A quantitative review and meta‐analysis of performance of non‐standard laryngoscopes and rigid fibreoptic intubation aids

Abstract

SummaryThis quantitative review summarises studies of rigid fibreoptic laryngoscopy systems. In 6622 'normal' patients only the Bonfils and CTrach had homogenous data and first time intubation success rates above 90%. In 1110 patients predicted or known to be difficult to intubate only the Bonfils, CTrach and Glidescope had homogenous data and first-time success rates above 90%. In comparative studies with the Macintosh-3 blade, no device had homogenous data in more than one study. Many devices had higher summed performances, but due to data heterogeneity, interpretation is very difficult, if worthwhile at all. The currently available data do not provide strong evidence that these devices should supersede standard direct laryngoscopy for routine or difficult intubation. Further research needs to be of high quality, studying relevant patients to create such evidence. Multicentre collaborations are likely to be needed studying known difficult patients or creating databases reporting the success ⁄ failure rate of these devices.

Innovations in anesthesia education: the development and implementation of a resident rotation for advanced airway management

“…15 Only the Bonfils TM (Karl Storz Co, Tuttlingen, Germany) and CTrach TM (The Laryngeal Mask Company Ltd, Jersey, Channel Islands) had homogenous data and first-time intubation success rates above 90% in normal patients. The Bonfils TM , CTrach TM and Glidescope TM (Verathon Medical ULC, Burnaby, Canada) had first-time success rates above 90% in patients predicted or known to be difficult to intubate.…”

Comparison of tracheal intubation with the Airway Scope or Clarus Video System in patients with cervical collars

“…New rigid fibrescopes have been used as alternatives to a flexible bronchoscope [8]. The Clarus Video System (CVS; Clarus Medical, Minneapolis, MN, USA) [9] consists of a rechargeable battery, adjustable monitor and malleable stylet, that can be preloaded with a tracheal tube (Fig.…”

A reply

“…We would like to thank Drs Maloney and Walker for bringing to our attention the series published by the Galway group comparing the Macintosh and the Airtraq laryngoscopes [1][2][3][4][5].…”

“…It is commonplace to attend the trade show at conferences and expensive airway workshops, which usually make extensive use of manikins, many of which have almost no relevance to clinical use. Manikins for supraglottic airway insertion [4] and management of difficult intubation [5] are a particular problem.…”