube placement.…”

Videolaryngoscopy: towards a new standard method for tracheal intubation in the ICU?

“…However, during the last decade a variety of videolaryngoscopes have been introduced. To date, most studies on these instruments have taken place in the operating room, the emergency room, or the prehospital setting [7,8]. The larynx and glottis are easier to visualize with these instruments, but intubation may take longer due to potential difficulties in passing the tube into the trachea [7,8].…”