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Tao D, Zhang G, Zheng X, Wang X, Gao G, Yang Z, Lin Y, Lu L. Feasibility study of intubation in lateral position using Viva-sight double-lumen tube combined with video laryngoscope in patients undergoing pulmonary lobectomy. Asian J Surg 2024; 47:373-379. [PMID: 37696694 DOI: 10.1016/j.asjsur.2023.08.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Double-lumen tube (DLT) intubation in lateral decubitus position is rarely reported. We designed this study to evaluate the feasibility of VivaSight double-lumen tube (VDLT) intubation assisted by video laryngoscope in lateral decubitus patients. METHODS Patients undergoing elective video-assisted thoracoscopic surgery (VATS) for lung lobectomy were assessed for eligibility between January 2022 and December, 2022. Eligible patients were randomly allocated into supine intubation group (group S) and lateral intubation group (group L) by a computer-generated table of random numbers. The prime objective was to observe whether the success rate of VDLT intubation in lateral position with the aid of video laryngoscope was not inferior to that in supine position. RESULTS A total of 116 patients were assessed, and 88 eligible patients were randomly divided into group L (n = 44) and group S (n = 44). The success rate of the first attempt intubation in the L group was 90.5%, lower than that of S group (97.7%), but there was no statistical difference (p > 0.05). Patients in both groups were intubated with VDLT for no more than 2 attempts. The mean intubation time was 91.98 ± 26.70 s in L group, and 81.39 ± 34.35 s in S group (p > 0.05). The incidence of the capsular malposition in the group L was 4.8%, less than 36.4% of group S (p < 0.001). After 24 h of follow-up, it showed a higher incidence of sore throat in group S, compared to that in group L (p = 0.009). CONCLUSION Our study shows the comprehensive success rate of intubation in lateral decubitus position with VDLT assisted by video laryngoscope is not inferior to that in supine position, with less risk of intraoperative tube malposition and postoperative sore throat. TRIAL REGISTRATION Chinese Clinical Trail Register (ChiCTR2200062989).
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Affiliation(s)
- Deqiang Tao
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Guyue Zhang
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Xiangli Zheng
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Xiaofan Wang
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Guangya Gao
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Zhanmin Yang
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Yanjun Lin
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
| | - Liangyuan Lu
- Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
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Bakshi SG, Panigrahi AR, Bhawalkar P, Divatia JV. Comparison of double lumen tube insertion using the McGrath MAC versus direct laryngoscopy in adult patients with a limited glottis view: A prospective interventional study. J Anaesthesiol Clin Pharmacol 2022; 38:624-627. [PMID: 36778794 PMCID: PMC9912895 DOI: 10.4103/joacp.joacp_578_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 12/30/2022] Open
Abstract
Background and Aims Passage of double-lumen tubes (DLT) can be challenging in patients with limited glottis view. This study aims to determine the usefulness of McGrath® MAC videolaryngoscope (VL) in cases with limited glottis view on direct laryngoscopy with Macintosh blade. Material and Methods After study approval and registration of trial, consent was sought from all adult patients planned for elective DLT insertion for lung isolation during the course of general anesthesia. Patients not consenting, less than 18 years, with anticipated difficult mask ventilation or need for rapid sequence induction were excluded. Following routine anesthetic induction, laryngoscopy was attempted by an experienced anesthesiologist using Macintosh scope. If the view obtained was Cormack and Lehane (CL) view IIB and above or the attempt at intubation using DLT failed despite a CL I/IIA view, the patient was included in the trial. The laryngoscope was removed and after ensuring adequate oxygenation and depth of anesthesia, intubation was attempted using McGrath® MAC VL. The percentage of glottis opening (POGO) score was noted for both the scopes. Results DLT insertion was attempted in 76 patients in the study period. Eight patients were included in the trial on account of limited glottis view/failure with Macintosh scope. Insertion of DLT with McGrath MAC was tried only in six patients, in two patients, the VL was not available for use. The mean (standard deviation) POGO score with Macintosh scope was 9 (±20), which significantly improved with the use of VL to 71 (±24), P = 0.01. Conclusion McGrath MAC is helpful in inserting DLT in patients with limited glottis view with Macintosh scope.
