Videolaryngoscope versus Macintosh laryngoscope for tracheal intubation in adults with obesity: A systematic review and meta-analysis

Hoshijima, Hiroshi; Denawa, Yohei; Tominaga, Asako; Nakamura, Chiaki; Shiga, Toshiya; Nagasaka, Hiroshi

doi:10.1016/j.jclinane.2017.11.008

Cited by 61 publications

(50 citation statements)

References 22 publications

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“…In many studies, C-L scores of 3 and above are defined as a poor laryngoscopic view [13]. Our results and those of other researchers' show that video laryngoscopy is much more successful compared with the Macintosh DL in evaluating glottic viewing with C-L scores [6,10,14,15]. However, providing a good glottic image on the VL screen does not necessarily mean that the endotracheal tube will pass through the larynx easily.…”

Section: Discussionsupporting

confidence: 45%

“…Therefore, airway safety in obese patients should be provided as soon as possible. Although it is claimed that the time of intubation with VL is shortened [15], there are some contradictions [10,14]. First, there is a difference between the studies concerning the definition of intubation time.…”

Section: Discussionmentioning

confidence: 99%

“…First, there is a difference between the studies concerning the definition of intubation time. In addition, the patient groups in the studies are heterogeneous [11,15]. In a study by Yumul et al [14], they compared 3 types of VL and DL in obese patients.…”

Section: Discussionmentioning

confidence: 99%

“…Complications may occur as a result of directing the endotracheal tube towards these blind spots [22]. Hoshijima et al [15] claim that the VL enables less lifting force to be applied to the laryngeal structures and may cause less intra-oral damage. However, reports on this issue are contradictory [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamic in bariatric surgery

Çakir

Özyurt

2020

Turk J Med Sci

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Background/aim: In the recent years, videolaryngoscopes (VL) have emerged as alternative devices to direct laryngoscopes (DL) in difficult intubation situations. Therefore, we aimed to compare the Macintosh DL and McGrath VL in terms of the glottic image quality, intubation success, intubation time, hemodynamic response after intubation, and complications in bariatric surgery patients. Material and methods:After obtaining approval by the ethics committee and receiving informed consent, we recorded the demographic and physical data of patients undergoing bariatric surgery. Patients were divided into 2 groups: Group M was intubated with the Macintosh DL, and Group V was intubated with the McGrath VL. After intubation, we noted the Cormack-Lehane score, the duration of intubation, the number of intubation interventions, and the hemodynamic data of patients. Results:A total of 62 patients (ASA II, body mass index of >35 kg/m 2 ) were included in the study. All patients except 1 patient were intubated on the first attempt. Although there was a decrease in heart rate and blood pressure with induction, similar hemodynamic data were obtained between groups during the operation. In group V, we obtained a better glottic image (P = 0.011), but intubation success was similar between the study groups. We also measured the intubation time in group M as 45.9 ± 19.1 s and group V as 57.1 ± 15.8 s (P = 0.015).Discussion: Although we measured longer intubation times with the McGrath VL compared with the Macintosh DL, we obtained a better glottic image without causing hemodynamic changes. However, these findings did not make any difference in terms of intubation success.

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Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamic in bariatric surgery

Çakir

Özyurt

2020

Turk J Med Sci

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“…VLs were found to be superior to the Macintosh laryngoscope for tracheal intubation in adults with obesity [16,17]. VLs improve the laryngeal view, increase the first attempt success rate, and reduce patient trauma.…”

Section: Discussionmentioning

confidence: 95%

Tracheal intubation with the McGrath MAC X-blade videolaryngoscope in morbidly obese and nonobese patients

Arslan¹,

Yörükoğlu²

2019

Turk J Med Sci

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Background/aim: Increased body mass index (BMI) and neck circumference are the two independent predictors of difficult intubation. McGrath MAC X-Blade is a videolaryngoscope specifically designed for difficult intubations. Materials and methods: Eighty patients with the American Society of Anesthesiologists (ASA) physical status I-III undergoing elective surgery requiring endotracheal intubation were enrolled in the study. Patients were divided into two groups, nonobese (BMI < 30) and morbidly obese (BMI > 35). All patients were intubated with the McGrath MAC X-Blade in both groups. View optimization and tube insertion maneuvers such as reinsertion of the device, slight removal of the device, cricoid pressure, handling force, 90° anticlockwise rotation of the tube, use of stylet, and head flexion maneuvers were recorded. Cormack-Lehane grades, insertion times, intubation, and total intubation times were recorded. The hemodynamic changes and postoperative minor complications were also recorded. Results: Body mass index, neck circumference, Mallampati scores, and ASA physical status were statistically higher in the morbidly obese group (P < 0.001 and P < 0.05). Sternomental distances were shorter in the morbidly obese (P < 0.05). Cormack-Lehane grades were comparable among the groups. The morbidly obese patients required more reinsertion attempts and cricoid pressure maneuvers during intubation than the nonobese patients (P = 0.019 versus P = 0.012, respectively). Slight removal of the device, handling force, use of the stylet, 90° anticlockwise rotation of the tube, and head flexion maneuvers were also helpful in both groups. Although device insertion times were similar between the groups, intubation and total intubation times were longer in the morbidly obese group (P = 0.009 and P = 0.034, respectively). The groups were comparable in hemodynamic changes and postoperative minor complications. Conclusion: The McGrath MAC X-Blade videolaryngoscope could safely be used both in nonobese (BMI < 30) and morbidly obese (BMI > 35) patients with the aid of some key maneuvers and with a statistically significant but clinically negligible prolongation of the intubation time.

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Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

Lewis

Butler

Parker

et al. 2016

Cochrane Database of Systematic Reviews

245

250

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Videolaryngoscopes may reduce the number of failed intubations, particularly among patients presenting with a difficult airway. They improve the glottic view and may reduce laryngeal/airway trauma. Currently, no evidence indicates that use of a VLS reduces the number of intubation attempts or the incidence of hypoxia or respiratory complications, and no evidence indicates that use of a VLS affects time required for intubation.

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Videolaryngoscope versus Macintosh laryngoscope for tracheal intubation in adults with obesity: A systematic review and meta-analysis

Cited by 61 publications

References 22 publications

Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamic in bariatric surgery

Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamic in bariatric surgery

Tracheal intubation with the McGrath MAC X-blade videolaryngoscope in morbidly obese and nonobese patients

Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation

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