Comparison of three video laryngoscopy devices to direct laryngoscopy for intubating obese patients: a randomized controlled trial

Yumul, Roya; Elvir-Lazo, Ofelia Loani; White, Paul F.; Sloninsky, Alejandro; Kaplan, Marshal B.; Kariger, Robert; Naruse, Robert; Parker, Nathaniel W.; Pham, Christopher H; Zhang, Xiao; Wender, Ronald H.

doi:10.1016/j.jclinane.2015.12.042

Cited by 57 publications

(67 citation statements)

References 27 publications

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“…Moreover, slight design modification may significantly change the success rate and IT with VLs. [7980] Thus, different designs may be attributable to more benefits with UEscope. Second, all the available trials comparing the performance of UEscope and DL are executed in Chinese patients.…”

Section: Uescope and Tracheal Intubation Teachingmentioning

confidence: 99%

Current Evidences for the Use of UEscope in Airway Management

Xue

Yang

Liu

et al. 2017

Chinese Medical Journal

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Objective:UEscope is a new angulated videolaryngoscope (VL). This review aimed to describe the features of UEscope and provide clinical evidences regarding the efficacy and safety of this video device in adult tracheal intubation and its roles in airway management teaching.Data Sources:The Wan Fang Data, CNKI, PubMed, Embase, Cochrane Library, and Google Scholar were searched for relevant English and Chinese articles published up to January 15, 2017, using the following keywords: “HC video laryngoscope”, “UE videolaryngoscope”, “video laryngoscope”, and “videolaryngoscopy”.Study Selection:Human case reports, case series, observable studies, and randomized controlled clinical trials were included in our search. The results of these studies and their reference lists were cross-referenced to identify a common theme.Results:UEscope features the low-profile portable design, intermediate blade curvatures, all-angle adjustable monitor, effective anti-fog mechanisms, and built-in video recording function. During the past 5 years, there have been a number of clinical studies assessing the application and roles of UEscope in airway management and education. As compared with direct laryngoscope, UEscope improves laryngeal visualization, decreases intubation time (IT), and increases intubation success rate in adult patients with normal and difficult airways. These findings are somewhat different from the previous results regarding the other angulated VLs; they can provide an improved laryngeal view, but no conclusive benefits with regard to IT and intubation success rate. Furthermore, UEscope has extensively been used for intubation teaching and shown a number of advantages.Conclusions:UEscope can be used as a primary intubation tool and may provide more benefits than other VLs in patients with normal and difficult airways. However, more studies with large sample are still needed to address some open questions about clinical performance of this new VL.

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Section: Uescope and Tracheal Intubation Teachingmentioning

confidence: 99%

Current Evidences for the Use of UEscope in Airway Management

Xue

Yang

Liu

et al. 2017

Chinese Medical Journal

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“…In patients with predicted or known difficult airways, C-MAC device can achieve a better laryngeal view, higher intubation success rate and shorter intubation time than direct laryngoscopy 30,31,34,35. Furthermore, C-MAC device has been shown to be an effective rescuing device for unexpectedly difficult laryngoscopy or failed intubations 36–38.…”

Section: Commentsmentioning

confidence: 99%

“…Furthermore, the tracheal tube placement may occasionally fail despite a good laryngeal view 33. In morbidly obese patients, V-MAC or C-MAC videolaryngoscope compared with Macintosh laryngoscope improves the laryngeal view and allows for fast tracheal intubation 34,35…”

Section: Introductionmentioning

confidence: 99%

“…In patients with cervical spine disorders and immobilization, Glidescope and C-MAC videolaryngoscopes provide comparable laryngeal views, but the C-MAC device has a higher first-attempt failure rate, and requires significantly more intubation attempts and optimizing manoeuvers 59. Moreover, a RCT trial in obese patients undergoing bariatric surgery shows that V-MAC videolaryngoscope significantly reduces the intubation time compared with the McGrath and Glidescope devices, and requires a fewer number of intubation attempts and a less frequent use of ancillary intubating devices compared to McGrath device 35. In addition, a retrospective study comparing Glidescope and C-MAC videolaryngoscopes in patients requiring emergency intubation showed that both the first-pass success rate and overall success rate were similar with 2 devices 60…”

Section: Introductionmentioning

confidence: 99%

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Current evidence for the use of C-MAC videolaryngoscope in adult airway management: a review of the literature

Xue

Liu

et al. 2017

TCRM

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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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“…In patients with cervical immobilization, Glidescope and Storz C-MAC VLs provided comparable laryngeal views, but the Storz C-MAC device had a higher firstattempt failure rate, and required significantly more intubation attempts and optimizing manoeuvers (59). Moreover, a RCT in obese patients undergoing bariatric surgery showed that Storz V-MAC VL significantly reduced the intubation time compared to McGrath Series 5 and Glidescope VLs, and required a fewer number of intubation attempts and a less frequent use of ancillary intubating devices compared to McGrath device (60). In addition, a multi-center, prospective, non-randomized trial comparing Storz C-MAC and KingVision VLs for prehospital emergency intubation showed that Storz C-MAC device provided significantly higher firstattempt success and overall success, and needed a less number of intubation attempts, but two devices were similar in term of intubation complication (61).…”

mentioning

confidence: 98%

Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

Xue¹,

Liu²,

Li³

et al. 2018

J Anesth Perioper Med

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Aim of review:The aim of this article is to convey several hotspot issues regarding the use of videolaryngoscopy (VL) in airway management that anesthesiologists are often concerned. Methods: Recent literature in the past 20 years about the use of VL in the clinical airway management were searched from the Pubmed and Cochrane databases and reviewed, in order to determine the strengths and weakness of VL and conflicting issues regarding the role of VL in airway management. Recent findings: The benefits of VL are most significant in patients with difficult airways, with an improved laryngeal view and an increased success rate of intubation. However, VL cannot give a 100% success rate and there is no specific evaluation system of difficult or failed VL as with direct laryngoscopy. Awake VL-assisted intubation is a useful alternative to awake fiberoptic intubation, but the fiberoptic bronchoscope cannot be discarded and still is gold standard tool of difficult airway management. There are several differenttype VLs available and their efficacies may be different between devices due to various designs and shapes. Due to the limited number of comparative studies, however, there is inconclusive evidence to recommend which VL design is more advantageous in various clinical situations. A Macintosh-type VL allows residents to learn laryngoscopy and intubation more quickly and effectively. Given that VL has tremendous advantages, it should be used as the first-line device for all tracheal intubations. Summary: The introduction of VL has resulted in a dramatic transformation of clinical airway management and is seen as the evolutionary step in intubation technology. There are considerable disagreements over the role of VL in airway management and the need of more investigation, but VL continues to get popularity both inside and outside the operating room. With increasing use of VL in airway management, experience and skill will undoubtedly increase, and the evidence will suggest that the attempt numbers and complications of intubations may be decreased, and patient safety can be improved. (Funded by the Major Project of Zhejiang Science and Technology Fund.) ABSTRACT

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Comparison of three video laryngoscopy devices to direct laryngoscopy for intubating obese patients: a randomized controlled trial

Abstract: Video-Mac and GlideScope required fewer intubation attempts than standard DL and the McGrath device. The Video-Mac also significantly reduced the time needed to secure the airway and improved the glottic view compared to standard DL.

Cited by 57 publications

References 27 publications

Current Evidences for the Use of UEscope in Airway Management

Current Evidences for the Use of UEscope in Airway Management

Current evidence for the use of C-MAC videolaryngoscope in adult airway management: a review of the literature

Videolaryngoscopy in Airway Management: What Every Anesthesiologist Should Know!

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