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Affiliation(s)
- Sumitra G. Bakshi
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Amit R. Panigrahi
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Pranay Bhawalkar
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Jigeeshu V. Divatia
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Yao W, Li M, Zhang C, Luo A. Recent Advances in Videolaryngoscopy for One-Lung Ventilation in Thoracic Anesthesia: A Narrative Review. Front Med (Lausanne) 2022; 9:822646. [PMID: 35770016 PMCID: PMC9235869 DOI: 10.3389/fmed.2022.822646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Since their advent, videolaryngoscopes have played an important role in various types of airway management. Lung isolation techniques are often required for thoracic surgery to achieve one-lung ventilation with a double-lumen tube (DLT) or bronchial blocker (BB). In the case of difficult airways, one-lung ventilation is extremely challenging. The purpose of this review is to identify the roles of videolaryngoscopes in thoracic airway management, including normal and difficult airways. Extensive literature related to videolaryngoscopy and one-lung ventilation was analyzed. We summarized videolaryngoscope-guided DLT intubation techniques and discussed the roles of videolaryngoscopy in DLT intubation in normal airways by comparison with direct laryngoscopy. The different types of videolaryngoscopes for DLT intubation are also compared. In addition, we highlighted several strategies to achieve one-lung ventilation in difficult airways using videolaryngoscopes. A non-channeled or channeled videolaryngoscope is suitable for DLT intubation. It can improve glottis exposure and increase the success rate at the first attempt, but it has no advantage in saving intubation time and increases the incidence of DLT mispositioning. Thus, it is not considered as the first choice for patients with anticipated normal airways. Current evidence did not indicate the superiority of any videolaryngoscope to another for DLT intubation. The choice of videolaryngoscope is based on individual experience, preference, and availability. For patients with difficult airways, videolaryngoscope-guided DLT intubation is a primary and effective method. In case of failure, videolaryngoscope-guided single-lumen tube (SLT) intubation can often be achieved or combined with the aid of fibreoptic bronchoscopy. Placement of a DLT over an airway exchange catheter, inserting a BB via an SLT, or capnothorax can be selected for lung isolation.
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Dean P, Kerrey B. Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review. J Am Coll Emerg Physicians Open 2022; 3:e12630. [PMID: 35028640 PMCID: PMC8738719 DOI: 10.1002/emp2.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/08/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022] Open
Abstract
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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Affiliation(s)
- Preston Dean
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Benjamin Kerrey
- Division of Emergency MedicineCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
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5
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Piccioni F, Droghetti A, Bertani A, Coccia C, Corcione A, Corsico AG, Crisci R, Curcio C, Del Naja C, Feltracco P, Fontana D, Gonfiotti A, Lopez C, Massullo D, Nosotti M, Ragazzi R, Rispoli M, Romagnoli S, Scala R, Scudeller L, Taurchini M, Tognella S, Umari M, Valenza F, Petrini F. Recommendations from the Italian intersociety consensus on Perioperative Anesthesa Care in Thoracic surgery (PACTS) part 2: intraoperative and postoperative care. Perioper Med (Lond) 2020; 9:31. [PMID: 33106758 PMCID: PMC7582032 DOI: 10.1186/s13741-020-00159-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/22/2020] [Indexed: 02/08/2023] Open
Abstract
Introduction Anesthetic care in patients undergoing thoracic surgery presents specific challenges that require a multidisciplinary approach to management. There remains a need for standardized, evidence-based, continuously updated guidelines for perioperative care in these patients. Methods A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, was established to develop recommendations for anesthesia practice in patients undergoing elective lung resection for lung cancer. The project addressed three key areas: preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventive Services Task Force criteria. Results Recommendations for intraoperative care focus on airway management, and monitoring of vital signs, hemodynamics, blood gases, neuromuscular blockade, and depth of anesthesia. Recommendations for postoperative care focus on the provision of multimodal analgesia, intensive care unit (ICU) care, and specific measures such as chest drainage, mobilization, noninvasive ventilation, and atrial fibrillation prophylaxis. Conclusions These recommendations should help clinicians to improve intraoperative and postoperative management, and thereby achieve better postoperative outcomes in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve.
