Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 1:2019:1067473.
doi: 10.1155/2019/1067473. eCollection 2019.

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Florian Jürgen Raimann  1 , Philipp Edmund Dietze  1 , Colleen Elizabeth Cuca  1 , Dirk Meininger  1   2 , Paul Kessler  3 , Christian Byhahn  1   4 , Daniel Gill-Schuster  1   3 , Kai Zacharowski  1 , Haitham Mutlak  1
Affiliations

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Florian Jürgen Raimann et al. Emerg Med Int. .

Abstract

Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process. Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score. Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases. Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway. Trial Registration Number. This trial is registered under number NCT03403946.

PubMed Disclaimer

Figures

Figure 1
Figure 1
C-MAC PM®. C-MAC PM® videolaryngoscope (right), D-Blade® (middle), and Macintosh blade size 3 (left).
Figure 2
Figure 2
Study Flowchart. Flowchart study design. Supplementary online material.
Figure 3
Figure 3
Results of examination of glottis view using the Cormack-Lehane score.
See this image and copyright information in PMC

References

    1. Peterson G. N., Domino K. B., Caplan R. A., Posner K. L., Lee L. A., Cheney F. W. Management of the difficult airway: a closed claims analysis. Anesthesiology. 2005;103(1):33–39. doi: 10.1097/00000542-200507000-00009. - DOI - PubMed
    1. Cook T. M., Woodall N., Harper J., Benger J. Major complications of airway management in the UK: results of the fourth national audit project of the royal college of anaesthetists and the difficult airway society. part 2: intensive care and emergency departments. British Journal of Anaesthesia. 2011;106(5):632–642. doi: 10.1093/bja/aer059. - DOI - PubMed
    1. Timmermann A., Eich C., Russo S. G., et al. Prehospital airway management: a prospective evaluation of anaesthesia trained emergency physicians. Resuscitation. 2006;70(2):179–185. doi: 10.1016/j.resuscitation.2006.01.010. - DOI - PubMed
    1. Heath K. J. The effect on laryngoscopy of different cervical spine immobilization techniques. Anaesthesia. 1994;49(10):843–845. doi: 10.1111/j.1365-2044.1994.tb04254.x. - DOI - PubMed
    1. Aziz M. Use of video-assisted intubation devices in the management of patients with trauma. Anesthesiology Clinics. 2013;31(1):157–166. doi: 10.1016/j.anclin.2012.10.001. - DOI - PubMed

Associated data

LinkOut - more resources