Comparison of two sizes of GlideScope® blades in tracheal intubation of infants: a randomised clinical trial

Kwon, Ji‐Hye; Chung, Yoon Joo; Her, Sukyoung; Jeong, Ji Seon; Kim, Chungsu; Jun, Min

doi:10.1016/j.bja.2022.07.015

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…We speculate that the shorter glottis viewing time may be attributed to the smaller blade size, which results in the need for a smaller opening to insert the blade into the oral cavity, and reduced loss of orientation owing to the deep insertion of the blade. In Glidescope, Ji-Hye Kwony et al reported that the time to guide the tube to the glottis was prolonged with the use of size 1 blade compared to that using size 2 blade owing to less adequate eld of view [10]. In the present study, the closer distance between the camera and tip did not affect the tube guidance time.…”

Section: Discussionmentioning

confidence: 42%

“…Regarding Glidescope(GlideScope Cobalt AVL System, Verthon Inc., Bothell, WA, USA), it was reported that the time required for tracheal intubation was longer for a size 1 blade than for a size 2 blade due to the closer distance between the camera and tip [10]. However, regarding McGRATH™ MAC, no report has examined the relationship between blade size and the time required for tracheal intubation.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the intubation time between McGRATHTM MAC size 1 and size 2 blades for infants: an observational study

Uchinami,

Fujita,

Mizunoya

et al. 2023

Preprint

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Purpose: This study aimed to determine whether the McGRATHTM MAC size 1 blade, which has become available in recent years, reduced the tracheal intubation time in infants compared to that of the McGRATHTM MAC size 2 blade. Methods: This single-center, retrospective, observational study included patients aged < 1 y who underwent cardiac surgery under general anesthesia. Cases in which the McGRATHTM MAC size 2 blade was used were classified as MAC2 and those in which the McGRATHTM MAC size 1 blade was used as MAC1. The primary endpoint was the difference in time required for tracheal intubation. The results were adjusted for confounding factors (patient weight, career of intubation provider, and risk of difficult tracheal intubation). Other variables included the first successful tracheal intubation rate, number of tracheal intubations, Cormack classification, and adverse events during tracheal intubation. Results: In total, 94 patients met the inclusion criteria, 26 met the exclusion criteria¸ thus 68 patients were analyzed. The median time to tracheal intubation was significantly shorter for MAC1 than for MAC2. (23.5 s vs. 27.0 s; hazard ratio, 1.79; 95% confidence interval, 1.08, 2.95). The adjusted time to tracheal intubation was also significantly shorter in the MAC1 group than in the MAC2 group (hazard ratio, 1.71; 95% confidence interval, 1.00, 2.89). No secondary endpoint showed significant differences. Conclusions: For tracheal intubation in cardiac surgery in infants, using the McGRATHTM MAC size 1 blade may reduce the tracheal intubation time compared to the McGRATHTM MAC size 2 blade.

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Section: Discussionmentioning

confidence: 42%

Section: Introductionmentioning

confidence: 99%

Comparison of the intubation time between McGRATHTM MAC size 1 and size 2 blades for infants: an observational study

Uchinami,

Fujita,

Mizunoya

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…19 A recent randomized controlled trial in neonatal intubation found the larger size 2 Glidescope was associated with shorter time to intubation than a size 1 Glidescope blade. 20 Case reports of the use of an oversize C-MAC D-blade in pediatric patients with a difficult airway have recently been reported. 8,10 The description from these reports is similar to our case series using the C-MAC4 blade in that good glottic views were obtained, and intubation was successful.…”

Section: Discussionmentioning

confidence: 99%

“…Given the differences in intubation technique between VL and DL, this translation between blade size and age (or weight) groups may not be so straightforward 19 . A recent randomized controlled trial in neonatal intubation found the larger size 2 Glidescope was associated with shorter time to intubation than a size 1 Glidescope blade 20 . Case reports of the use of an oversize C-MAC D-blade in pediatric patients with a difficult airway have recently been reported 8,10 .…”

Section: Discussionmentioning

confidence: 99%

Out-of-Hospital Pediatric Video Laryngoscopy With an Adult Device

Miller¹,

Storey

Andrew

et al. 2023

Pediatr Emer Care

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Objectives: After introducing an adult video laryngoscope (VL) in our physician-paramedic prehospital and retrieval medical service, our quality assurance process identified this blade being used during pediatric intubations. We present a case series of pediatric intubations using this oversized adult VL alongside a contemporaneous group of direct laryngoscopy (DL) intubations. Methods:We performed a retrospective review of intubated patients 15 years or younger in our electronic quality assurance registry from January 1, 2017, to December 31, 2020. Data collected were demographic details, intubation equipment, drug doses, the number of intubation attempts, and complications. Results are presented according to those intubated with C-MAC4 VL (Karl Storz) alongside age-appropriate DL sizes.Results: Ninety-nine pediatric patients were intubated, 67 (67%) by CMAC4 and 32 (33%) by DL. Video laryngoscopy had a first-attempt success rate of 96% and DL 91%. A Cormach and Lehane view 1 or 2 was found in 66 VL (99%) and 29 DL patients (91%). Desaturation was reported in two VL and 1 DL patient.Conclusions: Adult VL became the most common method of intubation in patients older than 1 year during the study period. An adult C-MAC4 VL could be considered for clinicians who prefer VL when a pediatric VL is unavailable or as a second-line device if a pediatric VL is not present when intubating children older than 1 year.

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Efficacy of McGRATH®MAC videolaryngoscope blade 1 for tracheal intubation in small children: a randomized controlled clinical study

2023

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Comparison of two sizes of GlideScope® blades in tracheal intubation of infants: a randomised clinical trial

Cited by 4 publications

References 17 publications

Comparison of the intubation time between McGRATHTM MAC size 1 and size 2 blades for infants: an observational study

Comparison of the intubation time between McGRATHTM MAC size 1 and size 2 blades for infants: an observational study

Out-of-Hospital Pediatric Video Laryngoscopy With an Adult Device

Efficacy of McGRATH®MAC videolaryngoscope blade 1 for tracheal intubation in small children: a randomized controlled clinical study

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