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Affiliation(s)
- Federico Piccioni
- Department of Critical and Supportive Care, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Alessandro Bertani
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT - UPMC, Palermo, Italy
| | - Cecilia Coccia
- Department of Anesthesia and Critical Care Medicine, National Cancer Institute "Regina Elena"-IRCCS, Rome, Italy
| | - Antonio Corcione
- Department of Critical Care Area Monaldi Hospital, Ospedali dei Colli, Naples, Italy
| | - Angelo Guido Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Roberto Crisci
- Department of Thoracic Surgery, University of L'Aquila, L'Aquila, Italy
| | - Carlo Curcio
- Thoracic Surgery, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy
| | - Carlo Del Naja
- Department of Thoracic Surgery, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, FG Italy
| | - Paolo Feltracco
- Department of Medicine, Anaesthesia and Intensive Care, University Hospital of Padova, Padova, Italy
| | - Diego Fontana
- Thoracic Surgery Unit - San Giovanni Bosco Hospital, Turin, Italy
| | | | - Camillo Lopez
- Thoracic Surgery Unit, 'V Fazzi' Hospital, Lecce, Italy
| | - Domenico Massullo
- Anesthesiology and Intensive Care Unit, Azienda Ospedaliero Universitaria S. Andrea, Rome, Italy
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Ragazzi
- Department of Morphology, Surgery and Experimental Medicine, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy
| | - Marco Rispoli
- Anesthesia and Intensive Care, AORN dei Colli Vincenzo Monaldi Hospital, Naples, Italy
| | - Stefano Romagnoli
- Department of Health Science, Section of Anesthesia and Critical Care, University of Florence, Florence, Italy.,Department of Anesthesia and Critical Care, Careggi University Hospital, Florence, Italy
| | - Raffaele Scala
- Pneumology and Respiratory Intensive Care Unit, San Donato Hospital, Arezzo, Italy
| | - Luigia Scudeller
- Clinical Epidemiology Unit, Scientific Direction, Fondazione IRCCS San Matteo, Pavia, Italy
| | - Marco Taurchini
- Department of Thoracic Surgery, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, FG Italy
| | - Silvia Tognella
- Respiratory Unit, Orlandi General Hospital, Bussolengo, Verona, Italy
| | - Marzia Umari
- Combined Department of Emergency, Urgency and Admission, Cattinara University Hospital, Trieste, Italy
| | - Franco Valenza
- Department of Critical and Supportive Care, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy
| | - Flavia Petrini
- Department of Anaesthesia, Perioperative Medicine, Pain Therapy, RRS and Critical Care Area - DEA ASL2 Abruzzo, Chieti University Hospital, Chieti, Italy
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6
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Risse J, Schubert AK, Wiesmann T, Huelshoff A, Stay D, Zentgraf M, Kirschbaum A, Wulf H, Feldmann C, Meggiolaro KM. Videolaryngoscopy versus direct laryngoscopy for double-lumen endotracheal tube intubation in thoracic surgery - a randomised controlled clinical trial. BMC Anesthesiol 2020; 20:150. [PMID: 32546128 PMCID: PMC7296647 DOI: 10.1186/s12871-020-01067-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023] Open
Abstract
Background Double-lumen tube (DLT) intubation is necessary for thoracic surgery and other operations with the need for lung separation. However, DLT insertion is complex and might result in airway trauma. A new videolaryngoscopy (GVL) with a thin blade might improve the intubation time and reduce complexity as well as iatrogenic airway complications compared to conventional direct laryngoscopy (DL) for DLT intubation. Methods A randomised, controlled trial was conducted in 70 patients undergoing elective thoracic surgery using DLT for lung separation. Primary endpoint was time to successful intubation. The secondary endpoints of this study were number of intubation attempts, the assessment of difficulty, any complications during DLT intubation and the incidence of objective trauma of the oropharynx and supraglottic space and intubation-related subjective symptoms. Results 65 patients were included (DL group [n = 31], GVL group [n = 34]). Median intubation time (25th–75th percentiles) in GVL group was 93 s (63–160) versus 74 (58–94) in DL group [p = 0.044]. GVL resulted in significantly improved visualisation of the larynx (Cormack and Lehane grade of 1 in GVL group was 97% vs. 74% in DL Group [p = 0.008]). Endoscopic examinations revealed significant differences in GVL group compared to DL group showing less red-blooded vocal cord [p = 0.004], vocal cord haematoma [p = 0.022] and vocal cord haemorrhage [p = 0.002]. No significant differences regarding the postoperative subjective symptoms of airway were found. Conclusions Videolaryngoscopy using the GlideScope®-Titanium shortly prolongs DLT intubation duration compared to direct laryngoscopy but improves the view. Objective intubation trauma but not subjective complaints are reduced. Trial registration German Clinical Trial Register DRKS00020978, retrospectively registered on 09. March 2020.
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Affiliation(s)
- Joachim Risse
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany. .,Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany.
| | - Ann-Kristin Schubert
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - Thomas Wiesmann
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - Ansgar Huelshoff
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - David Stay
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - Michael Zentgraf
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - Andreas Kirschbaum
- Visceral, Thoracic and Vascular Surgery Clinic, University Hospital Giessen and Marburg GmbH, Baldingerstraße, 35033, Marburg, Germany
| | - Hinnerk Wulf
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - Carsten Feldmann
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
| | - Karl Matteo Meggiolaro
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany
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Collins SR, Titus BJ, Campos JH, Blank RS. Lung Isolation in the Patient With a Difficult Airway. Anesth Analg 2019; 126:1968-1978. [PMID: 29189274 DOI: 10.1213/ane.0000000000002637] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
One-lung ventilation is routinely used to facilitate exposure for thoracic surgical procedures and can be achieved via several lung isolation techniques. The optimal method for lung isolation depends on a number of factors that include (1) the indication for lung isolation, (2) anatomic features of the upper and lower airway, (3) availability of equipment and devices, and (4) the anesthesiologist's proficiency and preferences. Though double-lumen endobronchial tubes (DLTs) are most commonly utilized to achieve lung isolation, the use of endobronchial blockers offer advantages in patients with challenging airway anatomy. Anesthesiologists should be familiar with existing alternatives to the DLT for lung isolation and alternative techniques for DLT placement in the patient with a difficult airway. Newer technologies such as videolaryngoscopy with or without adjunctive fiberoptic bronchoscopy may facilitate intubation and lung isolation in difficult airway management.
