Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway
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TLDR
C-MAC laryngoscopy seems to be a useful technique for the initial approach to a potentially difficult airway in a broad range of patients with predictors of difficult intubation.Abstract:
Background Video laryngoscopy may be useful in the setting of the difficult airway, but it remains unclear if intubation success is improved in routine difficult airway management. This study compared success rates for tracheal intubation with the C-MAC® video laryngoscope (Karl Storz, Tuttlingen, Germany) with conventional direct laryngoscopy in patients with predicted difficult airway. Methods We conducted a two arm, single-blinded randomized controlled trial that involved 300 patients. Inclusion required at least one of four predictors of difficult intubation. The primary outcome was successful tracheal intubation on first attempt. Results The use of video laryngoscopy resulted in more successful intubations on first attempt (138/149; 93%) as compared with direct laryngoscopy (124/147; 84%), P = 0.026. Cormack-Lehane laryngeal view was graded I or II in 139/149 of C-MAC attempts versus 119/147 in direct laryngoscopy attempts (P Conclusion A diverse group of anesthesia providers achieved a higher intubation success rate on first attempt with the C-MAC in a broad range of patients with predictors of difficult intubation. C-MAC laryngoscopy seems to be a useful technique for the initial approach to a potentially difficult airway.read more
Citations
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Journal ArticleDOI
practice Guidelines for Management of the Difficult airway An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway
Jeffrey L. Apfelbaum,Carin A. Hagberg,Robert A. Caplan,Casey D. Blitt,Richard T. Connis,David G. Nickinovich,Jonathan L. Benumof,Frederic A. Berry,Robert H. Bode,Frederick W. Cheney,Orin F. Guidry,Andranik Ovassapian +11 more
TL;DR: This document updates the “Practice Guidelines for Management of the Difficult Airway: An Updated Report by”, which provides basic recommendations that are supported by a synthesis and analysis of the current literature, expert and practitioner opinion, open-forum commentary, and clinical feasibility data.
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Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation
TL;DR: The primary objective was to assess whether use of videolaryngoscopy for tracheal intubation in adults requiring general anaesthesia reduces risks of complications and failure compared with direct laryngoscope.
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Incidence, predictors, and outcome of difficult mask ventilation combined with difficult laryngoscopy: a report from the multicenter perioperative outcomes group.
Sachin Kheterpal,David W. Healy,Michael F. Aziz,Amy Shanks,Robert E. Freundlich,Fiona Linton,Lizabeth D. Martin,Jonathan Linton,Jerry L. Epps,Ana Fernandez-Bustamante,Leslie C. Jameson,Tyler Tremper,Kevin K. Tremper +12 more
TL;DR: DMV combined with DL is an infrequent but not rare phenomenon, most patients can be managed with the use of direct or videolaryngoscopy, and an easy to use unweighted risk scale has robust discriminating capacity.
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The difficult airway with recommendations for management ??? Part 1 ??? Difficult tracheal intubation encountered in an unconscious/induced patient
J. Adam Law,Natasha Broemling,Richard M. Cooper,Pierre Drolet,Laura V. Duggan,Donald E. G. Griesdale,Orlando Hung,Philip M. Jones,George Kovacs,Simon Massey,Ian R. Morris,Timothy Mullen,Michael F. Murphy,Roanne Preston,Viren N. Naik,Jeanette Scott,Shean Stacey,Timothy P. Turkstra,David T. Wong +18 more
TL;DR: The CAFG arrived at updated practice recommendations for management of the unconscious/induced patient in whom difficult or failed tracheal intubation is encountered to arrive at evidence- or consensus-based recommendations together with assigned levels of evidence modelled after previously published criteria.
Journal ArticleDOI
Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation: a Cochrane Systematic Review
Sharon R Lewis,Andrew R Butler,J. Parker,Tim Cook,Tim Cook,Oliver J Schofield-Robinson,Andrew F Smith +6 more
TL;DR: There is no evidence that use of a videolaryngoscopes reduces the number of intubation attempts or the incidence of hypoxia or respiratory complications, and no evidence indicates that useof a videOLaryngoscope affects time required forintubation.
References
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Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance.
TL;DR: The most useful bedside test for prediction was found to be a combination of the Mallampati classification and thyromental distance, and currently available screening tests for difficult intubation have only poor to moderate discriminative power when used alone.
Journal ArticleDOI
Emergency Tracheal Intubation: Complications Associated with Repeated Laryngoscopic Attempts
TL;DR: Data support the recommendation of the ASA Task Force on the Management of the Difficult Airway to limit laryngoscopic attempts to three in lieu of the considerable patient injury that may occur and confirm the number of larygoscopic attempts is associated with the incidence of airway and hemodynamic adverse events.
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Management of the difficult airway: a closed claims analysis.
Gene N. Peterson,Karen B. Domino,R. A. Caplan,Karen L. Posner,Lorri A. Lee,Frederick W. Cheney +5 more
TL;DR: In this paper, the authors identify the patterns of liability associated with malpractice claims arising from management of the difficult airway, using the American Society of Anesthesiologists Closed Claims database.
Journal ArticleDOI
Preoperative Airway Assessment: Predictive Value of a Multivariate Risk Index
Abdel Raouf El-Ganzouri,Robert J. McCarthy,Kenneth J. Tuman,Erik N. Tanck,Anthony D. Ivankovich +4 more
TL;DR: Improved risk stratification for difficulty with visualization during rigid laryngoscopy (Grade IV) can be obtained by use of a simplified preoperative multivariate airway risk index, with better accuracy compared to oropharyngeal (Mallampati) classification at both low- and high-risk levels.
Journal ArticleDOI
Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients.
TL;DR: GS laryngoscopy consistently yielded a comparable or superior glottic view compared with DL despite the limited or lack of prior experience with the device.
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