Dataset Information

A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study.

ABSTRACT:

Background

The efficacy of devices for difficult intubation in paediatric patients, especially with a Cormack-Lehane grade 4 view, has yet to be established. We compared intubating parameters among three devices (the Airtraq®, McGrath®, and Macintosh laryngoscopes).

Methods

This study is a randomised cross-over trial. Participants were 20 anaesthetists. Each device was tested three times using a paediatric manikin with a Cormack-Lehane grade 4 view. The order to use each device was randomised by a computer-generated random sequence. The primary endpoint was the rate of successful intubation. Secondary endpoints included the time taken to intubate, percentage of glottic opening score, and severity of potential dental trauma.

Results

The successful intubation rates of the Airtraq®, McGrath®, and Macintosh laryngoscopes were 100%, 72%, and 45%, respectively. The risk ratio of the success rates of Airtraq® compared with McGrath® and Macintosh laryngoscopes were 1.40 (95% CI; 1.19-1.64, P < 0.001) and 2.22 (95% CI; 1.68-2.94, P < 0.001), respectively. The modified Cormack-Lehane grade and percentage of the glottic opening score were better for the Airtraq® than for the other devices. The dental trauma score was lower for the Airtraq® than for the other devices. There were no significant differences in the intubation time among the groups.

Conclusions

The Airtraq® had higher success rate, had better visibility, and was associated with less dental trauma than the other devices in a difficult paediatric intubation model with a Cormack-Lehane grade 4 view.

SUBMITTER: Owada G

PROVIDER: S-EPMC5302788 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study.

Owada Gen G Mihara Takahiro T Inagawa Gaku G Asakura Ayako A Goto Takahisa T Ka Koui K

PloS one 20170210 2

<h4>Background</h4>The efficacy of devices for difficult intubation in paediatric patients, especially with a Cormack-Lehane grade 4 view, has yet to be established. We compared intubating parameters among three devices (the Airtraq®, McGrath®, and Macintosh laryngoscopes).<h4>Methods</h4>This study is a randomised cross-over trial. Participants were 20 anaesthetists. Each device was tested three times using a paediatric manikin with a Cormack-Lehane grade 4 view. The order to use each device wa ...[more]

PMID: 28187213

Similar Datasets

Project description:The aim of the study was to test the hypothesis that the results obtained with three different types of video laryngoscopes (UESCOPE VL-400, I-View, Non-Channeled Aitraq) with and without an endotracheal stylet should be better than the results obtained with a Macintosh laryngoscope in a simulated out-of-hospital scenario by a person without clinical experience. Primary outcome measures were the time taken to successfully achieve tracheal intubation (TI). Secondary outcomes included the grade of glottic view (Cormack and Lehane grades 1-4), the incidence of successful TI, the number of audible dental clicks indicating potential dental damage, the level of effort required to perform TI, and the operator's comfort during the procedure. The time required to achieve tracheal intubation successfully was significantly longer with the Macintosh laryngoscope and Airtraq than with the other video laryngoscopes. The use of the stylet significantly reduced the time required for tracheal intubation with the Macintosh laryngoscope (21.8 sec. vs. 24.0 sec., p = 0.026), UESCOPE VL 400 (18.1 sec. vs. 23.4 sec., p = 0.013), and Airtraq (22.7 sec. vs. 34.5 sec., p < 0.001). There were no significant differences in intubation time when using the I-View with or without stylets. No differences were observed in the Cormack-Lehane grading. The success rate of intubation was 100% for the Macintosh and I-View laryngoscopes used with or without stylets and for the UESCOPE VL 400 and Airtraq laryngoscopes used with stylets. Without stylets, the success rate of intubation was 96.6% for the UESCOPE VL 400 and 86.6% for the Airtraq. There were no significant differences in the risk of dental damage between the Macintosh, UESCOPE VL 400, I-View, and Airtraq laryngoscopes, regardless of the use of stylets (without and with stylets). The use of stylets significantly reduced dental damage only for the Airtraq laryngoscope: 8 (26.6%) vs. 2 (6.6%). Statistically significant differences in perceived exertion were observed between the mentioned laryngoscopes, both with and without stylets. However, there were no differences in the comfort of use between the laryngoscopes, regardless of the use of stylets (without and with stylets. The use of stylets led to better comfort in the case of the Macintosh (2.5 vs. 3, p = 0.043) and UESCOPE VL 400 (2 vs. 3, p = 0.008) laryngoscopes. In our study, the I-View and UESCOPE VL-400 video laryngoscopes provided better intubation results than the Macintosh laryngoscope in terms of time needed to intubate, glottis visibility, and reduction in dental damage. The use of the stylet did not significantly improve the intubation results compared to the results obtained in direct laryngoscopy. Due to the small study group and the manikin model, additional studies should be performed on a larger study group.

Dataset Information

A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study.

Background

Methods

Results

Conclusions

Publications

A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study.

Similar Datasets

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