Comparative Effectiveness of the C-MAC Video Laryngoscope <i>versus</i>  Direct Laryngoscopy in the Setting of the Predicted Difficult Airway

Aziz, Michael; Dillman, Dawn; Fu, Rongwei; Brambrink, Ansgar M.

doi:10.1097/aln.0b013e318246ea34

Cited by 300 publications

(172 citation statements)

References 34 publications

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“…In this operating room study, the authors found that in patients with predicted difficult airways, the C-MAC was more successful than a direct laryngoscope. 28 …”

Section: Discussionmentioning

confidence: 99%

A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department

Sakles

Mosier

Chiu

et al. 2012

Annals of Emergency Medicine

172

115

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Study objective We determine the proportion of successful intubations with the C-MAC video laryngoscope (C-MAC) compared with the direct laryngoscope in emergency department (ED) intubations. Methods This was a retrospective analysis of prospectively collected data entered into a continuous quality improvement database during a 28-month period in an academic ED. After each intubation, the operator completed a standardized data form evaluating multiple aspects of the intubation, including patient demographics, indication for intubation, device(s) used, reason for device selection, difficult airway characteristics, number of attempts, and outcome of each attempt. Intubation was considered ultimately successful if the endotracheal tube was correctly inserted into the trachea with the initial device. An attempt was defined as insertion of the device into the mouth regardless of whether there was an attempt to pass the tube. The primary outcome measure was ultimate success. Secondary outcome measures were first-attempt success, Cormack-Lehane view, and esophageal intubation. Multivariate logistic regression analyses, with the inclusion of a propensity score, were performed for the outcome variables ultimate success and first-attempt success. Results During the 28-month study period, 750 intubations were performed with either the C-MAC with a size 3 or 4 blade or a direct laryngoscope with a Macintosh size 3 or 4 blade. Of these, 255 were performed with the C-MAC as the initial device and 495 with a Macintosh direct laryngoscope as the initial device. The C-MAC resulted in successful intubation in 248 of 255 cases (97.3%; 95% confidence interval [CI] 94.4% to 98.9%). A direct laryngoscope resulted in successful intubation in 418 of 495 cases (84.4%; 95% CI 81.0% to 87.5%). In the multivariate regression model, with a propensity score included, the C-MAC was positively predictive of ultimate success (odds ratio 12.7; 95% CI 4.1 to 38.8) and first-attempt success (odds ratio 2.2; 95% CI 1.2 to 3.8). When the C-MAC was used as a video laryngoscope, a Cormack-Lehane grade I or II view (video) was obtained in 117 of 125 cases (93.6%; 95% CI 87.8% to 97.2%), whereas when a direct laryngoscope was used, a grade I or II view was obtained in 410 of 495 cases (82.8%; 95% CI 79.2% to 86.1%). The C-MAC was associated with immediately recognized esophageal intubation in 4 of 255 cases (1.6%; 95% CI 0.4% to 4.0%), whereas a direct laryngoscope was associated with immediately recognized esophageal intubation in 24 of 495 cases (4.8%; 95% CI 3.1% to 7.1%). Conclusion When used for emergency intubations in the ED, the C-MAC was associated with a greater proportion of successful intubations and a greater proportion of Cormack-Lehane grade I or II views compared with a direct laryngoscope.

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“…In this operating room study, the authors found that in patients with predicted difficult airways, the C-MAC was more successful than a direct laryngoscope. 28 …”

Section: Discussionmentioning

confidence: 99%

A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department

Sakles

Mosier

Chiu

et al. 2012

Annals of Emergency Medicine

172

115

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“…As part of the advanced airway kit, EMRS now carries the McGrath Mac EMS video laryngoscope, which is available to clinicians performing emergency anaesthesia. Hospital studies using video laryngoscopes have demonstrated an improvement in the grade of laryngoscope view and success at first intubation in patients deemed to have difficult airways 15 16. However, studies looking at the use of indirect and video laryngoscopes in the prehospital environments have shown mixed results with evidence of improved laryngoscopic view but no improvement or in first pass success rates 17 18.…”

Section: Discussionmentioning

confidence: 99%

Comparison of factors associated with desaturation in prehospital emergency anaesthesia in primary and secondary retrievals

2014

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“…Recent evidence suggests video laryngoscopy may be superior for glottic visualization and successful endotracheal tube insertion during emergent adult intubation, including in the ED. [23][24][25][26][27][28] However, there are also studies from several settings to suggest that video laryngoscopy is associated with longer duration of laryngoscopy [29,30], which we have found to be independently associated with oxyhemoglobin desaturation. [17] Some video laryngoscopes, such as the Storz C-MAC (Karl Storz, Tuttlingen,Germany), employ laryngoscope blades almost identical in size, shape, and…”

Section: Laryngoscope and Bladesmentioning

confidence: 56%

A Modern and Practical Review of Rapid-Sequence Intubation in Pediatric Emergencies

Mittiga

Rinderknecht

Kerrey

2015

Clinical Pediatric Emergency Medicine

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Comparative Effectiveness of the C-MAC Video Laryngoscope versus Direct Laryngoscopy in the Setting of the Predicted Difficult Airway

Cited by 300 publications

References 34 publications

A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department

A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department

Comparison of factors associated with desaturation in prehospital emergency anaesthesia in primary and secondary retrievals

A Modern and Practical Review of Rapid-Sequence Intubation in Pediatric Emergencies

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