Evaluation of the McGrath MAC™ and Macintosh laryngoscope for tracheal intubation

Kriege, Marc; Noppens, Rüdiger

doi:10.1016/j.bja.2020.04.038

Cited by 13 publications

(12 citation statements)

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“…For calculating the required information size, we used an O'Brien‐Fleming alpha‐spending function and assumed a first pass success incidence of 95% and 85% in the videolaryngoscopy and direct laryngoscopy groups, respectively. This relative risk reduction of about 12% is roughly in keeping with the findings of both the EMMA trial and the Cochrane review [4, 12].…”

Section: Hundreds Of Studies and More To Come: Have We Had Enough?supporting

confidence: 79%

“…Trial sequential analysis of (a) first‐pass success and (b) failed intubation for Macintosh‐style videolaryngoscopy, combining data from the 2022 Cochrane systematic review [12] and the EMMA trial [4]. The red line represents the Z‐curve and the blue line the monitoring boundary from benefit.…”

Section: Hundreds Of Studies and More To Come: Have We Had Enough?mentioning

confidence: 99%

“…Kriege et al. share the findings of their large open‐label randomised controlled trial comparing the McGrath videolaryngoscope (McGrath MAC®, Medtronic, Dublin, Ireland) with the Macintosh direct laryngoscope in 2000 adult patients undergoing elective tracheal intubation in the operating theatre setting (EMMA trial) [4]. In line with previous studies, they demonstrated a significantly higher first‐pass success rate with the McGrath (94% vs. 82% with the McGrath and Macintosh direct laryngoscope, respectively).…”

mentioning

confidence: 99%

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Are we there yet? The long journey of videolaryngoscopy into the mainstream

Hansel

El‐Boghdadly

2023

Anaesthesia

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Section: Hundreds Of Studies and More To Come: Have We Had Enough?supporting

confidence: 79%

Section: Hundreds Of Studies and More To Come: Have We Had Enough?mentioning

confidence: 99%

mentioning

confidence: 99%

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Are we there yet? The long journey of videolaryngoscopy into the mainstream

Hansel

El‐Boghdadly

2023

Anaesthesia

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“…Recently, Kriege et al . published preliminary data in abstract form from a multicentre RCT including more than 2100 patients [ 30 ]. Therein, VAL was superior to direct laryngoscopy in terms of first pass success.…”

Section: Discussionmentioning

confidence: 99%

Conventional versus video-assisted laryngoscopy for perioperative endotracheal intubation (COVALENT) - a randomized, controlled multicenter trial

et al. 2023

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Background Data on the routine use of video-assisted laryngoscopy in peri-operative intubations are rather inconsistent and ambiguous, in part due to small populations and non-uniform outcome measures in past trials. Failed or prolonged intubation procedures are a reason for relevant morbidity and mortality. This study aims to determine whether video-assisted laryngoscopy (with both Macintosh-shaped and hyperangulated blades) is at least equal to the standard method of direct laryngoscopy with respect to the first-pass success rate. Furthermore, validated tools from the field of human factors will be applied to examine within-team communication and task load during this critical medical procedure. Methods In this randomized, controlled, three-armed parallel group design, multi-centre trial, a total of more than 2500 adult patients scheduled for perioperative endotracheal intubation will be randomized. In equally large arms, video-assisted laryngoscopy with a Macintosh-shaped or a hyperangulated blade will be compared to the standard of care (direct laryngoscopy with Macintosh blade). In a pre-defined hierarchical analysis, we will test the primary outcome for non-inferiority first. If this goal should be met, the design and projected statistical power also allow for subsequent testing for superiority of one of the interventions. Various secondary outcomes will account for patient safety considerations as well as human factors interactions within the provider team and will allow for further exploratory data analysis and hypothesis generation. Discussion This randomized controlled trial will provide a solid base of data in a field where reliable evidence is of major clinical importance. With thousands of endotracheal intubations performed every day in operating rooms around the world, every bit of performance improvement translates into increased patient safety and comfort and may eventually prevent significant burden of disease. Therefore, we feel confident that a large trial has the potential to considerably benefit patients and anaesthetists alike. Trial registration ClincalTrials.gov NCT05228288. Protocol version 1.1, November 15, 2021.

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“…Recently, Kriege et al published preliminary data in abstract form from a multicentre RCT including more than 2100 patients [30]. Therein, VAL was superior to direct laryngoscopy in terms of rst pass success.…”

Section: Discussionmentioning

confidence: 99%

Conventional versus Video-assisted Laryngoscopy for Perioperative Endotracheal Intubation (COVALENT): A Randomized, Controlled Multicenter Trial

Schmid

Eckert

Meixner

et al. 2022

Preprint

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Background:Data on the routine use of video-assisted laryngoscopy in peri-operative intubations are rather inconsistent and ambiguous, in part due to small populations and non-uniform outcome measures in past trials. Failed or prolonged intubation procedures are a reason for relevant morbidity and mortality. This study aims to determine whether video-assisted laryngoscopy (with both Macintosh-shaped and hyperangulated blades) is at least equal to the standard method of direct laryngoscopy with respect to the first-pass success rate. Furthermore, validated tools from the field of human factors will be applied to examine within-team communication and task load during this critical medical procedure. Methods: In this randomized, controlled, three-armed parallel group design, multi-centre trial, a total of more than 2500 adult patients scheduled for perioperative endotracheal intubation will be randomized. In equally large arms, video-assisted laryngoscopy with a Macintosh-shaped or a hyperangulated blade will be compared to the standard of care (direct laryngoscopy with Macintosh blade). In a pre-defined hierarchical analysis, we will test the primary outcome for non-inferiority first. If this goal should be met, the design and projected statistical power also allow for subsequent testing for superiority of one of the interventions. Various secondary outcomes will account for patient safety considerations as well human factors interactions within the provider team and will allow for further exploratory data analysis and hypothesis generation. Discussion:This randomized controlled trial will provide a solid base of data in a field where reliable evidence is of major clinical importance. With thousands of endotracheal intubations performed every day in operating rooms around the world, every bit of performance improvement translates into increased patient safety and comfort and may eventually prevent significant burden of disease. Therefore, we feel confident that a large trial has the potential to considerably benefit patients and anaesthetists alike. Trial registration: ClincalTrials.gov NCT05228288 Protocol version: 1.1, November 15, 2021

show abstract

Evaluation of the McGrath MAC™ and Macintosh laryngoscope for tracheal intubation

Cited by 13 publications

References 0 publications

Are we there yet? The long journey of videolaryngoscopy into the mainstream

Are we there yet? The long journey of videolaryngoscopy into the mainstream

Conventional versus video-assisted laryngoscopy for perioperative endotracheal intubation (COVALENT) - a randomized, controlled multicenter trial

Conventional versus Video-assisted Laryngoscopy for Perioperative Endotracheal Intubation (COVALENT): A Randomized, Controlled Multicenter Trial

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