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Affiliation(s)
- Stephen R Collins
- From the Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia
| | - Brian J Titus
- From the Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia
| | - Javier H Campos
- Department of Anesthesia, University of Iowa Healthcare, Iowa City, Iowa
| | - Randal S Blank
- From the Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia
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Bakshi SG, Gawri A, Divatia JV. McGrath MAC video laryngoscope versus direct laryngoscopy for the placement of double-lumen tubes: A randomised control trial. Indian J Anaesth 2019; 63:456-461. [PMID: 31263297 PMCID: PMC6573042 DOI: 10.4103/ija.ija_48_19] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background and Aims Role of video laryngoscopes (VLs) in the management of difficult airway with single-lumen tubes (SLTs) is established. VLs provide improved glottis view but are associated with longer time to intubate (TTI). We aimed to compare the TTI for double-lumen tube (DLT) insertion using the McGrath® MAC VL versus direct Macintosh laryngoscope (DL). Methods Eleven senior anaesthesiologists experienced in SLT insertion, but not DLT insertion with VL participated. Seventy-four adults belonging to American Society of Anesthesiologists physical status I-II posted for elective surgery needing lung isolation were randomised to both intubator and laryngoscope (VL/DL). Primary endpoint was TTI; secondary endpoints included glottic view assessed by the Cormack and Lehane (CL) grade, need for external laryngeal manipulation, ease of intubation [scored using Numeric Rating Scale (1 - easiest, 10 - most difficult)] and associated complications. TTI was compared using Student's t-test. Results No difference was found in TTI with DL and VL [(56.6 ± 14) s vs (64.4 ± 24) s, P = 0.104] as well as ease of use of laryngoscope [median score of 2 (1-3) in both]. Use of VL resulted in more patients with CL I glottic view - 86.0% versus 58.0% (P = 0.007). Fewer patients required external laryngeal manipulations (19% vs 47%, P = 0.013), and complications were fewer in the VL group (5% vs 24%, P = 0.023). Conclusion TTI for DLT insertion was similar with VL and DL. However, VL was associated with better glottis visualisation, reduced need of external laryngeal manipulation and fewer complications.
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Affiliation(s)
- Sumitra G Bakshi
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ajay Gawri
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Jigeeshu V Divatia
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Glidescope versus Airtraq DL for double-lumen tracheal tube insertion in patients with a predicted or known difficult airway: A randomised study. Eur J Anaesthesiol 2018; 34:456-463. [PMID: 28525401 DOI: 10.1097/eja.0000000000000655] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN Randomised study. PATIENTS Adults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index). INTERVENTION Between March 2014 and March 2015, adult patients, scheduled for elective thoracic surgery, requiring double-lumen tracheal tube placement, and with a predicted risk (evaluated preoperatively using the Arné score) or a history of difficult intubation, were allocated to a Glidescope or an Airtraq group. MAIN OUTCOME MEASURES The primary outcome was the overall success rate of tracheal intubation after two attempts. Secondary outcomes were success rates on the first attempt, duration of intubation, need for laryngeal pressure, Cormack and Lehane grade and side-effects. RESULTS Of 277 patients, 78 were predicted to have a difficult airway. Finally, 72 patients were enrolled. Neither the overall success rates of tracheal intubation [Glidescope group 31/36 (86%) versus Airtraq group 34/36 (94%), P = 0.43] nor the side-effects differed between groups. There was no difference concerning visualisation of the glottis using the Cormack and Lehane grade (P = 0.18) or intubation time [Glidescope group 67 s (49 to 90) versus Airtraq group 81 s (59 to 101), P = 0.28]. All patients with a previous history of difficult intubation were intubated successfully. CONCLUSION There is no difference in success rates of tracheal intubation with a double-lumen tube in patients with a predicted or known difficult airway when using either a Glidescope or Airtraq device. TRIAL REGISTRATION National register of the French National Agency for Medicines and Health Products Safety No. 2014-A00143-44.
