McGRATH MAC Video Laryngoscope
- Conditions
- Intubation; Difficult
- Interventions
- Device: McGrath MAC enhanced direct laryngoscope
- Registration Number
- NCT02250521
- Brief Summary
This study was designed to determine the first attempt success rate of tracheal intubation with the McGRATH™ MAC laryngoscope using direct visualization in patients with known difficult airways, as well as exploring the possibility of identifying a particular direct Cormack-Lehane (C-L) grade view where indirect (video) visualization can be most beneficial during laryngoscopy and intubation.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- BMI < 50 kg/m2
- Two or more of the following inclusion criteria: Mallampati class: III-IV; Reduced mouth opening < 4 cm; Neck circumference > 40 cm for females and > 43 cm for males; Thyromental distance < 6 cm; Ratio of the patient's height to thyromental distance ≥ 23.5; Sternomental distance < 12 cm
- BMI ≥ 50 kg/m2
- emergency status
- cervical injury or pathology
- neck irradiation
- known difficult airway
- risk of gastric aspiration
- hemodynamic instability
- requiring rapid sequence intubation
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description McGrath Mac intubations McGrath MAC enhanced direct laryngoscope All 100 patients will be intubated using the McGRATH® MAC video laryngoscope, either through direct or indirect vision laryngoscopy. The liquid crystal display (LCD) monitor of the McGRATH™ MAC was initially covered; if the anesthesiologist visualized a modified C-L grade 1-3 view, the patient was intubated utilizing this direct view. If the anesthesiologist observed a modified C-L grade 4 view during their initial direct view, the patient was intubated using the indirect method. If intubation via direct laryngoscopy was unsuccessful on the first attempt, the patient was intubated using the indirect view. If both methods of laryngoscopy were unsuccessful, the rescue intubation technique was performed at the discretion of the anesthesiologist.
- Primary Outcome Measures
Name Time Method Number of Participants Successfully Intubated on First Attempt With Use of Either a Direct or Indirect Laryngoscopic View after successful endotracheal tube placement All 100 patients will be intubated using the McGRATH® MAC video laryngoscope, either through direct or indirect vision laryngoscopy. The LCD monitor of the McGRATH™ MAC was initially covered; if the anesthesiologist visualized a modified C-L grade 1-3 view, the patient was intubated utilizing this direct view. If the anesthesiologist observed a modified C-L grade 4 view during their initial direct view, the patient was intubated using the indirect method. If intubation via direct laryngoscopy was unsuccessful on the first attempt, the patient was intubated using the indirect view. If both methods of laryngoscopy were unsuccessful, the rescue intubation technique was performed at the discretion of the anesthesiologist.
- Secondary Outcome Measures
Name Time Method Glottic View With Direct Laryngoscopy at the time of laryngoscopy Glottic view as described by Cormack and Lehane, scored as follows- Grade 1. Full view of glottis Grade 2a. Partial view of glottis Grade 2b. Arytenoids or posterior portion of cords just visible Grade 3. Only the epiglottis visible Grade 4. Neither epiglottis nor glottis visible
Glottic View With Indirect Laryngoscopy at the time of laryngoscopy Glottic view as described by Cormack and Lehane (Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anesthesia 1987; 42:487), scored as follows- Grade 1. Full view of glottis Grade 2a. Partial view of glottis Grade 2b. Arytenoids or posterior portion of cords just visible Grade 3. Only the epiglottis visible Grade 4. Neither epiglottis nor glottis visible
Number of Participants on Whom Bougie (Introducer) Was Used to Facilitate Intubation on the First Attempt at the time of intubation Time for Intubation at the time of laryngoscopy Time for laryngoscopy (either direct or indirect) plus the time for endotracheal tube (ETT) cuff to pass vocal cords.
Number of Intubation Attempts at the time of intubation Time for Indirect View Laryngoscopy During the First Attempt at the time of laryngoscopy Time from mouth opening to best indirect laryngoscopic view
Number of Participants Who Received External Laryngeal Manipulation During the First Attempt at the time of intubation Time for Direct View Laryngoscopy During the First Attempt at the time of laryngoscopy Time from mouth opening to best direct laryngoscopic view
Subjective Ease of Laryngoscopy at the time of laryngoscopy The anesthesiologists rated the McGRATH™ MAC's ability in managing airways as "very easy," "easy," "slight resistance," "difficult," or "not possible." The difficulty of laryngoscopy was evaluated during the insertion and placement of the McGRATH™ MAC, from the patient's lips, into their oropharynx, until a glottic view was obtained.
Subjective Ease of Intubation at the time of laryngoscopy The anesthesiologists rated the McGRATH™ MAC's ability in managing airways as "very easy," "easy," "slight resistance," "difficult," or "not possible." The difficulty of endotracheal tube (ETT) delivery (that is, intubation) was evaluated during the insertion of the ETT into the patient's mouth, until the ETT passed the vocal cords.
Trial Locations
- Locations (1)
The University of Texas Health Science Center at Houston
🇺🇸Houston, Texas, United States