Endotracheal intubation using the C-MAC(R) video laryngoscope or the Macintosh laryngoscope: a prospective, comparative study in the ICU
Critical Care, 06/14/2012
Noppens RR et al. – Use of the C–MAC video laryngoscope improved laryngeal imaging and improved intubating success rate on first attempt in patients with predictors for difficult intubation in the intensive care unit (ICU) setting. Video laryngoscopy seems to be a useful tool in the ICU where potential difficult endotracheal intubations regularly occur.Methods
- In a single center, prospective, comparative before–after study in an anesthetist–lead surgical intensive care unit of a tertiary university hospital predictors of potentially difficult tracheal intubation, number of intubation attempts, success rate and glottic view were evaluated during a two–year study period (first year: Macintosh laryngoscopy (ML), second year: C–MAC).
- A total of 274 critically ill patients requiring endotracheal intubation were included.
- 113 intubations using ML and 117 intubations using the C–MAC were assessed.
- In patients with at least one predictor for difficult intubation, C–MAC resulted in more successful intubations on first attempt compared to ML (34/43; 79% vs. 21/38; 55%), P=0.03.
- The visualization of the glottis with ML using Cormack and Lehane (C&L) grading, was more frequently rated as difficult (20%; C&L 3 and 4) compared to C–MAC (7%, C&L 3 and 4), P<0.0001.