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10
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Yoo JY, Park SY, Kim JY, Kim M, Haam SJ, Kim DH. Comparison of the McGrath videolaryngoscope and the Macintosh laryngoscope for double lumen endobronchial tube intubation in patients with manual in-line stabilization: A randomized controlled trial. Medicine (Baltimore) 2018. [PMID: 29517671 PMCID: PMC5882448 DOI: 10.1097/md.0000000000010081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Double lumen endobronchial tube (DLT) intubation is commonly used for one-lung ventilation in thoracic surgery. However, because of its large size and shape, it is difficult to perform intubation compared with a single lumen tube. The aim of this randomized controlled trial was to determine whether the McGrath videolaryngoscope has any advantage over the direct Macintosh laryngoscope for DLT intubation in patients with a simulated difficult airway. METHODS Forty-four patients (19-60 years of age); scheduled to undergo general anesthesia with one-lung ventilation were assigned to 1 of 2 groups: DLT intubation with the McGrath videolaryngoscope (ML group [n = 22]); or conventional Macintosh laryngoscope (DL group [n = 22]). After manual in-line stabilization was applied as a way of simulating a difficult airway, the time required for intubation and the quality of glottic view were evaluated. RESULTS The time to successful intubation was not different between the 2 groups (ML group, 45 s [interquartile range, 38-52 s] versus DL group, 54 s [45-59 s]; P = .089). The McGrath videolaryngoscope, however, provided a significantly better glottic view. Modified Cormack and Lehane grade was better (P < .001), and the percentage of glottis opening score was higher in the ML group (P < .001). Overall intubation difficulty scale score was lower in the ML group (1 [0-2]) versus the DL group (3 [2-4]) (P < .001). CONCLUSION The McGrath videolaryngoscope improved glottic view and resulted in lower overall intubation difficulty scale score in patients with in-line stabilization.
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Affiliation(s)
| | | | | | | | - Seok Jin Haam
- Department of Cardiovascular and Thoracic Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Dae Hee Kim
- Department of Anesthesiology and Pain Medicine
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Granell M, Parra MJ, Jiménez MJ, Gallart L, Villalonga A, Valencia O, Unzueta MC, Planas A, Calvo JM. Review of difficult airway management in thoracic surgery. ACTA ACUST UNITED AC 2017; 65:31-40. [PMID: 28987399 DOI: 10.1016/j.redar.2017.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 12/21/2022]
Abstract
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers. In both cases, double lumen tubes should be reserved for when lung separation is absolutely indicated. Finally, extubation should be a time of maximum care and be performed according to the safety measures of the Difficult Arway Society.
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Affiliation(s)
- M Granell
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España.
| | - M J Parra
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínico Universitario de Valencia, Valencia, España
| | - M J Jiménez
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic Universitari, Barcelona, España
| | - L Gallart
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital del Mar, Barcelona, España
| | - A Villalonga
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari Dr. Josep Trueta, Gerona, España
| | - O Valencia
- Hospital Universitario 12 de Octubre, Madrid, España
| | - M C Unzueta
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - A Planas
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de La Princesa, Madrid, España
| | - J M Calvo
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínico Universitario de Salamanca, Salamanca, España
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12
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Kriege M, Alflen C, Tzanova I, Schmidtmann I, Piepho T, Noppens RR. Evaluation of the McGrath MAC and Macintosh laryngoscope for tracheal intubation in 2000 patients undergoing general anaesthesia: the randomised multicentre EMMA trial study protocol. BMJ Open 2017; 7:e016907. [PMID: 28827261 PMCID: PMC5724220 DOI: 10.1136/bmjopen-2017-016907] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The direct laryngoscopy technique using a Macintosh blade is the first choice globally for most anaesthetists. In case of an unanticipated difficult airway, the complication rate increases with the number of intubation attempts. Recently, McGrath MAC (McGrath) video laryngoscopy has become a widely accepted method for securing an airway by tracheal intubation because it allows the visualisation of the glottis without a direct line of sight. Several studies and case reports have highlighted the benefit of the video laryngoscope in the visualisation of the glottis and found it to be superior in difficult intubation situations. The aim of this study was to compare the first-pass intubation success rate using the (McGrath) video laryngoscope compared with conventional direct laryngoscopy in surgical patients. METHODS AND ANALYSIS The EMMA trial is a multicentre, open-label, patient-blinded, randomised controlled trial. Consecutive patients requiring tracheal intubation are randomly allocated to either the McGrath video laryngoscope or direct laryngoscopy using the Macintosh laryngoscope. The expected rate of successful first-pass intubation is 95% in the McGrath group and 90% in the Macintosh group. Each group must include a total of 1000 patients to achieve 96% power for detecting a difference at the 5% significance level. Successful intubation with the first attempt is the primary endpoint. The secondary endpoints are the time to intubation, attempts for successful intubation, the necessity of alternatives, visualisation of the glottis using the Cormack & Lehane score and percentage of glottic opening score and definite complications. ETHICS AND DISSEMINATION The project was approved by the local ethics committee of the Medical Association of the Rhineland Palatine state and Westphalia-Lippe. The results of this study will be made available in the form of manuscripts for publication and presentations at national and international meetings. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT 02611986; pre-results.
