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

Abstract

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

A randomised controlled trial comparing the McGrath® videolaryngoscope with the straight blade laryngoscope when used in adult patients with potential difficult airways*

“…The use of a gum-elastic bougie, a common adjunct to difficult tracheal intubations, was left to the preference of the anaesthetist [17]. The videolaryngoscope blade was inserted along the midline of the tongue, and a styletted tracheal tube angulated according to the curve of the videolaryngoscope blade was introduced as suggested by the product information and a previous case series [18,19]. If more than one intubation attempt was required, the patient received bag-andmask ventilation between attempts and various manoeuvres were employed, including external laryngeal pressure, readjustment of the stylet and use of a bougie.…”

A comparison of McGrath and Macintosh laryngoscopes in novice users: a manikin study

“…The McGrath Ò videolaryngoscope (Aircraft Medical, Edinburgh, Scotland) is a novel, portable videolaryngoscope that provides excellent laryngoscopic views in patients with normal airways [17], and in patients in whom direct laryngoscopy has been difficult or has failed [18]. Information about its use by novice practitioners is limited [9].…”

The McGrath Series 5 video laryngoscope versus the Macintosh laryngoscope: a randomized trial in obstetric patients

“…The present study revealed an intubation time of 47. among studies (6,9,12). While conducting an orotracheal intubation with the McGrath video laryngoscope, a stylet has to be used for the orotracheal tube.…”

“…In addition, various studies and case reports have demonstrated that the McGrath Series 5 video laryngoscope has several advantages, such as improved view of the glottis, low incidence of injury, and ease of use as an alternative to direct laryngoscopy (5,(7)(8)(9).…”

“…There are several video laryngoscopes in clinical use; however, only limited comparative studies have been conducted to evaluate the exact performance of these devices (5)(6)(7)(8)(9)(11)(12)(13)(14)(15)(16)(17). Hence, we compared the McGrath Series 5 video laryngoscope and the Macintosh laryngoscope in patients who underwent cesarean section.…”