Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway

Michael Aziz, Dawn Dillman, Rongwei (Rochelle) Fu, M Brambrink Ansgar M Brambrink

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Abstract

Background: Video laryngoscopy may be useful in the setting of the difficult airway, but it remains unclear if intubation success is improved in routine difficult airway management. This study compared success rates for tracheal intubation with the C-MAC® video laryngoscope (Karl Storz, Tuttlingen, Germany) with conventional direct laryngoscopy in patients with predicted difficult airway. Methods: We conducted a two arm, single-blinded randomized controlled trial that involved 300 patients. Inclusion required at least one of four predictors of difficult intubation. The primary outcome was successful tracheal intubation on first attempt. Results: The use of video laryngoscopy resulted in more successful intubations on first attempt (138/149; 93%) as compared with direct laryngoscopy (124/147; 84%), P = 0.026. Cormack-Lehane laryngeal view was graded I or II in 139/149 of C-MAC attempts versus 119/147 in direct laryngoscopy attempts (P <0.01). Laryngoscopy time averaged 46 s (95% CI, 40-51) for the C-MAC group and was shorter in the direct laryngoscopy group, 33 s (95% CI, 29-36), P

Original languageEnglish (US)
Pages (from-to)629-636
Number of pages8
JournalAnesthesiology
Volume116
Issue number3
DOIs
StatePublished - Mar 2012

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Laryngoscopes
Laryngoscopy
Intubation
Airway Management
Germany
Randomized Controlled Trials

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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title = "Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway",
abstract = "Background: Video laryngoscopy may be useful in the setting of the difficult airway, but it remains unclear if intubation success is improved in routine difficult airway management. This study compared success rates for tracheal intubation with the C-MAC{\circledR} video laryngoscope (Karl Storz, Tuttlingen, Germany) with conventional direct laryngoscopy in patients with predicted difficult airway. Methods: We conducted a two arm, single-blinded randomized controlled trial that involved 300 patients. Inclusion required at least one of four predictors of difficult intubation. The primary outcome was successful tracheal intubation on first attempt. Results: The use of video laryngoscopy resulted in more successful intubations on first attempt (138/149; 93{\%}) as compared with direct laryngoscopy (124/147; 84{\%}), P = 0.026. Cormack-Lehane laryngeal view was graded I or II in 139/149 of C-MAC attempts versus 119/147 in direct laryngoscopy attempts (P <0.01). Laryngoscopy time averaged 46 s (95{\%} CI, 40-51) for the C-MAC group and was shorter in the direct laryngoscopy group, 33 s (95{\%} CI, 29-36), P",
author = "Michael Aziz and Dawn Dillman and Fu, {Rongwei (Rochelle)} and {Ansgar M Brambrink}, {M Brambrink}",
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