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Affiliation(s)
- Marc Kriege
- Department of Anaesthesiology, University Medical Centre of the Johannes, Gutenberg University, Mainz, Germany
| | - Christian Alflen
- Department of Anaesthesiology, University Medical Centre of the Johannes, Gutenberg University, Mainz, Germany
| | - Irene Tzanova
- Department of Anaesthesiology, Christophorus Hospital, Coesfeld, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Tim Piepho
- Department of Anaesthesiology, University Medical Centre of the Johannes, Gutenberg University, Mainz, Germany
| | - Ruediger R Noppens
- Department of Anaesthesiology, University Medical Centre of the Johannes, Gutenberg University, Mainz, Germany
- Department of Anesthesia and Perioperative Medicine, Western University, London, Ontario, Canada
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13
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Xue FS, Li HX, Liu YY, Yang GZ. Current evidence for the use of C-MAC videolaryngoscope in adult airway management: a review of the literature. Ther Clin Risk Manag 2017; 13:831-841. [PMID: 28740393 PMCID: PMC5505682 DOI: 10.2147/tcrm.s136221] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation. In patients with predicted or known difficult airways, C-MAC videolaryngoscope can achieve a better laryngeal view, a higher intubation success rate and a shorter intubation time than direct laryngoscopy. Furthermore, the option to perform direct and video laryngoscopy with the same device makes C-MAC videolaryngoscope exceptionally useful for emergency intubation. In addition, the C-MAC videolaryngoscope is a very good tool for tracheal intubation teaching. However, tracheal intubation with C-MAC videolaryngoscope may occasionally fail and introduction of C-MAC videolaryngoscope in clinical practice must be accompanied by formal training programs in normal and difficult airway managements.
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Affiliation(s)
- Fu-Shan Xue
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Hui-Xian Li
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Ya-Yang Liu
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Gui-Zhen Yang
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Wan L, Liao M, Li L, Qian W, Hu R, Chen K, Zhang C, Yao W. McGrath Series 5 videolaryngoscope vs Airtraq DL videolaryngoscope for double-lumen tube intubation: A randomized trial. Medicine (Baltimore) 2016; 95:e5739. [PMID: 28002347 PMCID: PMC5181831 DOI: 10.1097/md.0000000000005739] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Many studies have shown Airtraq videolaryngoscope provided faster tracheal intubation and a higher success rate than other videolaryngoscopes. Recently, different types of videolaryngoscopes have been reported for use in double-lumen tube (DLT) intubation. However, the advantages and disadvantages between them remain undetermined for DLT intubation. In this study, we compared the Airtraq DL videolaryngoscope with the McGrath Series 5 videolaryngoscope for DLT intubation by experienced anesthesiologists. METHODS Ninety patients with expected normal airways were randomly allocated to either the Airtraq or McGrath group. The primary outcome was DLT intubation time. The secondary outcomes were glottic view, success rate, subjective ease of intubation (100-mm visual analog scale, 0 = easy; 100 = difficult), incidence of DLT malposition, and postoperative intubation-related complication. RESULTS The airway characteristics were comparable between the 2 groups. Cormack and Lehane grades significantly improved with the use of the McGrath and Airtraq videolaryngoscopes, compared with the Macintosh laryngoscope. The intubation success rate on the first attempt was 93% in the Airtraq group and 95% in the McGrath group (P > 0.05). The intubation time in the McGrath group is longer than that in the Airtraq group (39.9 [9.1]s vs 28.6 [13.6]s, P < 0.05). But intubation difficulty score, the incidence of DLT malposition and intubation-related complication were comparable between groups (P > 0.05). CONCLUSIONS When using videolaryngoscopes for DLT intubation, the Airtraq DL is superior to the McGrath Series 5 in intubation time, but it does not decrease intubation difficulty.
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Affiliation(s)
- Li Wan
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Mingfeng Liao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Li Li
- Department of Physiology, Hubei University of Chinese Medicine, Wuhan, China
| | - Wei Qian
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Rong Hu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Kun Chen
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Chuanhan Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Wenlong Yao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
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15
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El-Tahan MR. Videolaryngoscopes for placement of double lumen tubes: Is it time to say goodbye to direct view? Saudi J Anaesth 2016; 10:218-27. [PMID: 27051377 PMCID: PMC4799618 DOI: 10.4103/1658-354x.168804] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The advances in thoracic procedures require optimum lung separation to provide adequate room for surgical access. This can be achieved using either a double-lumen tube (DLT) or a bronchial blocker (BB). Most thoracic anesthesiologists prefer the use of DLT. However, lung separation in patients with potential difficult airway can be achieved using either BB through a single lumen tube or placement of a DLT over a tube exchanger or a fiberoptic bronchoscope. Numerous videolaryngoscopes (VL) have been introduced offering both optical and video options to visualize the glottis. Many studies reported improved glottis visualization and easier DLT intubation in patients with normal and potential difficult airway. However, these studies have a wide diversity of outcomes, which may be attributed to the differences in their designs and the prior experience of the operators in using the different devices. In the present review, we present the main outcomes of the available publications, which have addressed the use of VL-guided DLT intubation. Currently, there is enough evidence supporting using VL for DLT intubation in patients with predicted and unanticipated difficult airway. In conclusion, the use of VL could offer an effective method of DLT placement for lung separation in patients with the potential difficult airway.
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Affiliation(s)
- M R El-Tahan
- Department of Anesthesiology, University of Dammam, Dammam, Al Khubar 31952, Saudi Arabia
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16
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Koele-Schmidt L, Vasquez MM. NewB for newbies: a randomized control trial training housestaff to perform neonatal intubation with direct and videolaryngoscopy. Paediatr Anaesth 2016; 26:392-8. [PMID: 26714736 DOI: 10.1111/pan.12832] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Competency rates in neonatal intubation among pediatric residents are low and currently not meeting ACGME/AAP standards. AIMS The aim of this study was to compare standard bedside teaching of neonatal endotracheal intubation to a computer module, as well as introduce residents to the emerging technology of videolaryngoscopy. METHODS The study population consisted of The University of Texas Health Science Center at San Antonio Pediatric interns/residents and PGY-1 Anesthesia interns rotating through the NICU. Prior to participating in the study, the residents completed a survey addressing past experiences with intubation, comfort level, and prior use of direct and videolaryngoscopy. Participants then performed timed trials of both direct and videolaryngoscopy on the SimNewB(®). They had up to three attempts to successfully intubate, with up to 30 s on each attempt. After randomization, participants received one of the following teaching interventions: standard, computer module, or both. This was followed by a second intubation trial and survey completion. RESULTS Thirty residents were enrolled in the study. There was significant improvement in time to successful intubation in both methods after any teaching intervention (direct 22.0 ± 13.4 s vs 14.7 ± 5.9 s, P = 0.002 and videolaryngoscopy 42.2 ± 29.3 s vs 26.8 ± 18.6 s, P = 0.003). No differences were found between the types of teaching. Residents were faster at intubating with direct laryngoscopy compared to videolaryngoscopy before and after teaching. By the end of the study, only 33% of residents preferred using videolaryngoscopy over direct laryngoscopy, but 76% felt videolaryngoscopy was better to teach intubation. CONCLUSIONS Both standard teaching and computer module teaching of neonatal intubation on a mannequin model results in improved time to successful intubation and overall improved resident confidence with intubation equipment and technique. Although intubation times were lower with direct laryngoscopy compared to videolaryngoscopy, the participating residents felt that videolaryngoscopy is an important educational tool.
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Affiliation(s)
- Lindsey Koele-Schmidt
- Department of Pediatrics, Division of Neonatology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Margarita M Vasquez
- Department of Pediatrics, Division of Neonatology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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17
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Kido H, Komasawa N, Matsunami S, Kusaka Y, Minami T. Comparison of McGRATH MAC and Macintosh laryngoscopes for double-lumen endotracheal tube intubation by anesthesia residents: a prospective randomized clinical trial. J Clin Anesth 2015; 27:476-80. [PMID: 26111665 DOI: 10.1016/j.jclinane.2015.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 04/21/2015] [Accepted: 05/21/2015] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE This study aimed to compare the utility of McGRATH MAC (McG) and Macintosh (McL) laryngoscopes for double-lumen endotracheal tube intubation in patients undergoing elective surgery. DESIGN Randomized clinical trial. SETTING Operating room. PATIENTS Fifty adult patients scheduled for elective surgery under 1-lung ventilation with American Society of Anesthesiologists physical status 1 to 3. INTERVENTIONS Double-lumen endotracheal tube intubation was performed with the McG (McG group; 25 patients) or conventional McL (McL group; 25 patients) laryngoscope by anesthesia residents. MEASUREMENTS The number of attempts to successful intubation, intubation time, percentage of glottis opening score, and subjective difficulty of laryngoscopy and tube passage through the glottis were assessed. MAIN RESULTS The total numbers of intubation attempts were 1 (McG group, 24 patients; McL group, 16 patients), 2 (McG group, 1 patient; McL group, 8 patients), and 3 (McG group, 0 patient; McL group, 1 patient), with significant differences between the two groups (P = .018). Intubation time was significantly shorter in the McG group compared with the McL group (McG: 17.1 ± 4.6 seconds vs McL: 20.8 ± 5.9 seconds, P = .026). The percentage of glottis opening score was significantly higher in the McG group compared with the McL group (McG: 88.4% ± 13.7% vs McL: 71.4% ± 20.4%, P = .004). CONCLUSIONS The McG demonstrated a better intubation profile compared with the McL, possibly due to its ease of use for double-lumen endotracheal tube intubation. Clinical Trial registry number: UMIN000014636.
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Affiliation(s)
- Haruki Kido
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
| | - Nobuyasu Komasawa
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan.
| | - Sayuri Matsunami
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
| | - Yusuke Kusaka
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
| | - Toshiaki Minami
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
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Chastel B, Perrier V, Germain A, Seramondi R, Rozé H, Ouattara A. Usefulness of the Airtraq DL™ videolaryngoscope for placing a double-lumen tube. Anaesth Crit Care Pain Med 2015; 34:89-93. [DOI: 10.1016/j.accpm.2014.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 06/06/2014] [Indexed: 11/30/2022]
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19
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Yao WL, Wan L, Xu H, Qian W, Wang XR, Tian YK, Zhang CH. A comparison of the McGrath®Series 5 videolaryngoscope and Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a good glottic view at direct laryngoscopy. Anaesthesia 2015; 70:810-7. [PMID: 25721326 DOI: 10.1111/anae.13040] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- W. L. Yao
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - L. Wan
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - H. Xu
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - W. Qian
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - X. R. Wang
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Y. K. Tian
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - C. H. Zhang
- Department of Anesthesiology; Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
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Moreira A, Koele-Schmidt L, Leland M, Seidner S, Blanco C. Neonatal intubation with direct laryngoscopy vs videolaryngoscopy: an extremely premature baboon model. Paediatr Anaesth 2014; 24:840-4. [PMID: 24916063 DOI: 10.1111/pan.12435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the ability to successfully intubate extremely preterm baboons using conventional direct laryngoscopy (DL) vs videolaryngoscopy. METHODS A prospective randomized crossover study using experienced and inexperienced neonatal intubators. All participants were shown an educational video on intubation with each device, followed by attempt of the procedure. The time for successful intubation was the primary outcome. RESULTS Seven subjects comprised the experienced group, while 10 individuals were in the inexperienced group. The overall intubation success rate was comparable between both devices (53% vs 26%, P = 0.09); however, mean time to intubate with the conventional laryngoscope was faster (25.5 vs 39.4 s, P = 0.02). Although both groups intubated faster with DL, it only reached statistical significance in the inexperienced group (27.0 vs 48.7 s, P < 0.05). CONCLUSION Conventional DL and videolaryngoscopy are suitable modes for intubating extremely preterm baboons. Although experienced intubators prefer DL, intubation success rate and time to intubate with both devices were comparable. In inexperienced intubators, participants preferred and intubated faster with DL.
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Affiliation(s)
- Alvaro Moreira
- Division of Neonatology, Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA
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El-Tahan M, Doyle DJ, Khidr AM, Hassieb AG. Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision (™) videolaryngoscope. F1000Res 2014; 3:129. [PMID: 25309730 PMCID: PMC4184295 DOI: 10.12688/f1000research.4481.3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 11/20/2022] Open
Abstract
We describe the insertion of the double lumen endobronchial tube (DLT) using a non-channeled standard blade of the King Vision
TM videolaryngoscope for one lung ventilation (OLV) in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision
™ videolaryngoscope. We conclude that the use of King Vision
™ videolaryngoscope could offer an effective method of DLT placement for OLV.
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Affiliation(s)
- Mohamed El-Tahan
- Department of Anesthesiology, King Fahd Hospital, Dammam University, Al Khubar, 31952, Saudi Arabia
| | - D John Doyle
- Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Alaa M Khidr
- Department of Anesthesiology, King Fahd Hospital, Dammam University, Al Khubar, 31952, Saudi Arabia
| | - Ahmed G Hassieb
- Department of Anesthesiology, King Fahd Hospital, Dammam University, Al Khubar, 31952, Saudi Arabia
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22
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Yao WL, Wang XR, Xu H, Zhang Y, Zhang CH. McGrath®series 5 videolaryngoscope evaluation for double-lumen tube intubation. Anaesthesia 2014; 69:646-7. [PMID: 24813140 DOI: 10.1111/anae.12720] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- W. L. Yao
- Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - X. R. Wang
- Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - H. Xu
- Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - Y. Zhang
- Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
| | - C. H. Zhang
- Tongji Hospital; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
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23
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Lin WQ, Quan SB, Liu WJ, Zhang TH, Li HT, Zhong ZJ, Cao LH. Evaluation of the CEL-100 videolaryngoscopeTMfor double-lumen tracheal tube insertion after failure using the Macintosh laryngoscope. Anaesthesia 2012; 67:1232-6. [DOI: 10.1111/j.1365-2044.2012.07261.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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